HomeMy WebLinkAboutReimbursable Work Request - Public WorksGRANT COUNTY 1Fir'-Cm-®
REQUEST TO THE COUNTY ROAD DEPARTMENT
FOR REIMBURSABLE WORK APR Z 4 2Q2Q
GRANT COUNTY
To The County Engineer/ Public Works Director: PUBLIC WORKS
Pursuant to terms of an agreement between the County and Cit of Ro al \
(Name of Requesting Agency)
Adopted and approved on 4/07/202 the undersigned hereby requests the County to perform the
work listed below at a time and in a manner convenient to the County. The undersigned further requests that the
work be completed no later than 10/31/2020 and hereby guarantees reimbursement to the
County for all work done up to a maximum of $37,620.
Work to be done on Acacia Street from Royal Avenue to Apple Avenue includes: Chip Seal,Fog Seal Crack
i
( f GCPw
Seal, Project Temporary Traffic Control. d
�S F. Se�vty t2 Sw�SE 4T 1i1.
-F�wnt� �er J'o4.v� dn'ssey -
DATED:
SIGNATURE • 0��
yyJJ (Agency Representative)
TITLE
To the Board of County Commissioners: DATE 4.12-7112-0
1 have examined the above request and made the following recommendations:
The request is approved ❑ The request is disapproved or modified as follows:
my Engineer/ Public Works Director
Action of the Board of County Commissioners: DATE
XThe Engineer's / Directors recommendation is hereby approved.
❑The Engineer's / Director's recommendations is disapproved or modified as follows:
test: BOARD O �UNTY OMMI $TONER IOFGRANTCOUNTY, WASHINGTON
/ V
Cl rk of the d