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HomeMy WebLinkAboutReimbursable Work Request - Public Works1 1:3 GRANT COUNTY COMMISSIONERS AGENDA MEETING REQUEST FORM (Must be submitted to the Clerk of the Board by 12:00pm on Thursday) REQUESTING DEPARTMENT: PUBLIC WORKS REQUEST SUBMITTED BY: SHILO NELLIS CONTACT PERSON ATTENDING ROUNDTABLE..ANDY BOOTH CONFIDENTIAL INFORMATION: DYES i9NO DATE: 02/13/25 PHONE: 509-754-6082 FwAgreement / Contract OAP Vouchers OAppointment / Reappointment DARPA Related OBids / RFPs I Quotes Award OBid Opening Scheduled []Boards I Committees ElBudget []Computer Related []County Code OErnergency Purchase []Employee Rel. []Facilities Related El Financial 1--1 Funds 0 Hearing OInvoices / Purchase Orders [] Grants — Fed/State/County L-1Leases DIVIOA / MOU DMInutes 00rdinances FlOut of State Travel []Petty Cash OPolicies 0 Proclamations F1 Request for Purchase n Resolution ORecommendation 0 Professional Serv/Consultant El Support Letter E]Surplus Req. E]Tax Levies []Thank You's []Tax Title Property OWSLCB ---- - -- ------------ 01- Wh-zft, WehP.IOWORDING�FORAGENDhn WhTerm, cast, o t et" REQUEST FOR REIMBURSABLE WORK FOR THE CITY OF MATTAWA COMPLETED NO LATER THAN 04/30/2025 FOR A MAXIMUM OF $1,450 FOR 120 TONS 5/8 MINUS TOP COURSE & 10-0--TONS 1-1/4 BASE COURSE If necessary, was this document reviewed by accounting`? El YES El NO 5R N/A If necessary, was this document reviewed by legal? F] YES 0 NO W N/A DATE OF ACTION.- APPROVE- DENIED ABSTAIN D1: D2: D3: DEFERRED OR CONTINUED TO: RECEIVED 4/23/24 FEB 13 2025 GRANT COUNTY COMMISSIONERS GRANT COUNTY RETEST TO THE COUNTY ROAD DEPARTMENT FOR REIMBURSABLE ''CORK To The County Engineer; Pursuant to terms of an agreement between the County and City of Mttawa (Name of Requesting Agency) adopted and approved can 8-18-2020 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 he completed no later than 4/30/2025 and herebyguarantees reimbursement to the for all work done up to a maximum of `1,4 0 � County Work to he Completed: 120 tons 5/8 minus tap course & 100 tons 1-114 bass course(City to load & haul) DATED: 1/22/2025 SIGNATURE 4(AgencFyR=epresentat1ve) TITLE Public Works Director ------- can ossioners. DATE To The Board. of t I have examined the above request and made t following recommendations: Approved County fUad Engineer/Director of PublieWorks El Denied Action of the Board of County omrnissioners: DATE The Engineer's recommendation is hereby approved. The Engineer's recommendations is disapproved or modified as follows: A s . BOARD COUNTY COMMISSIONERS P O T , WASHrNGTON ✓Clerk of the Board i 't 4 Recommended for use with Section ? of Form- CRAB # 101 and WA.0 136-32-030