HomeMy WebLinkAboutReimbursable Work Request - Public WorksA
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GRANT COUNTY 0 n AV
REQUO T
EST THE COUNTY ROAD DEPARTM Ni VE dft"V
I
FOR REIMBURSABLE WORK I MAR 2 1 2022
To The County Engineer / Public Works Director,-,
Pursuant to terms of an agreement between the County and Adams County
Adopted and approved an Jutv_30201z the undersigned hereby requests the County to perform the
work listed below at a ti rne and in a manner convenient to the County, The undersigned further reget s that the
work be completed no later than ARpmx1mate1Y MaXA1.1t tO J 1t 2022, with a
and hereby guarantees reimbursement to the .1otal ofl days of inspgctloi I
County for all work done up to a maximum ofd . .......... 7,000.90
All terms of said agreement shall apply with the following exceptions:
DATED41 VZL
Work .Requested: SIIWO"
GNATU
Asphalt Plant Inspection (Agenc pres - e ntatire.
fior Sootier Rd Overlay #2 Auk
1 00
CRP -195 TITLE
To the Board of County Commissioners,
DATE
I have examined the above request and made the following recommendations*,
46VIThe request
is approved 13 The requ
e Si Is !$approved or modified as follows,
County Engineer/ Public Works Director
Actlonof the 8 and of County Commissionerso
DATE 2cl 21J.2
zThe Engineees / Dlrector-*s recommendation is hereby approved,
0 The Engineer's / Director's recommendations Is disapproved or modified as follows:
';'
MIMA
C1 k of the B6kd'
Recommended for use with Section 2 of Form.,
-CRAB #101 and WAC 136.32-030 Revised 10/15
BOARD OF COUNTY COMMISSIONERS OF GRANTCOUNTY. WAq141K1r..Tr1K1