HomeMy WebLinkAboutReimbursable Work Request - Public WorksGRANT 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 NG'IIIS
CONTACT PERSON ATTENDING MEETING:Dave Br2n
CONFIDENTIAL INFORMATION: EYES ® NO
DATE: 11/14/2023
PHONE:509-754-6082
[APPROVED ���0
71DENIED
DTABLED/DEFERRED/NO ACTION TAKEN:
EICONTINUED TO DATE:
7WITOW00,
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DATE OF ACTION: �I 3 ''Z�=
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NOV - 8. 2023
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]Agreement / Contract
EIAP Vouchers
DAppointment / Reappointment
0
DARPA Related
7 Bids / RFPs / Quotes Award
DBid Opening Scheduled
F-1 Boards / Committees
El Budget
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E Emergency Purchase
7 Employee Rel.
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0Support Letter
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F]Tax Levies
E]Thank You's
OTax Title Property
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[APPROVED ���0
71DENIED
DTABLED/DEFERRED/NO ACTION TAKEN:
EICONTINUED TO DATE:
7WITOW00,
0
DATE OF ACTION: �I 3 ''Z�=
I V E D
NOV - 8. 2023
GP I RMW r'L-1
L NTY C0MM1SS10NcR_§]
GRANT COUNTY
REQUEST TO THE COUNTY ROAD DEPARTMENT
FOR REIMBURSABLE WORK
To The COLInty Engineer:
PWSLIallt to terms of an aareement between the Cou ty and
Town of Coulee City
(Name of Req.Liesting Aaency)
adopted and aroved on March 3 0 1976
ppI
the Unde.rsigned hereby requests the
Countv to t)erform the work listed below at a time andA
in a manner convenient to the County. The
2023
undersigned in er reqUests that the work be coMpleted no later than December 1.,
and hereby guarantees reimbursement to the County for all work done up to a maximum of $1,500.00
Work to beCom 'leted:
p
Gravel Purchase
10131/2023
DATED*,
SIGNATURE
(Agency Reptesentative)
TITLE. Mayor
To The Board. of County Comm"ission ers.:
DATE I I . Z• ZOZ3
'
I have eXarnined the above request and made t ing recomm Maris:.
Approved ----------
-- - ---------
t6 . 1 6
y Road Engineer/D Xtor of PubficWorkg
Denied
Action of the Board of County Commissi
i toners: DATE. --.-I J_z.13 JLO;)3
The Engineer's recommendation is hereby approved,
The Engineer' reco mi-nendat "Ions 'is disapproved or modified as follows.
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Cler
k of th, a , rd
Recorumended for use with Section 2
of Perm: CRAB # 10 1 and WAC 136-32-030
BOARD OF COUNTY COMMISSIONERS OF
WASHINGTON