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Reimbursement Work Agreement with County Road Department - Interlocal Agreement INTERDEPARTMENTAL REQUEST & AGREEMENT FOR REIMBURSABLE WORK BY COUNTY ROAD DEPARTMENT To the County Engineer: The undersigned hereby requests that the following described work be performed by the County Road Department for the agency or department shown. It is understood that this work will be done at the convenience of the Road Department. Description of work or services requested: Maintenance/ Emergency / Sign work Work Provided: Per request Total cost not to exceed: $ Actual Costs The undersigned certifies that sufficient budgeted funds are available to cover the cost of the requested work or services, and that payment to the Road Department will be made promptly unless otherwise modified in this agreement. Agency or Dept.: Mason County Utility and Waste Management Sign Date: Title: To the Board of County Commissioners: Date: / -2 e9 I have examined the above request and make the following recommendation: I recommend the Board approve the above as presented. County E ine Action of the Board of County Commissioners: Date: �C The Engineer's recommendation is hereby approved. _ The Engineer's recommendation is disapproved or modified as follows: BOARD OF COMMISSIONERS MASON COUNTY, WASHINGTON A 9- LX-KDA RING ER KSON, Chair ATTEST: ;TI SHE ON, Commissioner REBECCA S. ROGERS, Cl k of the Board S GALLAGHER, Ceffrimissioner Km h:\wp10\maint\reimb-utility&wastemanag-Dept.doc