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�yJ 6 <br />KITTITAS COUNTY <br />KITTZTASi COUNTY <br />DEPARTMENT OF PUBLIC WORKS <br />REQUEST TO THE PUBLIC WORKS DEPARTMENT <br />FOR REIMBURSEMENT OF WORK <br />To The County Engineer: <br />Pursuant to terms of an agreement between the county and <br />adopted and approved on <br />of Requesting Agency) <br />the undersigned hereby requests the county <br />to perform the work listed on Exhibit "A" attached hereto at a time and in a manner convenient <br />to the county. The undersigned further requests that the work be completed no later than <br />and hereby guarantees reimbursement to the county for all work <br />done up to a maximum of $ <br />All terms of said agreement shall apply with the following exceptions: <br />DATE <br />SIGNATURE <br />(Agency Representative) <br />TITLE <br />To The Board of County Commissioners: DAT <br />I have examined the above request and make the following recommendations: <br />Perform work as requested <br />SIGNATURE <br />(County Engineer) <br />411 N. Ruby, Suite #1 TEL (509) 962-7523 <br />Ellensburg, WA 98926 FAX (509)962-7663 <br />