E-Gov Services City of Milford

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Special Public Works Services Agreement

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This form is used to request special Public Works services to be provided by the City Public Works Department at the standard rate of $60 per hour. This rate includes a marked City of Milford vehicle and 1 service worker. The employee is compensated by the City and therefore will be covered under the worker's compensation insurance and remain under the control of the City of Milford. All requests will be reviewed and someone will contact you before the agreement is approved. Requests should be submitted at least 30 days in advance for scheduling purposes. Cancellations and revisions must be submitted 10 days in advance.

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Contact Information

First Name:
Last Name:
Business Name:
Email:
Daytime Phone:	() –
Address:
City:
State:
ZIP:

* Address where services are needed

* Date and Time services are needed

* Number of Service Workers needed

* Reason for requesting special Public Works services: What services are you requesting the worker provide? For Example, trash control, labor?

* Payment will be make at the standard rate per hour ($60), with a 3 hour minimum, to the City of Milford (745 Center Street, Milford, OH 45150) within 30 calendar days after the date of service rendered. I/We agree to pay the City of Milford the following amount:

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Notes:

If you send us a message, you will receive a Tracking Number allowing you to follow-up with your request, at your convenience.

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