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Mn/DOT Agreement No. Work Order O 1 <br />CFMS Contract No. NA <br />^Payable by State <br />_® Receivable by State <br />[INSTRUCTIONS FOR COMPLETING THIS FORM ARE IN BRACKETS. FILL IN EVERY BLANK AND <br />DELETE ALL INSTRUCTIONS BEFORE SENDING THIS TO THE LOCAL GOVERNMENT. IF YOU NEED <br />ASSISTANCE WITH THIS FORM, CONTACT Mn/DOT's STATE AID .DIVISION. SEND A DRAFT OF THIS <br />WORK ORDER FOR REVIEW TO CONTRACT MANAGEMENT.] <br />STATE OF NIINNESOTA <br />WORK ORDER UNDER <br />MASTER PARTNERSHIP CONTRACT <br />State Project (SP): NA Trunk Highway (TH): NA <br />Project Identification: Services provided by State <br />This Work Order Contract is issued under the authority of State of Minnesota, Department of Transportation (Mn/DOT) <br />Master Partnership Contract No. listed above between the state of Minnesota acting through its Commissioner of <br />Transportation ("State") and [Insert the Legal Name of the Local Government], a political subdivision of the State of <br />Minnesota ("Local Government") and is subject to all applicable provisions and covenants of that Agreement which are <br />incorporated herein by reference. <br />Work Order Contract <br />Article 1 Term of Work Order Contract; Incoraoration of Exhibits: <br />1.1 Effective date: This Work Order Contract will be effective on the date that all required signatures are <br />obtained by State, pursuant to Minnesota Statutes Section 16C.05, subdivision 2. The <br />Providing Agency must not begin work under this Contract until ALL required <br />signatures have been obtained and the Providing Agency has been notified in <br />writing to begin such work by the Requesting Agency's Authorized Representative. <br />1.2 Expiration date: This Work Order Contract will expire on November 30, 2012, or when all obligations <br />have been satisfactorily fulfilled, which ever occurs first. <br />1.3 Exhibits: Exhibits A through B are attached and incorporated into this Work Order Contract. <br />Article 2 Nature of Work; Requesting and Providing Party: <br />2.1 The box(es) checked below indicate the nature of the work to be performed. See Section 2.1 of the Master <br />Partnership Contract for applicable defmitions. <br />® Routine Roadway Maintenance (See Exhibit B) <br />® Professional And Technical Services (See Exhibit B) <br />^ Construction Administration <br />2.2 The boxes checked below show which party is the "Requesting Party" and which party is the "Providing Party". <br />2.2.1 The Requesting Party is ^ State ®Local Government <br />2.2.2 The Providing Party is ®State ^ Local Government <br />(Rev 09/26/07) - 1 - <br />