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44\ PROJECT AUTHORIZATION FORM <br /> Eugene Public Works <br /> Parks&Open Space <br /> GENERAL PROJECT INFORMATION <br /> Project Title Skinner Butte Park Service ID/ 1000_ <br /> River Play Pour-in-place Renovation Phase 2 GJN: <br /> Project Manager(Ph Ext.) Date: 1/11/2016 <br /> Contractor(s) Contract# 2015- <br /> FUNDING SOURCES AND AMOUNTS: <br /> Funding Source Identification Account Code Amount <br /> City Funds Park SDC Reimbursement 336-9335-6xxxx-9xxxxx-922 $50,000.00 <br /> Other Agency $0.00 <br /> Other Agency $0.00 <br /> Grant Funding $0.00 <br /> Donations $0.00 <br /> Total Funding $50,000.00 <br /> COMMENTS/SPECIAL PROJECT INFO./INTERDEPARTMENTAL WORK DESCRIPTION: <br /> Project Description: Work with vendor to develop contract to remove worn poured-surfacing areas at RiverPlay playground and <br /> replace with Pebbleflex product. <br /> APPROVAL (Each approver should type their name into the form, along with the date they acknowledge <br /> approval, then forward the document to the next approver. When all approvals have been completed, <br /> forward the approved document with the approval email string to the Contract Administrator for <br /> processing.): <br /> Project Manager Pam Symond Date: 1/11/2016 <br /> Supervisor Emily Proudfoot Date: 1/13/2016 <br /> Section Manager Neil Bjorklund Date: 1/21/16 <br /> Financial Analyst Lacey Risdal Date: 1/25/2016 <br /> Division Manager Craig Carnagey Date 1/25/2016 <br /> FOR USE BY ADMINISTRATION ONLY: <br /> Capital Project No. ACK <br /> GL Title(limited to 30 characters) <br /> Assigned by Date: <br /> ATTACHMENTS ® Budget Estimate ❑ Revised Budget El Map El Other <br /> PWM/POS 100 Revised: July 2015 <br />