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Supplemental Budget One-Time Dollar (1X$) REQUEST FORM ~ <br /> TO: Budget Office DATE: <br /> Department: Public Works <br /> I <br /> Executive Manager Signature: I~~ <br /> 1. Description of 1X$ Request/Justification: (attach additional pages as needed) <br /> Please include the source of funds supporting the request and the specific project which re uires ~i, <br /> completion. (ex: Request 1X$ from unspent resources to implement new technology that ill incur ' <br /> longer term savings of $x per year.) Recognize $159,000 of revenue and increase appropri tion for <br /> General Capital Planning by $159,000. In response to requests from the City Council and ' <br /> neighborhoods the two project teams have provided capital planning for: <br /> • Siting a hospital on EWEB's property <br /> • Whole Foods and East Broadway Redevelopment <br /> • Petition poll to improve Arcadia Street ~ <br /> • Capital planning for improving Edison and Wilkie Streets <br /> 2. Fiscal Information <br /> Fund: 312 Amounfof 1X$ Request: $ 159,000 <br /> II <br /> FTE Impact: 0.0 Revenues Offset: $ <br /> Net Request: $ 159 000 ~i <br /> Revenue Object Code(s).. Expenditure Object Code(s) 312-9332-61.7 5-915040 <br /> If Grant involved: Grant Number Fiscal Year Grant Received <br /> I <br /> I <br /> Original Grant Amount: $ ~,I <br /> Balance Remaining: (as of ) <br /> 3. Has a purchase order been issued on this request? Yes NoI <br /> If yes, Prior or Current Year purchase order? <br /> If prior year, has purchase order been included in the Reserve for Encumbrances? If not, lease I <br /> explain. <br /> 4. Attach a prepared, signed BJE. 53368 I~ <br /> I <br /> I <br /> <br /> • <br /> <br />