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<br />City of Eugene Public Works <br />Closeout Form <br />April 28, 2017 <br />GOOD JOB NUMBER005028 <br />PROJECT NUMBER965266 <br />PROJ / GJN DESC2017 WW & SW Repairs <br />BudgetExpendituresDifferencePM ActualsAJE adjBJE adj <br />FUND / DESC <br />531 - Stormwater Utility - Capital 30,000.000.0030,000.0012,808.5012,808.50(17,191.50) <br />532 - Wastewater Utility - Capital 20,000.0021,347.50(1,347.50)8,539.00(12,808.50)(11,461.00) <br />0.00 <br />0.00 <br />0.00 <br />0.00 <br />Totals$50,000.00$21,347.50$28,652.5021,347.500.00(28,652.50) <br />Notes: <br />Warranty/As-built FeeBJE#$0 <br />Tree'sBJE#$0 <br />Project ManagerDate <br />Principal Civil EngineerDate <br />1. Review funding and expenditures <br />2. Project Manager sign <br />3. Principal Civil Engineer sign <br />4. Forward to PWA <br />