<br />City of Eugene Public Works <br />Closeout Form <br />May 1, 2017 <br />GOOD JOB NUMBER005039 <br />PROJECT NUMBER965300 <br />PROJ / GJN DESC2016 WW Lateral Inspections <br />BudgetExpendituresDifferencePM ActualsAJE adjBJE adj <br />FUND / DESC <br />532 - Wastewater Utility - Capital 65,785.0060,669.605,115.4060,669.600.00(5,115.40) <br />0.00 <br />0.00 <br />0.00 <br />0.00 <br />Totals$65,785.00$60,669.60$5,115.4060,669.600.00(5,115.40) <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 />