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Supplemental Budget One-Time Dollar (1X$) REQUEST FORM <br /> TO: Budget Office DATE: 5/12/2006 <br /> Department:. Public Works <br /> Executive Manager Signature: <br /> 1. Descri tion of 1X Re ue <br /> p $ q st/Justification: (attach additional pages as needed) <br /> Please include the source of funds supporting the request and the specific project which requires <br /> completion. (ex: Request 1X$ from unspent resources to implement new technology that will incur <br /> longer term savings of $x per year.) Recognize $159,000 of revenue and increase appropriation for <br /> General Capital Planning by $159,000. In response to requests from the City Council and <br /> neighborhoods the two project teams have provided capital planning for: <br /> • Siting a hospital on EWEB's property <br /> • Whole Foods and East Broadway Redevelopment <br /> ~ .Petition poll to improve Arcadia Street <br /> . • Capital planning for improving Edison and Wilkie Streets <br /> { <br /> 2. Fiscal Information <br /> Fund: 312 Amountof 1X$ Request: $ 159,000 - <br /> FTE Impact:. 0.0 Revenues Offset: $ - <br /> ~ Nef Request 159,000 <br /> Revenue Object Code(s) Expenditure O}~ject Code(s) 312-9332-61..735-91504:0 <br /> <br /> i <br /> If Grant involved; Grant Number Fiscal Year Grant Received <br /> Original Grarit Amount: <br /> Balance Remaining: - (as of ) <br /> 3. Has a purchase order been issued on this request? Yes No <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, please <br /> explain. <br /> 4. Attach a prepared, signed BJE, 53368 <br /> <br />