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Supplemental Budget One-Time Dollar (1X$) REQUEST FORM <br />TO: Budget Office DATE: 4/29/2010 <br />Department: PW Wastewater <br />Executive Manager Signature: <br />1. Description of 1X$ Request/Justification: (attach additional pages as needed) <br />Please include the source of funds supporting the request and the specific project which requires <br />completion. (ex: Request 1X$ from unspent resources to implement new technology that will incur <br />longer term savings of $x per year.) <br />Request additional MWMC pass through authority. An increased in FYI 0 budgeted pass, through <br />appropriation is needed due to increased MWMC user fee revenues. No net change to fund balance will <br />occur as all revenues received are passed through to MWMC per intergovernmental agreement. <br />2. Fiscal Information <br />Fund: 533 Amount of 1X$ Request: $615,000 <br />FTE Impact: none Revenues Offset: $(615,000) <br />Net Request: $ 0 <br />Revenue Object Code(s) 45992 Expenditure Object Code(s)99302 <br />If Grant involved: Grant Number Fiscal Year Grant Received <br />Original Grant_Ainotint: $ <br />Balance Remai3)inL- (as of ) <br />3. Has a purchase order been issued on this request? Yes . No _x <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. <br />:;~-D33$ <br />