Supplemental Budget One-Time Dollar (1X$) REQUEST FORM <br />TO: Budget Office DATE: 6/28/2010 <br />Department: Public Works <br />Executive Manager Signature: <br />1. Description of 1X$ 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 $x per year.) <br />Public Works Department receives grants from outside sources for capital rehabilitation projects for <br />Airport runways, Wetland restoration, and trails. NOAA grant overhead cap transferring operating <br />funds to cover capital expenditure. <br />2. Fiscal Information <br />Fund: Various Amountof.lX$ Request: $2;261,854 <br />FTE.Impact: 0 Revenues Offset $2,261;854 <br />Net Request: $ 0.00 <br />Revenue Object Code(s) See attachement Expenditure :Object Code(s) See:Attachments <br />If-Grant involved' Grant Number Fiscal Year Grant Received 2010 <br />Original Grant Amount: <br />Balance Remaining: (as: of ) <br />3. Has a purchase order been issued on this request? Yes x No <br />If yes, Prior or Current Year purchase order? Current Year. <br />If prior year, has purchase order been included in the Reserve for Encumbrances? If not, please <br />explain. Capital purchase order will automatically roll. <br />4. Attach a prepared, signed BJE. 69985 and 70606 <br />