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Supplemental Budget One-Time Dollar (1X$) REQUEST FORM <br />TO. Budget Office DATE: 10/18/10 <br />Department: Public Works <br />Executive Manager Signature: <br />1. Description of 1X$ Request/Justification: (attach additional pages as needed) <br />Re-appropriation of 2010 Pothole program funding to finish work on unimproved streets and pothole <br />repair from dedicated revenue. <br />Unimproved Street Overlay $219,790 <br />Pothole Patrol Program $257,182 <br />2. Fiscal Information <br />3. Has a purchase order been issued on this request? Yes X No <br />If yes, Prior or Current Year purchase order? 2011-100044 <br />If prior year, has purchase order been included in the Reserve for Encumbrances? If not, please <br />explain. <br />4. Attach a prepared BJE # 72507 <br />