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Supplemental Budget One-Time Dollar (1X$) REQUEST FORM <br /> TO: Budget Office DATE: __1 l/2/2009 <br /> Department: Public Works <br /> Executive Manager Signature: <br /> 1. Description of 1X$ Request/Justification: (attach additional pages as needed) <br /> STP-U funds for study of W. 11 corridor from Greenhill to Eugene Station, integrating this study <br /> with the EmX corridor study from Eugene Station. <br /> 2. Fiscal Information <br /> Fund: 131 Amount of 1X$ Request_$ $5.0,000 <br /> FTETmpact: none Revenues Offset: $ $50,000 <br /> Net Request: $ 0 <br /> Revenue Object Code(s) Expef~diture Object Code(s) <br /> If Grant involved: Grant Number 314 Fiscal Year Grant Received <br /> Original Grant Amount: $ <br /> Balance. Remaining: (asof~ ) <br /> <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 /> <br /> 4. Attach a prepared BJE # 68554 <br /> <br />