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City of Eugene Public Works <br />Closeout Form <br />March 26, 2010 <br />GOOD JOB NUMBER <br />PROJECT NUMBER <br />PROJ / GJN DESC <br />004420 <br />975584 <br />FUND / DESC Budget Expenditures Difference <br />333 - Transportation SDC <br />8,646.00 <br />8,647.50 <br />(1.50) <br />341 - Road General Capital Fund <br />12,000.00 <br />11,800.20 <br />199.80 <br />Totals <br />$20,646.00 <br />$20,447.70 <br />$198.30 <br />Notes: <br />Fund 341 only received grant funds of $11,800.20, will not roll balance in capital rollover. <br />Warranty/As-built Fee BJE# <br />Tree's BJE# <br />Project Manager <br />Principal Civil Engineer <br />1. Review funding and expenditures <br />2. Project Manager sign <br />3. Principal Civil Engineer sign <br />4. Forward to PWA <br />Date <br />Date <br />