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Supplemental Budget One-Time Dollar (1X$) REQUEST FORM <br />TO: Budget Office DATE: 6/28/2010 <br />Department: Public Works Administration - Capital Grants <br />Executive Manager Signature: <br />1. Description of 1X$ 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 $x per year.) <br />Public Works Department receives grants from outside sources for capital rehabilitation projects for <br />Airport runways, Wetland restoration, and trails. <br />2. Fiscal Information <br />Fund- Various Amount of IX$ Request:,$2;261;854 <br />FTE Impact: 0 Revenues Offset: 2,261.,854 . <br />Net Request: 0.00. <br />Revenue0tject Code(s) See attachement Expenditure Object Code(s) See'A.ttachments. <br />If Grant involved: Grant Number Fiscal Year Grant Received 2010 <br />66, 0 al Grant Amount: <br />Balance Remaining: (as of ) <br />3. Hasa 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 <br />