CM-04-09-032Re
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to the City Manager for approval.
Action/Finance Approval G� Arnifit
Resolutions Cc l(.
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Please submit this form when placing items on the council agenda or when submitting an item
Department: Legal Project Manager/Resource Don Rundell
Contact Person: Steve Sheets/Laura Levinson Council Meeting Date: 9 -Sep -04
Project Name: Waste Water Treatment Plant Offsite wastewat Funding Source: Utility Capital Project Funs
ContractorNendor Name: Paul Hornsby and Company Assigned Attorney: Steve Sheets
Amount: $13,000.00
Agenda Wording:
Finance Approval
Is Funding Required? Yes No
If Yes, is the Amount over $5,000? Yes No
(contract, agreement,amendment,change order, purchase order,etc.)
▪ Initial Construction Contract
▪ Construction Contract Amendment
▪ Change Order
n Change in Quantity
Fl Unforeseen Circumstances
▪ Initial Professional Services Agreement
▪ Supplemental Professional Svcs. Agr.
▪ Purchase Order
Item(s) to be purchased:
Amount
• Other (Please clearly identify action on lines below) $13,000.00
Professional appraisal services from Paul Hornsby & Company
for the extension of a wastewater line
X❑Council Agenda Item
Submission to City Manager -see required signatures below before submission to the
City Manager.
x❑
Comments:
Finance -Date and Signature: 08-18-04 L. Olsen
For Submissions to Citv Manager OnI
Project Mgr. Signature:
Dept. Director Signature:
Legal Approval Signature: *
se note that Legal Approval is required on change orders submitted to the City
Manager that are $10,000 and above.
g/lynn/finAprvlform.xls