CM-05-02-024�r1-05-aa. O L!
Request for City Council/City Manager Action kelp rfrk gyp/ fl
Please submit this form when placing items on the council agenda or when submitting an item to the City Manager for approva..
Department: EDS/Legal Project Manager/Resource: Eric Langhout
Contact Person: Latha (J. Kay Gayle)
Project Name: N/A
ContractorNendor Name: Wal-Mart
Council Meeting Date: N/A
Funding Source: N/A
Assigned Attorney: J. Kay Gayle
Amount: N/A (contract, agreement,amendment,change order, purchase order,etc.)
Is Funding Required? Yes
Council Agenda Item Yes
Submission to City Manager - Yes
x
No
No
No
x
x
a-7-cr Retuxn to Rtiti (I€ai)
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(see required signatures below before submission to the City Manager)
▪ Initial Construction Contract
▪ Construction Contract Amendment
▪ Change Order
n Change in Quantity
n Unforeseen Circumstances
Initial Professional Services Agreement
▪ Supplemental Professional Svcs. Agr. #
❑ Purchasing/Service Agreement
• Purchase Order
Item(s) to be purchased:
Amount
x❑ Other (Please clearly identify action on lines below)
Four (4) easements from Wal-Mart to City of Round Rock
Agenda Wording: Authorization for City Manager to counter -sign four easements
executed by Wal-Mart to the City.
For Submission to Cit Man a • er On!
Project Mgr. Signature:
Dept. Director Signature:
City Attorney Signature:
City Manager Signature:
Finance Approval
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Date:
Date:
Date:
Date:
2-Z0S
a . proval is required for all items requesting City Manager's approval.
x❑ Finance -Date and Signature: E. Wilson 2/1/05
I Purchasing -Date and Signature: N/A HB 01-31-05
X❑ Budget -Date and Signature: N/A CYD 1-31-05
gladministratonlcmgrcouncil action.xls 11-1-04