CM-05-02-025Cm -05 -0a -0a5
Request for City Council/City Manager Action Kiat) pfrrliVe z
Please submit this form when placing items on the council agenda or when submitting an item to the City Manager for approve,"W C41
Department:
Contact Person:
Project Name:
EDS/Legal
Latha (J. Kay Gayle)
N/A
ContractorNendor Name: Wal-Mart
Project Manager/Resource: Eric Langhout
005
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?
Council Agenda Item
Submission to City Manager -
Yes
No
Yes No
Yes
x
No
x
x
(see required signatures below before submission to the City Manager)
Agenda Wording:
Initial Construction Contract
❑ Construction Contract Amendment
❑ Change Order
nChange in Quantity
n Unforeseen Circumstances
❑ Initial Professional Services Agreement
❑ Supplemental Professional Svcs. Agr.
❑ Purchasing/Service Agreement
❑ Purchase Order
Item(s) to be purchased:
0
Amount
Other (Please dearly identify action on lines below)
Four (4) easements from Wal-Mart to City of Round Rock
Authorization for City Manager to counter -sign four easements
2-1-05 RettLy +0 ROA (1
R'Y vecordrr
Cc • Lai-ka El 0
executed by Wal-Mart to the City.
For Submission to Cit Mana•er OnI
Project Mgr. Signature:
Dept. Director Signature:
City Attorney Signature:
City Manager Signature:
Finance Approval X❑
0
r
Date:
Date:
Date:
Date:
2- 2°5
pproval is required for all items requesting City Manager's approval.
Finance -Date and Signature: E. Wilson 2/1/05
Purchasing -Date and Signature: N/A HB 01-31-05
Budget -Date and Signature: N/A CYD 1-31-05
g/administratio /cmg-council aclionxls 11-1-04