CM-05-03-060Request for City Council/City Manager Action
El City Council d City Manager
Submit completed form for al! City Manager and City Council approvals.
Department Name: EDS
Contact Person:
Latha Kumar/Laura Flores
Project
Manager/Resource: Michael Thane
Project Coordinator: n/a
Assigned Attorney: J.Kay
Council or
City Manager
Agenda Date: 3/18/2005
Blue Sheet Wording
For Administration Use ONLY
Orn -o5 -€?3 -ose.
Crt1-05-b ,-ofyt
Tag# CrY6-65-OA-otpn
Documents 7 or u ,.) ' O -PrACI(
Received: 3 - ., .7,
Return to:
Return date:
CC Lynn Olsen
Project Name: N/A (Easement for Mayfield Ranch)
Contractor/Vendor: n/a
Funding Source: n/a
Amount: Na
Authorization for City Manager to execute a Declaration of Waterline and Storm Sewer Easement for Mayfield Ranch, Section 7 subdivision.
Finance Information
Is Funding Required? Yes [ill No
D
0
Q Purchasing/Service Agreement
Initial Construction Contract
Construction Contract Amendment #
Change Order
Change in Quantity
Unforeseen Circumstances
Initial Professional Services Agreement
Supplemental Professional Svcs. A #
Finance Approval
Finance
X❑Finance
Purchasing
Budget
Purchase Order
Item(s) to be purchased:
Amount
Other (Please clearly identify action on lines below)
n/a L. Olsen
N/A E. Wilson
N/A
N/A CYD
Date
Date
Date
Date
3/16/2005
3/16/2005
HB 03-16-05
3/15/2005
For Submission to City Manager Only
Project Mgr. Signature:
Dept. Director Signature:
City Attomey Signature`:
City Manager Signature:
Date: 3
Date: )/
/6/05-
/_
Date:93 7 DJ
Date: �1 . -0 C..
royal is required for all items requesting City Manager's approval.
Updated 3-9-05