CM-05-04-076Request for City Council/City Manager Action
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City Council
rod City Manager
Submit completed form for all City Manager and City Council approvals.
Department Name:
Contact Person:
Project
Manager/Resource:
Project Coordinator:
Assigned Attorney:
Legal Department
Shelley Gonzales/Rose McMillin
David Bartels
Laura Levinson
Don Childs
Council or
City Manager
Agenda Date: 22 -Apr -05
Blue Sheet Wording
x
For Administration Use ONLY
Tag# t,rn-o "04-c7t,tl:
Documents
Received: Li - 2 J - 0 .
Retum to:
Return date:
CC: Lynn Olsen
Project Name: Sam Bass Reconstruction
ContractorNendor: Paul Homsby & Company
Funding Source: Go Bonds
Amount: $2,354.00
Authorization for City Manager to pay supplemental invoices to Paul Homsby & Company from Site Specifics for site plan for required parking for Sam Bass Reconstruction.
Finance Information
Is Funding Required?
LI
0
OPurchasing/Service Agreement
Yes
No
Initial Construction Contract
Construction Contract Amendment #
Change Order
Change in Quantity
Unforeseen Circumstances
Initial Professional Services Agreement
Supplemental Professional Svcs. Ag #
Purchase Order
Item(s) to be purchased.
Amount
$2,354.00
Q Other (Please clearly identify action on lines below)
Finance Approval
Finance
ElFinance
Purchasing
I Budget
L. Olsen
Date
Date
Date
Date
4/20/2005
For Submission to Ci Mana r On!
Project Mgr. Signal e: CNA./
Dept. Director Signature:
City Attorney Signature•:
City Manager Signature:
' V
pproval is
Date :T"CPO t/ 5
Date:
Date: L —2,/ — -
,1
Date: L! -22" DS
requi or all items requesting City Managers approval.
Updated 3-9-05