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Budgetary Impact Analysis
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Department �/z Division ��sziGr
Commission Meeting Date: f 4rr 4 2PP1
Title and brief description of legislation or attached ordinance/reso uti on:
1. Is this item related to revenue? NO Er. Yes ❑ (If yes, skip to item #4)
2. Are there sufficient funds in Line Item?
CIP Project #:
. (If applicable)
Yes: Index Code: Minor: Amount:
No: Complete the following information:
3. Source of funds: Amount budgeted in the line item:
Balance in line item:
Amount needed in line item:
Sufficient funds will be transferred from the following line items:
ACTION ACCOUNT NUMBER
Project No./Index/Minor Object
From
From
To
To
4. Comments:
TOTAL.
$
$
$
Approved by:
y t I Z—d3
Department Director/Designee Date
APPROVALS
Verified by:
Dept. of Strategic Planning, Budgeting
Performance
Date:
V fied by CIP: (If applicable)
Director/Designee
Date: