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Budgetary Impact Analysis
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r It zco.3 Mat nia -.ht. at Cal canter fl 4 — IOce & ogrierrarrir W *j7 Dada [iv.*, 1. Ts this item related to revenue? Nog Yes ❑ Revenue Sources mnrrirrir-g Cavi -
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2. Is this item an expenditure? No [ Yes 0
General Fund Account No:
Special Revenue Fund Account No:
CIP Project No:
Amount:
3. Are there sufficient funds in Line Item? No:A Yes: 0
Sufficient funds will be transferred from the fo
ACTION
ACCOUNT NUMBER
TOTAL
From
$
From
$
To
$
To
$
4. Is this item funded by Home
Project Name
Total Dosed
Allocation
1" Sorics
Appropriation
Total
Allocations/
Encumbrances
...
Bafaace
Dollars Spent
to Date
Comments:
Approved by:
Department Director/Designee
Date
of St
Performan
aLning, Budged g &
Date: 4 it ky4
APPROVALS
Verified by CIP: (If applicable)
DirectorlDesignee
Date: