HomeMy WebLinkAboutEncumbrance Form 2STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION FORM 350-020-01
ENCUMBRANCE INPUT FORM COMPTROLLER -FIN ADMIN 09/99
RUSH
Reason for RUSH :
Advertise (Letting Date) TerminationiCert of Comp
Award LOA XXX Supplemental # 1 Renewal Correction_
(Needed by 1I (date))
New Addition Court Order Overrun
Contract # AH877 Contract Type AH Method of Procurement G
Vendor Name CITY OF MIAMI DDA Vendor ID F591154607001
Has Written Verbal Approval from a Participating Federal Agency
been received Yes No XX
Fed Agmt Amt State Funds $1,900,000 Local Funds
Beginning date of this Agmt: 05/31/01(Must be after fund approval)
Ending date of this Agmt: 06/30/03 (Estimate if necessary)
Execution date of this Agmt: 11/04/99(Only on original agreements)
Has work been authorized to begin? Yes XX No
Have standard financial provisions been altered by contract terms?
Yes XX No If so, show Revision date:
Does this agreement and/or change order include provisions for
reimbursement to D,O.T. from other entities? Yes XX No
******************************************************************
Brief Description of Work/Comments: SUPPLEMENTAL #1 -
FLAGLER STREET MARKETPLACE - ROADWAY RECONSTRUCTION -
TWO-WAY CONVERSION OF FLAGLER ST/N 1ST ST/S 1ST ST
*****************»************************************************
ORG-CODE *EO * OBJECT * AMOUNT *FIN PROJ or JOB 4 *FCT
(FISCAL YEAR) (PROGRAM #) (FUND) alpha
55 064010612 *HC * 790092 * $1,900,000.00 * 40673415401 *215
(00/01) (02 ) (DS)
55 xxxxxxxxx *xx * xxxxxx * $
(xx/xx) (xxxx)
* xxxxxxxxxxx *xxx
55 xxxxxxxxx *xx * xxxxxx * $
(xx/xx) (xxxx)
* xxxxxxxxxxx *xxx
TOTAL AMOUNT * $1,900,000,00 *
Originator: J.R. GONZALEZ DATE SENT: 05/17/01 PH/SC: 452-5804
E-mail USERID(s) PE656J0
******************************************************************
TO BE COMPLETED, BY OFFICE OF COMPTROLLER
**•***************************************************************
BUDGET ENTITY 55100100 CATEGORY 088717
WORK PROGRAM VERIFICATION _ENCUMBER FUNDS
ALLOTMENT YEAR 01 DATE CHECKED
CI SOI 6S LINE 002
FUNDS APPROVED BY JOHN FAIN
CPA, COMPTROLLER DATE: _05.21-2001
FOR ROBIN M. NAITOVE, CPA, COMPTROLLER DATE:
*********************.***************************s****************
FOR ROBIN M. NAITOVE,
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION FORM 350-020-01
ENCUMBRANCE INPUT FORM COMPTROLLER -FIN ADMIN 03/98
RUSH (Needed by / 1 (date))
Reason for RUSH :
Advertise (Letting Date) — Termination/Cent of Comp
_ Award LOA _XX Supplemental Renewal — Correction
New Addition Court Order Overrun
Contract # AH877 Contract Type AH Method of Procurement G
Vendor Name CITY OF MIAMI DDA Vendor ID F591154607001
Has WrittenNerbal Approval from a Participating Federal Agency
been received Yes No _X
Fed Agmt Amt State Funds $407,000 Local Funds
Beginning date of this Agmt: 10/31/01 Must be after fund approval)
Ending date of this Agmt: 06/30/03(Estimate if necessary)
Execution date of this Agmt: 11/04/99(Only an original agreements)
Has work been authorized to begin? Yes _X_ No
Have standard financial provisions been altered by contract terms?
Yes _X_ No If so, show Revision date:
Does this agreement and/or change order include provisions for
reimbursement to D.O.T. from other entities? Yes _X_ No
Brief Description of Work/Comment: SUPPLEMENTAL # 1
FLAGLER STREET CORRIDOR IMPROVEMENT PROJECT
DESIGN AND CONSTRUCTION OF ADDITIONAL DRAINAGE IMPROVEMENTS
ORG-CODE *EO * OBJECT * AMOUNT *FIN PROJ or JOB # *FCT
(FISCAL YEAR) (PROGRAM #) (FUND) alpha
55 063030643 *PD *.750008 * $ 37,000.00 * 40673413401 *215
(01/02) (87) (CIGP)
55 064010606 *HC *750008 * $370,000.00 * 40673415401 *215
(01/02) (87) (CIGP)
55 xxxxxxxxx *xx * xxxxxx * $ * xxxxxxxxxxx *xxx
(xxlxx) (xxxx)
TOTAL AMOUNT * $407,000.00
Originator: J.R. GONZALEZ DATE SENT:10/05/01 PH/SC:452-5804
E-mail USERID(s)PE656JG
TO BE COMPLETED BY OFFICE OF COMPTROLLER
BUDGET ENTITY _55100100 CATEGORY 088572-02
WORK PROGRAM VERIFICATION OK
ALLOTMENT YEAR DATE CHECKED
CI SO2 0003 0004
FUNDS APPROVED BY C.B. SMITH
FOR ROBIN M. NAITOVE, CPA, COMPTROLLER DATE: 10-11-2001