USES:
1. Addition or substitution of a capital item (over $5,000) which is not listed in the adopted budget.
2. A change in the amount of an approved capital item that will cost 20% more or $2,000 more, whichever is less.
3. Used to notify and receive City Manager approval for a significant budget change.

Date of Request*

Requesting Department*

City Clerk City Manager Development Services Fire Library Parks/Pool Police Public Works - Engineering Public Works - Streets Wastewater

Person Requesting Change in Budget*

Item Requested *

CIP number of item

GL number*

Budget Year of Request*

FY2024 (7/1/2023 to 6/30/2024) FY2025 (7/1/2024 to 6/30/2025 FY2026 (7/1/2025 to 6/30/2026) FY2027 (7/1/2026 to 6/30/2027) FY2028 (7/1/2027 to 6/30/2028)

Approved Budget Amount of Item*

Dollar Amount of Budget Change (+/-)*

Budget Offset? List any amount(s) of unspent budget funds that may offset expenditure increase.*

Reason for Change in Expenditure*

Please upload supporting documentation (bids, quotes, etc.).

Convert to PDF?
(DOC, DOCX, XLS, XLSX, TXT)

FOR OFFICE USE ONLY:

DATE OF CITY MANAGER APPROVAL: __________________________

DATE OF CITY CLERK APPROVAL: ______________________________