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000usign Envelope ID:acocoocF-E oo12F58692 <br /> /-'tV �}f ��D K����[}� /��-�~�i| �&7r��(�����[lf <br /> City _ _ _ Agreement <br /> Fund Allocation Request F(]rDl <br /> 'Fund Allocation Number: <br /> ____ <br /> Instructions for Use: This Form will beused to "assign"o/allocate services for project scopes to approved firms <br /> through the related Master On-Call Agreement.Assigned services may NOT begin until this form is completed <br /> (front and back) with all signatures and o Purchase Order is issued byCOfM. <br /> Company Name: Project Name: <br /> c^mnavvpm: On-Call Agreement Name: <br /> On-Call Agreement <br /> This Fund Allocation Form authorizes the Consultant(Firm) to provide the nemioon described bn|mv in accordance with <br /> the Master On-Call Professional Services Agreement between the Consultant(Firm)and the City of San Marcos. <br /> PROJECT DESCRIPTION: <br /> SCOPE OF BASIC SERVICES: <br /> This information must b°completed prior m making the assignment/Fund Allocation: <br /> *Fill out page 2 first for calculations. <br /> Original On-Call Agreement Amount: $ <br /> Change In Service (change order/amendments)to Date: $ <br /> Revised Agreement Amount: $ 0.00 <br /> Previous Fund Allocations Amount: $ 0.00 <br /> Released Purchase Order Funds: $ 0.00 <br /> Amount of this Request: $ <br /> Funds Remaining on On-Call Agreement: $ 000 <br /> Requested By Data <br /> Reviewed and Approved by: <br /> City Project Manager Date <br /> Director mate <br /> Authorization to Proceed: Following receipt of COSM Purchase Order,the Consultant(Firm)is authorized to proceed with the Services <br /> described above. <br /> "For Internal Use Only.Toue filled out uvpm~~ <br /> Project Fund Phase Amount <br /> 6LAonun mv2/6/2U2O <br /> Submit invoices via email to the City PM and copy kfoxworth@sanmarcostx.gov � <br />