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<br />Approved by Office of Management and /PAGE OF <br />OUTLAY REPORT AND REQUEST FOR REIMBURSE- Budget. No. 80-RO181 1 I 1 PAGES <br />MENT FOR CONSTRUCTION PROGRAMS 1. TYPE OF REQUEST [ 2. BASIS OF REQUEST <br /> <br />(See instructions on back) [XI FINAL 0 PARTIAL 0 CASH 00 ACCRUAL <br /> <br />3. FEDERAL SPONSORING AGENCY AND ORGANIZATIONAL ELEMENT TO 4. FEDERAL GRANT OR OTHER 5. PARTIAL E'AYMENT REQUEST NO. <br />WHICH THIS REPORT IS SUBMITTED ~~E~~~Y~~E A~~~~~R ASSIGNED <br /> <br />FAA 3-48-0195-06 14 <br />6. EMPLOYER IDENTIFICATION 7. RECIPIENT ACCOUNT OR OTHER PERIOD COVERED BY THIS REPORT <br />NUMBER IDENTIFYING NUMBER <br />FROM (Month, day, year) TO (Month, day, year) <br />74-6000238 DOT FA 85-SW8677 9/04/90 12/04/90 <br />9. RECIPIENT ORGANIZATION 10. PAYEE (Where check should be sent if different than item 9) <br /> <br />Name: City of San Marcos Name: SAME <br /> <br />No. and 630 E. Hopkins Street No. and. SAME <br />Street: Street. <br />City. City. <br />~}~eC~d~: San Marcos, Texas 78666 i}pe~od~d: SAME <br /> <br />11. STATUS OF FUNDS <br />PROGRAMS-FU NCTIONS-ACTIVITI ES <br /> <br />CLASSIFICATION (a) (b) (c) TOTAL <br /> <br /> <br />a. Administrative expense $ -0- $ $ $ -0- <br /> <br />b. Preliminary expense -0- -0- <br /> <br />c. Land, structures, right-of-way -0-. -0- <br /> <br />d. Architectural engineering basic fees -0- -0- <br /> <br />e. Other architectural engineering fees -0- -0- <br /> <br />f. Project inspection fees 94,832.85 94,832.85 <br /> <br />g. Land development -0- -0- <br /> <br />h. Relocation expense -0- -0- <br /> <br />i. ::Ib:lm:atio.HU]IJXIJiI1t~måd1@tx:i[~ <br />»KM~ Construction Test'ng 13,226.75 13 226.75 <br /> <br />j. Demolition and removal -0- -0- <br /> <br />k. Construction and project improvement <br />cost 3.368.681. 50 3 368.681. 50 <br /> <br />I. Equipment -0- -0- <br /> <br />m. Miscellaneous cost -0- -0- <br /> <br />n. Total cumulative to date (sum of lines <br />athrum) 3.476.741.10 3 476 741 10 <br /> <br />o. Deductions for program income -0- -0- <br /> <br />p. Net cumulative to date (Line n minus <br />linea) 3.476.741.10 3 476 741.10 <br /> <br />q. Federal share to date 3,129.066..99 3.129 066.99 <br /> <br />r. Rehabilitation grants (100% reim. <br />bursement) -0- -0- <br /> <br />s. Total Federal share (sum of lines q <br />and r) 3.129.066.99 3 129 066.99 <br /> <br />t. Federal payments previously reo <br />ques~ed 2.948.729.23 ? QúH 72Q 21 <br /> <br />! u. Amount requested for reimbursement $ 180.337.76 $ $ $ 1HO 117 7n <br /> <br />v. Per~entage of physical completion of 100 01 01 01 100 01 <br />prOject /0 /0 70 /0 <br />12 CERTIFICATION SIGNATURE OF AUTHORIZED CERTIFYING DATE REPORT <br />. om~L ~~lTTro <br /> <br />I certify that to the best of my knowledge d L( DJ!l / ~ ~ / <..1?.1 tJ <br /> <br />and belief the billed costs or disburse. a. RECIPIENT TYPED OR PRI~D NAME ,AN~TLE TELEPHONE (Are~ code. <br />ments are in accordance with the terms number and exten8wn) <br />of the project and that the reimbursement Larry Gilley, City Manager (512) 353-4444 <br /> <br />represents the Federal share due which ~T~RE AUSjJJ'THORIZED CERTIFYING DATE SIGNED <br />. OF CIAL I <br />has not been previously requested and \ \ ()E:(:. Or 0 <br />that an inspection has been performed b. Representative <br />d II k.. . certifying to line <br />an a wor IS In accordance with the 11v NPfD OR PRINTED NAME AND TITLE TELEPHONE (Area code <br />. . . number and exten8ion) <br />terms of the award. CharlesA. Wl111S, AlA <br />President (817) 261-1863 <br />271-102 STANDARD FORM 271 (7-76) <br />Prescribed by Office of Management and Budget <br />Cir. No. A-lIO <br />