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D00701
P 1. L 1 7 U C S 6 1 B 1 Y d U'L F�?e2 ;i,p C1.2.TE V"tT_v5 UN 1'd1S Ci1SU5 �'\�/� ( U1RE _iQ2^CE �B➢L r; 1 ti 1 1�� � N� �u rDei�iSinRiivn "vnD"nn � �] (�� �aie: �� —L,�L_!�/ 5U7fU�1 1Sx¢1�SLh hL°lkt]i.HT1`l� i%nlJ�h� �CIl515LC^_S R1 ine a�i�horicp QI37LBd LO LLB [12f0' 15 �Br�'p7 .�U.U�.Q v= LitE L1*,'Y �ftfiti,E, 8IlG oased on ihe *eau�si oi iee uirecior oi iae u"ecatir�eni oi Publ i c Hedl th io zrsenc ice !9 oaeget o: ihe ` ^ iund, ioe Direcioz oi ihe Depa*i�en± 25_� __SpeciaLRe�esiu�_—_�^--- ai ?ia2nce xed azezge�eni Se_*vices is auicorized io aeend ssie oudrei in ioe ioiiowir,g aanner. �C'*BRL Bud¢eE • . SPBCiAL "x�VnnliB - HnaGin 365-33234-0352 �UJ'SSL3�-'JC1� JB3'J�23�-DZ19 au5-3323@-Qiit 3ira-3"a2"afi-0359 �DJ-3.1L3B^UG�� �G5-33247-�7$5n a02-33i4i-Dii9 Sa'a-33255-Oi1i 3ca-3ai50-i�299 3G3-"a3i50-"u3o5 aua-332�o-uci"s �Ua-3?258-033E 3G�-33i5&-ui19 1I9P11%iYtZAlAQN - HC111�A4 Sii"rFLicS TUB515LULO�IS CiL 1S�L' I� S11YY - i'ISri�- (iGU'1"LAL TllBBRGuLu"SI5 CTi, BnV 3u"rP - Fnn� uTHfin LNi[4UhIG9l1 - Fn&SGAN&:� �OriBN'3 Hnai;iri vLiiiiG - Orrifi& S6"rPLifi� �OcBA"9 H"naLTn CLINiC - r"nB8 GiriBB „�"r� FGOu {��i,Gi - Oiflnn CO�rri. �TIF� F�6D (�i,i,C.i - RB� �iTflfi$ i[iGri aISu FOUTfi FnG�6Ci - PnRSGtiiinG nFG� Rt85 Y6JiA F&6a'BC`f -OiHBB FOPIiLaT?�F BaSBD �i�ei &BGiBTF - SiJ�FLIHS YUSULAl'1Ufi BaSBif i�i� unGi�iSY - FBnS GeMIbY iinS - e3"nfiiCAL 9uFPLIEn FaidiGZ iin9 F&nS FBGFBSSiQNAG 7fU�UUU�UU S:II�VUO�it13 's6,PP0,G0 $i$?.Gy?.�aG ���lU��il �3�,UJU.IiU 's0,n0 $"si,"s4a',"uG 333,�aii�60 `s"a�.91L6G 3i,"rP0,G0 330.06u.0"v �a,ao 3i2"v.Quu.Gu .OU1�tOf�UU Coanee �LU,VOO.U� �a.UOU.UU 85,OG0,�0 i33u,0u0.u0i YIV,UOu,UU �214�OQs,�O� 'sfi 1�1D.VUU��Qj {gg,�9�,30j QE,6DO,Da si.G�iQ.uO (82,ono,aor 7z,00a,oc ��L�VUU.UOj �!i.Ul� 562➢CBC BcQgei 99�,OO�.QG 51�J.VUU.UU 4i1,000,0u 3i5a,05i3Ou 51U.LJJ�VU 3i6.QG"�.GQ YS�VUJ�UU ¢i9,9�5.@0 `s3i,yii3O0 33a,yii.GO Y.1� (Gi/,IIU �,s,aoa,a� 32,"uG0,04 �i1C���1i.�� $DU1,t04.UU }PI155�'�u, li�H Y'I��LLL II�i8L111��"7 1.�I:�U[�1LAllt�'R� Y141/GI4Af1 �V'61SU� �Ydf�l/L�i,rr llU1�:UxT1C P�l( �1f1111.9L ��Y1�LI$$, 1t1 CVit P(Gl/l1.:�1 il�'U LAE� enna, aGHBN'3 HBAiTi{ FOR SD"rFLI�S, idiC r"G& nr"t'viFi?fi�7i, iiii,ri Ei&� ifiiiri PnQ�HAA �iiS�, ?itp, nRSnu ia�, �&Gi,STBi RG: "siIFPLIBc, e�iu r"AHILT TIBS "rD"n �EuiCnL "aUF"rL"nS: AriG aiinx8n&. T6n&n ta aFBM�iNG AiiiH"uB:iT iN �eBi�dii3 Oi&au GuDES ihAi GOOi,u BB lfilSIVJL'SSS��BU 11i1SKiSCtllid t7C .r6B'JULt'ti'U 2f�P1 1�(�b PId1UK AYY&l1t�tS� ln$ I.hfltVU� lll lMiS 1Y52 IfJItIi7f1. ���� �_L'?"�� "rrepared 'ey: Activiiv Hanage* _�� c"'I_ L�-� ueouesied 'oy: uepariseni uireccn* �� f� 1� 1 011.-�`� __ Apnr v��apor Daie; Public Heaith TOTAL # OF SiGNATURE PAGES ���( N_ 3�426 10/187J95 GREEN SHEET _� - INITIPLlOATE �mm�wase � DEPARiMENT DIRECTOR O CITY COUNCIL �+� �CRYA7TOflNEY nCITYCLERK � NU O gU�� DIRECiO �U FlN. & MGT. SEi7VIC D1R. OBO� � MAYOR (OF ASSISTANiI ❑ ALL LOCATIQNS FOR SIGNATURE) City signatures on Administratfve Orfers budget revision for special funds. a _ PUWNING COMMISSION � GIVR _ CIB COMMRTEE _ _ _ STAFf _ _ _ OISTRIr.fCAURT _ _ SUPPORTS WHICH COUNqL O&IECTNE? PERSONAL SERVICE CONTRACTS MUSTANSWER TNE FOLLOWING �UESTIONS: 1. Has this person�rtn ever worked u�Wer a contracf fOr this departnerrt? - YES NO 2. Has this personfirm ever 6een a city empbyee? YES NO 3. Does this person7firm possess a skill not normaNy possessed by a+ry current ciry employee? YES NO Explsin sll yes a�fswera on aeparote sheet anA attac� to green aheet Spending authority is needed in Immunization for medical suppl7es, tn TB for medical and other fees, in Women's Health for supplies, in WIC for equipment, in H Risk for ay+pplies, Pop based Imm. for supplies, and Family Ties for supplies. There is authority in other obje codes that could be transferred. will be no def�cit object codes. NONE RECEfVEf3 OCT 2 51995 �fTY CLERK Vendors wi11 not be paid. AMOUNT OP TRANSACTION S � COST/REVENUE BUDGETED (CfRCLE ONE) YES NO 'UNDIHCaSOUHCE S�eCld� Fund ACTIYITYNUMBER MANCIAI INFOflMATION: (EXPIAIN) CI