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2014-04-23 CC Packet
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2014-04-23 CC Packet
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8/5/2014 7:22:15 AM
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i Encumbrance Worksheet <br /> G r ( Attach to all contracts, grants, and amendments <br /> Vendor Name: Vendor Number: <br /> City of Centerville <br /> Address: Federal Employer I.D. or Social Security #: <br /> 1880 Main Street 41- 1267014 <br /> City, State, Zip: Minnesota Tax I.D. No. (if applicable): <br /> Centerville, MN 55038 <br /> Starting Fiscal Year: 2014 1 Total Amount of Agreement: $ 10,000 <br /> Start Date: 6/1/2014 End Date: 6/30/2015 <br /> Accounting Information <br /> Fiscal Year 1 <br /> Fund Dept ID Appr ID Project ID Activity ID Amount <br /> 2302 H123 2139 H12555P $ 10,000 <br /> H123 $ <br /> H123 $ <br /> CFDA # (if Federal $) <br /> Fiscal Year 2 <br /> Fund Dept ID Appr ID Project ID Activity ID Amount <br /> H123 $ <br /> H123 $ <br /> H123 $ <br /> CFDA # (if Federal $) <br /> Fiscal Year 3 <br /> Fund Dept ID Appr ID Project ID Activity ID Amount <br /> H123 $ <br /> H123 $ <br /> H123 $ <br /> CFDA # (if Federal $) <br /> Financial Management Onl <br /> Authorized 5J nature for <br /> Encumbra Date <br /> Contract Number in code <br /> Purchase tDfrNOr Number Source'Fype <br /> ca - w'" .Coot Accaurd 10 <br /> NOTE: This page of the Agreement Contract contains confidential information and should not be reproduced or distributed externally without written <br /> permission from the Vendor. Internal circulation of this page should only be to individualsioffices signing this Agreement Contract and those that require <br /> access to the tax identification number. <br /> Financial Management (651) 201 -4622 7126111 <br /> 96 <br />
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