HomeMy WebLinkAboutSupplemental Attachments - 7/15/19City of Waterloo
Finance Committee Preliminary Draft Invoice Report
For July 15 2019 Approval
Finance Committee Accounts Payable Open Invoice Report Total
As of Friday, July 12, 2019
EFT Transactions:
943,122.47
Add: Wellmark EFT 143,847.62
Workers Compensation Issued by TPA
Housing Authority Housing Assistance EFT's
Housing Authority Housing Assistance EFT's
Payroll
1,086,970.09 1
53,623.04
1,783.20
168,741.83
Bill Payment Total - Monday, July 15, 2019
1,311,118.16
Payment to Council members or related entities:
CITY OF WATERLOO, IOWA
CITY ATTORNEY'S OFFICE
715 Mulberry Street • Waterloo, IA 50703 • (319) 291-4327 Fax (319) 291-4286
July 11, 2019
Mayor Quentin Hart and
City Council Members
City Hall
Waterloo, IA 50703
Dear Mayor Hart and Council Members:
I have examined the bonds filed with the City Clerk/Auditor's Office up to the
close of business on July 11, 2019.
Of the 2 bonds submitted, ,were approved and none rejected, as shown on
the attached list.
Very truly yours,
DA 'Pi R. ZELLHOEFER
Waterloo City Attorney
DRZ:sda
CITY WEBSITE: www.cityofwaterlooiowa.com
WE'RE WORKING FOR YOU!
An Equal Opportunity/Affirmative Action Employer
BONDS FOR COUNCIL APPROVAL
July 15, 2019
RIGHT OF WAY CONSTRUCTION BOND
7900383696
IA 5165833
CEDAR VALLEY RENOVATIONS LLC
JESUP LAND IMPROVEMENT CO.
AMOUNT $15,000.00
CEDAR FALLS, IA
JESUP, IA
RIGHT OF WAY CONSTRUCTION BOND
No. 7900383696
Applicant's Telephone Number:
KNOW ALL MEN BY THESE PRESENTS:
That (I), (We), Cedar Valley Renovations LLC
5t�,3 5q?' ozs
of 5700 Big Woods Rd.
Street
, Cedar Falls IA
City State
as Principal, and Nationwide Mutual Insurance Company of
1100 Locust Street, Department 2006, Des Moines, IA 50391
as Surety, are held and firmly bound unto the City of Waterloo, Black Hawk County, Iowa, in the penal
sum of FIFTEEN THOUSAND DOLLARS ($15,000.00) lawful money of the United States of America,
to the payment of which sum, well and truly to be made, the Principal herein firmly binds (himself)
(herself) (themselves) their heirs, executors and administrators, and the said Surety binds
themselves, their successors, assigns, executors and administrators, jointly and severally, firmly by
these presents.
THE CONDITIONS OF THE ABOVE OBLIGATION ARE SUCH that, by the provisions of the
Ordinances of the City of Waterloo, Iowa, a Surety Bond in the sum of Fifteen Thousand Dollars
($15,000.00) must be filed with the City Clerk/Auditor of the City of Waterloo, Iowa, before one may
engage in construction, reconstruction or excavation in the public right of way in said City.
NOW, THEREFORE, if the above bounden Cedar Valley Renovations LLC of
Cedar Falls IA will faithfully perform any and all duties
and abide by any and all regulations required by said Ordinances regulating the construction,
reconstruction and excavation projects within said City; and if (he), (she), (they) will promptly pay to
said City any and all sums and amounts due or that may become due or owing by reason of or under
said Ordinances; and if (he), (she), (they) will pay all fines imposed upon (him), (her), (them), or a
violation of said Ordinances occurring during the life of this bond; and if (he), (she), (they) will
indemnify and keep the City harmless from all liability for any accident and/or damages arising from
(his), (her), (their) doing, protecting or completing the work, then this obligation to be null and void,
otherwise to remain in full force and effect.
The effective date of this Bond is May 1, 20 19
, through April 30, 20 20
Witness our hands this 2nd day of May
PLEASE MAIL TO:
City of Waterloo, Iowa
Engineering Department
715 Mulberry Street
Waterloo, IA 50703
Updated 1-24-00
, 2019
Cedar Valley Renovations LLC
PRINCIPAL
By: a�y
2 2.
Printed Name: i2ae,...
Nationwide Mutual Insurance Company
SURET;
By:
Attorney-in-fact Cassie McKittrick
SEALS
PLEASE COMPLETE CHECKLIST ON REVERSE SIDE BEFORE SUBMITTING BOND.
Power of Attorney
KNOW ALL MEN BY THESE PRESENTS THAT:
Nationwide Mutual Insurance Company, an Ohio corporation AMCO Insurance Company, an Iowa corporation
Allied Property and Casualty Insurance Company, an Iowa corporation
hereinafter referred to severally as the "Company" and collectively as 'The Companies" does hereby make, constitute and appoint:
Cassie McKittrick
each in their individual capacity, its true and lawful attomey-in-fact, with full power and authority to sign, seal, and execute on its behalf any and all bonds and
undertakings, and other obligatory instruments of similar nature, in penalties not exceeding the sum of
Fifteen Thousand and no/100 dollars ($15,000.00)
and to bind the Company thereby, as fully and to the same extent as if such instruments were signed by the duly authorized officers of the Company; and all acts
of said Attorney pursuant to the authority given are hereby ratified and confirmed.
This power of attorney Is made and executed pursuant to and by authority of the following resolution duly adopted by the board of directors of the Company:
"RESOLVED, that the president, or any vice president be, and each hereby is, authorized and empowered to appoint attorneys -in -fact of the Company,
and to authorize them to execute and deliver on behalf of the Company any and all bonds, forms, applications, memorandums, undertakings,
recognizances, transfers, contracts of indemnity, policies, contracts guaranteeing the fidelity of persons holding positions of public or private trust, and other
writings obligatory in nature that the business of the Company may require; and to modify or revoke. with or without cause, any such appointment or
authority; provided, however, that the authority granted hereby shall in no way limit the authority of other duly authorized agents to sign and countersign any
of sald documents on behalf of the Company."
"RESOLVED FURTHER, that such attorneys -in -fact shall have full power and authority to execute and deliver any and all such documents and to blnd the
Company subject to the terms and limitations of the power of attorney issued to them, and to affix the seal of the Company thereto; provided, however, that
said seal shall not be necessary for the validity of any such documents."
This power of attorney is signed and sealed under and by the following bylaws duly adopted by the board of directors of the Company.
Execution of Instruments. Any vice president, any assistant secretary or any assistant treasurer shall have the power and authority to sign or attest all
approved documents, instruments, contracts, or other papers in connection with the operation of the business of the company in addition to the chairman of
the board, the chief executive officer, president, treasurer or secretary; provided, however, the signature of any of them may be printed, engraved, or
stamped on any approved document, contract, instrument, or other papers of the Company.
IN WITNESS WHEREOF, the Company has caused this instrumento tie sealedand duly attested by the signature of its officer the 27th day of February, 2019.
/
Antonio . Albanese, Vice President of Nationwide Mutual Insurance Company, AMCO Insurance
Company, Allied Property and Casualty insurance Company
I�cw !r. ,
00144 • EAL•
,i
`\a
ACKNOWLEDGMENT
STATE OF NEW YORK, COUNTY OF NEW YORK: ss
On this 27th day of February, 2019, before me came the above-named officer for the Company
aforesaid, to me personally known to be the officer described in and who executed the preceding
instrument, and he acknowledged the execution of the same, and being by me duly sworn, deposes
and says, that he is the officer of the Company aforesaid, that the seal affixed hereto is the
corporate seal of said Company, and the said corporate seal and his signature were duly affixed
and subscribed to said instrument by the authority and direction of said Company.
Suzanne C. Delia
Notary Public, State of New York
No. 020E6126649
Qualified in Westchester County
Commission Expires September 16, 2021
Notary Public
My Commission Expires
September 16, 2021
CERTIFICATE
I, Laura B. Guy, Assistant Secretary of the Company, do hereby certify that the foregoing is a full, true and correct copy of the original power of attorney issued
by the Company; that the resolution included therein is a true and correct transcript from the minutes of the meetings of the boards of directors and the same has
not been revoked or amended in any manner; that said Antonio C. Albanese was on the date of the execution of the foregoing power of attorney the duly elected
officer of the Company, and the corporate seal and hls signature as officer were duly affixed and subscribed to the said instrument by the authority of said board
of directors; and the foregoing power of attorney is still in full force and effect.
IN WITNESS WHEREOF, j ayg,hereunto subscribed my name as Assistant Secretary, and affixed the corporate seal of said Company this 2nd day of
May , L l J
BDJ 1(02-19)00
c.a-
Assistant Secretary
RIGHT OF WAY CONSTRUCTION BOND
No.
IA5165833
Applicant's Telephone Number: (319) 827-3626
KNOW ALL MEN BY THESE PRESENTS:
That (I), (We), Jesup Land Improvement Co.
of 1995 Baxter Ave.
Street
as Principal, and
Jesup Iowa
City State
Merchants Bonding Company (Mutual) of
P.O. Box 14498, Des Moines, IA 50306-3498
as Surety, are held and firmly bound unto the City of Waterloo, Black Hawk County, Iowa, in the penal
sum of FIFTEEN THOUSAND DOLLARS ($15,000.00) lawful money of the United States of America,
to the payment of which sum, well and truly to be made, the Principal herein firmly binds (himself)
(herself) (themselves) their heirs, executors and administrators, and the said Surety binds
themselves, their successors, assigns, executors and administrators, jointly and severally, firmly by
these presents.
THE CONDITIONS OF THE ABOVE OBLIGATION ARE SUCH that, by the provisions of the
Ordinances of the City of Waterloo, Iowa. a Surety Bond in the sum of Fifteen Thousand Dollars
($15,000.00) must be filed with the City Clerk/Auditor of the City of Waterloo, Iowa, before one may
engage in construction, reconstruction or excavation in the public right of way in said City.
NOW, THEREFORE, if the above boUndenJesup Land Improvement Co. of
Jesup. IAw I! 47, `N:, r��rm....-d 31i dufias
and abide by any a regu a lops required by s roar ces regulating the construction,
reconstruction and excavation projects within said City; and if (he), (she), (they) will promptly pay to
said City any and all sums and amounts due or that may become due or owing by reason of or under
said Ordinances; and if (he), (she), (they) will pay all fines imposed upon (him), (her), (them), or a
violation of said Ordinances occurring during the life of this bond; and if (he), (she), (they) will
indemnify and keep the City harmless from all liability for any accident and/or damages arising from
(his), {her), (their) doing, protecting or completing the work, then this obligation to be null and void,
otherwise to remain in full force and effect.
The effective dale of this Bond is May 1, 2019 , through April 30, 2021
Witness our hands this 12th day of
PLEASE MAIL TO:
City of Waterloo, Iowa
Engineering Department
715 Mulberry Street
Waterloo, IA 50703
Updated March 2017
June 2019
Jesup Land Improvement Co.
PRINCIPAL
By:
Printed Name: -Sh. C c1-Qrs
Merchants Bonding Company (Mutual)
SURETY
By:
Attorney-in-fact William Warner Jr., Attorney -in -Fact
PLEASE COMPLETE CHECKLIST ON REVERSE SIDE BEFORE SUBMITTING BOND.
LP 0467 IA (2/17)
THE FOLLOWING IS A HELPFUL CHECKLIST TO ASSIST THE PRINCIPAL
AND/OR SURETY. THERE MAY BE OTHER ITEMS REQUIRED BY THE SURETY,
WHICH ARE NOT LISTED HERE. BEFORE SUBMITTING THIS RIGHT-OF-WAY
CONSTRUCTION BOND FORM, PLEASE BE SURE THE FOLLOWING ITEMS ARE
COMPLETED:
✓ the correct local telephone number of the principal is included;
✓ the typewritten name of the principal is the sam_e__as_the name on the signature
line;
✓ the bond is signed by the principal;
✓ the correct address for the principal is included;
✓ surety's address is correct;
✓ beginning and expiration dates are correct, beginning date on bond may be
changed, all right-of-way construction bonds expire on April 30 of the following
year (i.e. bond written during 2005 shall expire April 30, 2006);
✓ the attached power-of-attorney muot - •
bond is issued;
✓ attorney-in-fact signing the right-of-way construction bond is listed on the
power-of-attorney; and
✓ name of attorney-in-fact is typed under the signature line;
✓ once the above -referenced items are completed this form must be submitted to
the City of Waterloo Engineering Department so that it can be forwarded to the
City Council for approval before any permits can be issued. Any items received
in the Engineering Department by 4:00 P.M. on Tuesdays will be placed on the
following Monday's agenda or the next available Council meeting due to a fifth
Monday in a month and/or holidays.
MERCHANTS
BONDING COMPANY,.
POWER OF ATTORNEY
Know All Persons By These Presents, that MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC.,
both being corporations of the State of Iowa (herein collectively called the "Companies") do hereby make, constitute and appoint, individually,
William Warner Jr.
their true and lawful Attorney(s)-in-Fact, to sign its name as surety(ies) and to execute, seal and acknowledge any and all bonds, undertakings,
contracts and other written instruments in the nature thereof, on behalf of the Companies in their business of guaranteeing the fidelity
actions or proceedings allowed by law.
of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any
This Power -of -Attorney is granted and is signed and sealed by facsimile under and by authority of the following By -Laws adopted by the Board
of Directors of Merchants Bonding Company (Mutual) on April 23, 2011 and amended August 14, 2015 and adopted by the Board of Directors
of Merchants National Bonding, Inc., on October 16, 2015.
"The President, Secretary, Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and authority
to appoint Attorneys -in -Fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and
undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof."
"The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney
or Certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the
Company, and such signature and seal when so used shall have the same force and effect as though manually fixed."
In connection with obligations in favor of the Florida Department of Transportation only, it is agreed that the power and aut hority hereby given to the
Attorney -in -Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction
contracts required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department
of Transportation making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of
its obligations under its bond.
In connection with obligations in favor of the Kentucky Department of Highways only, it is agreed that the power and authority hereby given
to the Attorney -in -Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner -
Department of Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation.
In Witness Whereof, the Companies have caused this instrument to be signed and sealed this 12th day of
STATE OF IOWA
COUNTY OF DALLAS ss.
On this this 12th day of June 2019 before me appeared Larry Taylor, to me personally known, who being by me duly sworn
did say that he is President of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC.; and that the
seals affixed to the foregoing instrument are the Corporate Seals of the Companies; and that the said instrument was signed and sealed in behalf
of the Companies by authority of their respective Boards of Directors.
2r2G
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p"
.. 2003 ;:2
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• ti ..
;9•�i�P0q•",.y,
• •,c :3•
•
1933 •
,, O •;�C•:• By
June , 2019 .
MERCHANTS BONDING COMPANY (MUTUAL)
MERCHANTS NATIONAL BONDING, INC.
President
ALICIA K. GRAM
Commission Number 767430
My Commission Expires
April 1, 2020
(Expiration of notary's commission
does not invalidate this instrument)
I, William Warner, Jr., Secretary of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., do hereby
certify that the above and foregoing is a true and correct copy of the POWER-OF-ATTORNEY executed by said Companies, which is still in full
force and effect and has not been amended or revoked.
In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on this 12th day of June
....... =pt.,. •.- ••. , 2019 .
....M..
. t�•0N..• .• PO 6►.• •,\10\NO• CO,•
Notary Public
POA 0018 (3/17)
'
:Q: -o- C�::f�' -o- rr,:�:
-J).\ 2003 .:,0 • _ 1933 .
♦ • .. •
Secretary
TRAVEL REQUEST
CITY OF WATERLOO
FINANCE DEPT.
UNE ITEM USED
FY &') BUDGETED
EXPENDED YTD
THIS REQUEST
LEFT AFTER THIS
REQUEST
DATE
Original - Clerk/Finance
'vireo
STAFF ONLY
010-11-1160-1512
f
Logo ve-
al
7-9-11
Co. - De•artment
NAME(S) AND POSITION(S):
Captain Dave Mohlis
DATE:
July 7th, 2019
NAME OF CLASS / MEETING:
Basic Financial Management Training
DESTINATION: DOJ/Office of Justice Programs
Washington D.C. 20531
DEPARTURE POINT
IF NOT WATERLOO:
DEPARTURE DATE:
July 23'd, 2019
RETURN DATE:
July 26th, 2019
DATE(S) OF MEETING:
July 24 -25th, 2019
PURPOSE OF TRAVEL:
Chief Trelka is requesting authorization to send Captain Dave Mohlis to Financial Management Training in Washington
D.C. The training is federally mandated for agencies that receive federal grant funding. Captain Mohlis who is in charge of
the Administration Division and is the financial point of contact and manages the federal grants for the police department,
requiring him to attend this training.
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
x COST $ 00.00
YES NO
METHOD OF TRAVEL:
xx
CITY VEHICLE PRIVATE VEHICLE
AIRFARE DEPARTING FROM: Waterloo Regional Airport
ESTIMATE OF COST:
$850.00 LODGING 100.00
$250.00 MEALS
$00.00 REGISTRATION 490.00
$00.00 MILEAGE/FUEL
TOTAL FOR ALL: $ 1690.00
TAXI
PARKING
AIRFARE
MISC/TOLLS
BUDGET LINE ITEM: 010-11-1160-1512
xx GRANT REIMBURSABLE
YES NO
xx REQUIRED CERTIFICATION
YES NO
TOTAL: $ PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WATERLOO
I APPROVE THIS TRAVEL REQUEST
y_A
DEPARTMENT HEAD MAYOR
DATE DATE
-7/H-111
TRAVEL REQUEST
CITY OF WATERLOO
FINANCE DEPT.
LINE ITEM USED
FY 0242()BUDGETED
EXPENDED YTD
THIS REQUEST
LEFT AFTER THIS
REQUEST
DATE
Ori "nal - Clerk/Finance
STAFF ONLY
as D2 SOO /34-(v
,✓ 7.9
co• - be•artment
NAME(S) AND POSITION(S):
Pat Morrissey, City Council
DATE:
July 9, 2019
NAME OF CLASS / MEETING:
2019 Iowa League of Cities Annual Conference
DESTINATION: Dubuque, IA
DEPARTURE POINT
IF NOT WATERLOO:
DEPARTURE DATE:
09/25/2019
RETURN DATE:
09/27/2019
DATE(S) OF MEETING:
09/25/2019-09/27/2019
PURPOSE OF TRAVEL/TRAINING:
The League's Annual Conference and Exhibit is the largest training in the state designed specifically for Iowa's elected
and appointed city officials.
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
x COST $
YES NO
METHOD OF TRAVEL:
CITY VEHICLE
AIRFARE
DEPARTING FROM:
PRIVATE VEHICLE
ESTIMATE OF COST:
LODGING TAXI
MEALS PARKING
$205.00 REGISTRATION AIRFARE
MILEAGE/FUEL MISC/TOLLS
TOTAL FOR ALL: $ $205.00
BUDGET LINE ITEM: 010-02-8100-1346
YES NO
YES NO
TOTAL: $
GRANT REIMBURSABLE
REQUIRED CERTIFICATION
PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WATERLOO
DEPARTMENT HEAD
July 9, 2019
I APPROVE THIS TRAVEL REQUEST
MAYOR
DATE DATE
K:\Shared Goodies\Forms\Travel Request Form January 2010
alis/i`I
TRAVEL REQUEST
CITY OF WATERLOO
FINANCE DEPT. STAFF ONLY
LINE ITEM USED 0/0 o?,z ,'8V 0 /346,
FY,2da()BUDGETED /5c)c
EXPENDED YTD 33 U
THIS REQUEST 33 C)
LEFT AFTER THIS
REQUEST icc)
DATE
Original - Clerk/Finance Copy - Department
NAME(S) AND POSITION(S):
Todd Henrich, Building Maintenance
Chris Petersen, Building Maintenance
DATE:
7/9/2019
NAME OF CLASS / MEETING:
Iowa Chapter of IAPMO Continuing Education
(International Association of Plumbing & Mechanical
Officials)
DESTINATION DEPARTURE POINT
IF NOT WATERLOO
Elks Club — Waterloo, Iowa
DEPARTURE DATE:
12/7/2019 (Plumbing)
RETURN DATE:
12/7/2019
DATE(S) OF MEETING:
12/7/2019
PURPOSE OF TRAVEL/TRAINING
Continuing education for State plumbing license
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
YES NO
COST $
METHOD OF TRAVEL:
X CITY VEHICLE
AIRFARE DEPARTING FROM:
PRIVATE VEHICLE
ESTIMATE OF COST:
LODGING TAXI
MEALS PARKING
165.00 each REGISTRATION AIRFARE
MILEAGE/FUEL MISC/TOLLS
TOTAL FOR ALL: $ 330.00
BUDGET LINE ITEM: 010-22-8800-1346
X GRANT REIMBURSABLE
YES NO
X
YES NO
REQUIRED CERTIFICATION
TOTAL: $ 165.00 PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WATERLOO
DEPARTMENT HEAD
I APPROVE THIS TRAVEL REQUEST
UL,L-Li'
MAYOR
DATE DATE
K:\Shared Goodies\Forms\Travel Request Form January 2010
TRAVEL REQUEST
CITY OF WATERLOO
FINANCE DEPT, STAFF ONLY
LINE ITEM USEDDa rr � aft) ss (1 '&O
FYOBUDGETED 1-S0_,(1~ fvd
EXPENDED YTD
THIS REQUEST
LEFT AFTER THIS
REQUEST
DATE
Original - Clerk/Finance
23o 4- /6'$•
_-_'2/17d y 33.s v.:—
'7i/4/
i" 7-/0"/
Copy - Department
NAME(S) AND POSITION(S):
Ed Abben, Building Maintenance
Todd Henrich, Building Maintenance
Joel Shepard, Building Maintenance
DATE:
7/9/2019
NAME OF CLASS / MEETING:
Iowa Chapter of IAPMO Continuing Education
(International Association of Plumbing & Mechanical
Officials)
DESTINATION DEPARTURE POINT
IF NOT WATERLOO
Elks Club — Waterloo, Iowa
DEPARTURE DATE:
11/23/2019 (mechanical)
RETURN DATE:
11/23/2019
DATE(S) OF MEETING:
11/23/2019
PURPOSE OF TRAVEL/TRAINING
Continuing education for State mechanical license
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
x COST $
YES NO
METHOD OF TRAVEL:
X CITY VEHICLE
AIRFARE DEPARTING FROM:
PRIVATE VEHICLE
ESTIMATE OF COST:
LODGING
MEALS
165.00 each REGISTRATION
MILEAGE/FUEL
TOTAL FOR ALL: $ 495.00
TAXI
PARKING
AIRFARE
MISC/TOLLS
010-22-8800-1346
(Ed, Todd)
BUDGET LINE ITEM: 010-22-6860-1346 (Joel)
X GRANT REIMBURSABLE
YES NO
X
YES NO
TOTAL: $ 165.00
REQUIRED CERTIFICATION
PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WATERLOO
EPQRTMENT HEAD
liAAtarcd Goodics\F rms\Travel Rcqucst F rm January 2010
I APPROVE THIS TRAVEL REQUEST
MAYOR
DATE
TRAVEL REQUEST
CITY OF WATERLOO
FINANCE DEPT.
LINE ITEM USED
FYo?0.° BUDGETED
EXPENDED YTD
THIS REQUEST
LEFT AFTER THIS
REQUEST
DATE
Ori.inal - Clerk/Finance
STAFF ONLY
6/o a2 1Qo /3410
600v``
34(1)
X464) rjyd-/`7
Co. - be•artment
NAME(S) AND POSITION(S):
Greg Ahlhelm, Building Official; Jeff Siebel, Property Safety
Inspector; Bob Osgood, Chief Plumbing Inspector; Brian
Baker, Chief HVAC Inspector
NAME OF CLASS / MEETING:
Iowa Chapter of IAPMO Continuing Education
(International Association of Plumbing & Mechanical
Officials)
DEPARTURE DATE:
11/23/2019 (mechanical)
DATE:
7/9/2019
DESTINATION DEPARTURE POINT
IF NOT WATERLOO
Elks Club — Waterloo, Iowa
RETURN DATE:
11/23/2019
DATE(S) OF MEETING:
11/23/2019
PURPOSE OF TRAVEL/TRAINING
Continuing education for State mechanical license
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
x COST $
YES NO
METHOD OF TRAVEL:
X CITY VEHICLE
AIRFARE DEPARTING FROM:
PRIVATE VEHICLE
ESTIMATE OF COST:
LODGING
MEALS
165.00 each REGISTRATION
MILEAGE/FUEL
TOTAL FOR ALL: $ 660.00
TAXI
PARKING
AIRFARE
MISC/TOLLS
BUDGET LINE ITEM: 010-22-5100-1346
X GRANT REIMBURSABLE
YES NO
X
YES NO
TOTAL: $ 165.00
REQUIRED CERTIFICATION
PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WATERLOO
DEPARTMENT HEAD
—1-cc..Iq
I APPROVE THIS TRAVEL REQUEST
G;r�, 1rX(1
MAYOR
—7 /
DATE DATE
K:\Shared Goodies\Forms\Travel Request Form January 2010
TRAVEL REQUEST
CITY OF WATERLOO
FINANCE DEPT.
LINE ITEM USED
FY%d O BUDGETED
EXPENDED YTD
THIS REQUEST
LEFT AFTER THIS
REQUEST
DATE
Original - Clerk/Finance
STAFF ONLY
010 ,7z5 /oo /3,4('
lUav
4G4�0�
271.-I7/6/f
co• - De•artment
NAME(S) AND POSITION(S):
Brian Baker, Chief HVAC Inspector; Bob Osgood, Chief
Plumbing Inspector; Jeff Siebel, Property Safety Inspector;
Scott Strader; Combination Inspector II
DATE:
7/9/2019
NAME OF CLASS / MEETING:
Iowa Chapter of IAPMO Continuing Education
(International Association of Plumbing & Mechanical
Officials)
DESTINATION DEPARTURE POINT
IF NOT WATERLOO
Elks Club — Waterloo, Iowa
DEPARTURE DATE:
12/7/2019 (Plumbing)
RETURN DATE:
12/7/2019
DATE(S) OF MEETING:
12/7/2019
PURPOSE OF TRAVEL/TRAINING
Continuing education for State plumbing license
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
COST $
YES NO
METHOD OF TRAVEL:
X CITY VEHICLE
AIRFARE DEPARTING FROM:
PRIVATE VEHICLE
ESTIMATE OF COST:
LODGING
MEALS
165.00 each REGISTRATION
MILEAGE/FUEL
TOTAL FOR ALL: $ 660.00
TAXI
PARKING
AIRFARE
MISC/TOLLS
BUDGET LINE ITEM: 010-22-5100-1346
X GRANT REIMBURSABLE
YES NO
X
YES NO
TOTAL: $ 165.00 PER PERSON
REQUIRED CERTIFICATION
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WATERLOO
DEPARTMENT HEAD
I APPROVE THIS TRAVEL REQUEST
L�cd` till,
MAYOR
7(,
DATE DATE
K:\Shared Goodies\Forms\Travel Request Form January 2010
1
TRAVEL REQUEST
CITY OF WATERLOO
FINANCE DEPT. STAFF ONLY
LINE ITEM USED
FY _2019' BUDGETED
EXPENDED YTD
THIS REQUEST
LEFT AFTER THIS
REQUEST
DATE
Original - Clerk/Finance
010-11-1100-1346
3oao
)7.41 �- /i f
'Co . - Department
NAME(S) AND POSITION(S):
Officers Alexander Bovy and Charles Nichols
DATE:
July 10th, 2019
NAME OF CLASS / MEETING:
Firearms Instructor School
DESTINATION: Johnston, Iowa
DEPARTURE POINT
IF NOT WATERLOO:
DEPARTURE DATE:
7/29/19
Return Date:
8/9/19
DATE(S) OF MEETING:
July 29th -Aug 9th, 2019
PURPOSE OF TRAVEL:
Lt. McClelland is requesting that the above listed Officer's attend the Firearms Instructor Certification Course held at the
Iowa Law Enforcement Academy July 29th through August 9th, 2019 in Johnston Iowa. This two week Instructor course
will certify these officers as Fire Arms Instructors in the state of Iowa. These Officers will be involved in facilitating training
for officers from our department as well as surrounding agencies. The cost of this training will not exceed $3530.00.
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
x COST $ N/A
YES NO
METHOD OF TRAVEL:
)0000000( CITY VEHICLE
AIRFARE DEPARTING FROM:
PRIVATE VEHICLE
ESTIMATE OF COST:
$600.00 LODGING
$780.00 MEALS
$2000.00 REGISTRATION
$150.00 MILEAGE/FUEL
TOTAL FOR ALL: $ 3530.00
TAXI
PARKING
AIRFARE
MISC/TOLLS
BUDGET LINE ITEM:
x GRANT REIMBURSABLE
YES NO
X REQUIRED CERTIFICATION
YES NO
TOTAL: $ 1765.00 PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IECESSARY AND BENEFICIAL TO THE
CITYATERLOO
I APPROVE THIS TRAVEL REQUEST
T HEAD MAYOR
DATE
(K
DATE
TRAVEL REQUEST
CITY OF WATERLOO
FINANCE DEPT. STAFF ONLY
LINE ITEM USED We) y kg,90 /3 `fr
FY02#,20 BUDGETED ov
EXPENDED YTD
THIS REQUEST �(p✓�"'
LEFT AFTER THIS o_
REQUEST 377S
DATE Mc) 7-42
Original - Clerk/Finance Co. - De••rtment
NAME(S) AND POSITION(S):
Quentin Hart
Mayor
DATE:
7/11/19
NAME OF CLASS / MEETING:
2019 annual Conference & Exhibit
Iowa League of Cities
DESTINATION DEPARTURE POINT
IF NOT WATERLOO
DEPARTURE DATE:
9/25/19
RETURN DATE: 1 DATE(S) OF MEETING:
9/27/19
PURPOSE OF TRAVEL/TRAINING
Iowa League of Cities
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
x COST $
YES NO
METHOD OF TRAVEL:
X CITY VEHICLE
AIRFARE DEPARTING FROM:
PRIVATE VEHICLE
ESTIMATE OF COST:
$400 LODGING TAXI
$165 MEALS PARKING
0.00 REGISTRATION AIRFARE
MILEAGE/FUEL MISCITOLLS
TOTAL FOR ALL: $ 56590
BUDGET LINE ITEM: 010-01-8200-1345
X GRANT REIMBURSABLE
YES NO
YES NO
TOTAL: $ 0.00 PER PERSON
REQUIRED CERTIFICATION
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WATERLOO
DEPARTMENT HEAD
I APPROVE THIS TRAVEL REQUEST
MAYOR
—7/1S— /1
DATE DATE
K:\Shared Goodies\Forms\Travel Request Form January 2010