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HomeMy WebLinkAboutApproved Documents - 2/10/2020City Clerk Use Only Finance Committee Approval Date rl1(2-6 City of Waterloo Expenditure Pre -Authorization Request Form The Finance Committee of the City Council is hereby requested to authorize the following purchase or expenditure submitted by the Community Dev Department to expend $ 2,995.00 plus est. shipping costs of $ 100.00 to pay for or purchase an update and /or resource on a Heuresis XRF machine This purchase or expenditure is being made because: a software update is needed / replace additional internal parts and provide three new battery holders Vendor selected for this purchase: Viken Detection ( formerly Heuresis) ❑ Bids or written quotes were taken on this purchase, as follows: n Bids or quotes were not taken on this purchase because: Prior Committee Actions (Dates): Please check the following box(es) as appropriate to describe the funding for this expense: ❑ General Fund Bonds ❑x Road Use Tax n Sewer Federal/other grants n Other (specify) Sanitation This expenditure is to be coded to the following budget line -item: Resource- 224-32-5853-1378 postage-224-32-5853-1343 BGLED18.CNSLT (BOTH) (Fund - Department - Activity - Account Number) (Project Code) in which the budgeted amount is $ and the current available balance is $ Res e tfully submitt d, i (Signature Do'p . Head or Designee) Date (Signature Finance Dept. Review) Date - 6 --- _3v9s K:\shared goodies\forms\Expenditure Pre-Authorization.xls (Mar 2010) VIKEN DETECTION formerly HEURESIS Return Materials Authorization (RMA): Repairs and Resourcing Viken Detection is pleased to service, repair, and resource your instrument(s). Payment Instructions *Please note that prior to returning your serviced instrument, Viken Detection will accept payment by Credit Card or Check. An invoice with an active link for credit card payments will be forwarded. Pb200i Lead Paint Analyzer Resourcing After you have submitted your Resourcing request to our service department, please contact Cathy Gilmer or Sue Grigolo at 617-467-5526 to make payment arrangements. Payment in advance will be accepted by Credit Card or Check. The cost of Resourcing is $2,995 per instrument. Shipping costs are $100 per instrument. Repairs After we receive your instrument for repair, we will contact you with any costs associated with your repair. We will generate an estimate reflecting these costs. Upon receipt of your estimate, please contact Cathy Gilmer or Sue Grigolo at 617-467-5526 to make payment arrangements. Payment in advance will be accepted by Credit Card or Check. Government Entities If your organization is a government entity, Viken Detection will accept Credit Cards, Checks, or Purchase Orders. Please contact Cathy Gilmer or Sue Grigolo at 617-467-5526 to make payment arrangements. Checks should be made payable to and mailed to: Viken Detection ATTN: RMA 21 North Avenue Burlington MA 01803 21 North Avenue Burlington, MA 01803 / 617.467.5526 / vikendetection.com City Clerk Use Only Finance Committee Approval Date City of Waterloo Expenditure Pre -Authorization Request Form The Finance Committee of the City Council is hereby requested to authorize the following purchase or expenditure submitted by the Convention Cente Department to expend $ 11,000.00 plus est. shipping costs of $ to pay for or purchase Replacement of carpet in coat check areas and office space. This purchase or expenditure is being made because: Modernize look and repair damaged areas in coat check, and replace damaged and worn carpet in office space. Vendor selected for this purchase: D&W Carpet ❑x Bids or written quotes were taken on this purchase, as follows: D&W Carpet: $9,595.78 Reilly Carpet: $10,067.27 ❑ Bids or quotes were not taken on this purchase because: Prior Committee Actions (Dates): Please check the following box(es) as appropriate to describe the funding for this expense: General Fund Bonds E Road Use Tax ❑ Sewer ❑ Sanitation Federal/other grants ❑ Other (specify) This expenditure is to be coded to the following budget line -item: 416-22-4900 2152 (Fund - Department - Activity - Account Number) (Project Code) in which the budgeted amount is $ 600,000.00 and the current available balance is Respe tfully submitted, eviAA (Signature Dept. HeadDesignee) $ 277,834.34 rLrt/Z.r Date (Signature Finance Dept. Review) Date �G-?U1c City Clerk Use Only Finance Committee Approval Dale `ti / ?-0 City of Waterloo Expenditure Pre -Authorization Request Form The Finance Committee of the City Council is hereby requested to authorize the following purchase or expenditure submitted by the Convention Cente Department to expend $ 11,000.00 plus est. shipping costs of $ 0.00 to pay for or purchase Replacement of ceilings in office spaces, and replacement of tiles in coat check areas. This purchase or expenditure is being made because: Office ceilings have deteriorated and are collapsing. Coat check tiles have water and other damage. Vendor selected for this purchase: Artisan Ceiling Systems ri Bids or written quotes were taken on this purchase, as follows: Artisan Ceiling Systems: $10,260.00 Iowa Wall Systems: $12,086 Bids or quotes were not taken on this purchase because: Prior Committee Actions (Dates): Please check the following box(es) as appropriate to describe the funding for this expense: ElGeneral Fund ❑ Road Use Tax 0 Sewer ❑ Sanitation EBonds ❑ Federal/other grants n Other (specify) Cony Center Bonds This expenditure is to be coded to the following budget line -item: 416-22-4900 2152 (Fund - Department - Activity - Account Number) in which the budgeted amount is (Project Code) $ 600,000.00 V and the current available balance is $ 270,834.34 r Respectfully submitted, (Signature Dept. Head or Designee) ;*/&' 01-5-,•"1•20 Date (Signature Finance Dept. Review) Date K:\shared goodies\forms\ (Mar 2010) City Clerk Use Only Finance Committee Approval Date �/(D /)-- 6 City of Waterloo Expenditure Pre -Authorization Request Form The Finance Committee of the City Council is hereby requested to authorize the following purchase or expenditure submitted by the Convention Cente Department to expend $ 7,000.00 plus est. shipping costs of $ 0.00 to pay for or purchase Glass wall construction to enclose coat check areas to create office and conference space. This purchase or expenditure is being made because: Need to expand office space, and also to create a conference room space which can be rented out. Vendor selected for this purchase: Allen Glass n Bids or written quotes were taken on this purchase, as follows: Allen Glass: $6,880.00 Laidig's Glass: $9,870.00 ❑ Bids or quotes were not taken on this purchase because: Prior Committee Actions (Dates): Please check the following box(es) as appropriate to describe the funding for this expense: ❑X General Fund ❑ Road Use Tax n Sewer ❑ Sanitation Bonds ❑ Federal/other grants ❑ Other (specify) This expenditure is to be coded to the following budget line -item: 416-22-4900 2152 (Fund - Department - Activity - Account Number) (Project Code) in which the budgeted amount is and the current available balance is RespeiCtfully submitted, /i✓�- 45/z� (Signature Dept. Head or Designee) Date $ 600,000 00 ✓ $ 277,834.34 (Signature Finance Dept. Review) Date K:\shared goodies \forms\ (Mar 2010) City Clerk Use Only Finance Committee Approval Date 711t)(7,..0 City of Waterloo Expenditure Pre -Authorization Request Form The Finance Committee of the City Council is hereby requested to authorize the following purchase or expenditure submitted by the Engineering Department to expend $ 4,214.00 plus est. shipping costs of $ 0.00 to pay for or purchase Autocad Infrastructure Design Suite Software support. This purchase or expenditure is being made because: Or current support contract expieres on March 5, 2019. The support contract provides tech support and upgrade in software. This is our main design software. Vendor selected for this purchase: DLT Solutions ❑ Bids or written quotes were taken on this purchase, as follows: x Bids or quotes were not taken on this purchase because: DLT Solutions is the only government supplier of AutoCad software. All vendors must go through DLT Solutions for pricing when supplying software to government agencies. Prior Committee Actions (Dates): Please check the following box(es) as appropriate to describe the funding for this expense: General Fund Bonds Road Use Tax Sewer Sanitation Federal/other grants I I Other (specify) Local Option This expenditure is to be coded to the following budget line -item: 205-07-7830-1520 (Fund - Department - Activity - Account Number) (Project Code) in which the budgeted amount is and the current available balance is Respectfully submitted, $ 7,500.00 ✓ $ 6,155.56 IV gnature Dept. Head or Designee) Pate (Signature Finance Dept. Review) Date K:\shared goodies\forms\Autocad 2021 Pre-Authorization.xlsx (Mar 2010) ELT Purchase Order Exemption Form Note to our Customer: We value your business and want to provide quality service. To ensure your products and invoices are delivered to the correct location we normally process orders after receipt of a purchase order. If your purchase order is not available, we request that you complete this form to provide us with the information necessary to properly process your order. Legal Customer name: C4 ei �Afeeko _Lea* * Shipping Address 17/5-AA/ Lera0 g• Ikli.eZroo, DI S063 Shipping contact:: Mrs Zijod56,0 Shipping phone: 3/q — 99/ — y,"a Reference Numbers Purchase order number: Purchase requisition number: DLT quote number: ygg3-06o TAX STATUS (check one) Taxable Tax-exempt Payment Terms: Net 30 Billing Address 7/S Ada/ LR7zy Water VC aYI'CL3 Billing contact::, ,e A .,cthO.ci Billing phone: j'i /_f1g/o2 Order Amount Software licenses $ 7 RV, or, Technical support services $ 425 Total $ fp/l, CO To: DLT Solutions, LLC. I cannot provide a purchase order for the above referenced purchase because: X1) My company does not issue purchase orders and I have completed all sections above The information I have provided in this form is accurate and I have complied with my company's business practices in making this purchase. This form affirms my company's commitment to pay for the products and services I have ordered. -o.iuie k/Se/tJ Name 6/Y ;veer Title City of Waterloo Expenditure Pre -Authorization Request Form City Clerk Use Only Finance Committee /- / Approval Date `�t'I Zb 2-0 The Finance Committee of the City Council is hereby requested to authorize the following purchase or expenditure submitted by the Fire Department to expend $ 1,437.00 plus est. shipping costs of $ 53.00 to pay for or purchase Chemguard-Training Foam This purchase or expenditure is being made because: We need to train and drill using live fire and foam. Vendor selected for this purchase: Sandry Fire Supply nBids or written quotes were taken on this purchase, as follows: Sandy Fire Supply- $1,437.00 Clarey's Safety Equip-$2,000.00 n Bids or quotes were not taken on this purchase because: Prior Committee Actions (Dates): Please check the following box(es) as appropriate to describe the funding for this expense: General Fund Bonds Road Use Tax n Sewer n Sanitation Federal/other grants n Other (specify) This expenditure is to be coded to the following budget line -item: 010-12-1400-1315 Training (Fund - Department - Activity - Account Number) (Project Code) in which the budgeted amount is $ 5,000.00 - and the rent availableance is $ 1,767.59 Respectf(al (Signature Dept. Hc.d or Designee /7,. r Date (Signature Finance Dept. Review) Date K:\shared goodies Worms \Expenditure Pre-Authorization.xls (Mar 2010) City Clerk Use Only Finance Committee Approval Date P'//b/2 2 City of Waterloo Expenditure Pre -Authorization Request Form The Finance Committee of the City Council is hereby requested to authorize the following purchase or expenditure submitted by the Leisure Services Department to expend $ NTE $24,800 plus est. shipping costs of $ to pay for or purchase 240 trees as part of the Plant Waterloo program that Young Family Foundation has generously funded. This purchase or expenditure is being made because: To encourage Waterloo citizens to plant trees after losing so many ash trees in the community. Vendor selected for this purchase: Multiple ❑X Bids or written quotes were taken on this purchase, as follows: Bids were received from Jordan's Nursery, Tiedt Nursery, & Wood Duck Tree Farms. Trees will be purchased from each vendor listed based on meeting specs. of bid and lowest prices for each species. Bids or quotes were not taken on this purchase because: Prior Committee Actions (Dates): Please check the following box(es) as appropriate to describe the funding for this expense: n General Fund Bonds Road Use Tax n Federal/other grants X Sewer Other (specify) Sanitation This expenditure is to be coded to the following budget line -item: 010-37-4105 1536 37GFT.TREE20 (Fund - Department - Activity - Account Number) (Project Code) in which the budgeted amount is and the current available balance is Respectfully submitted, $ 24,800.00" $ 24,800.00` . (Signature Dept. Jul d or Designee) Date (Signature Finance Dept. Review) Date K:\shared goodies\forms\plant waterloo pre auth 2020.xis (Mar 2010) City Clerk Use Only Finance Corrimittee Approval Date - r (c) ' City of Waterloo Expenditure Pre -Authorization Request Form The Finance Committee of the City Council is hereby requested to authorize the following purchase or expenditure submitted by the Leisure Services Department to expend $ 3,295.00 plus est. shipping cysts of $ n/a to pay for or purchase Installation of 12 x 10 commercial rolling steel overhead door for Young Arena. This purchase or expenditure is being made because: current door is 25 years old and has failed beyond repair and needs replaced. Supports the City's Strategic Plan, 4.5"Maintain City facilities that support quality of place". Vendor selected for this purchase: Christie Door Company, Cedar Falls lows 0 Bids or written quotes were taken on this purchase, as follows: Christie Door Company $3,295.00 Overhead Door Company $3,359.00 n Bids or quotes were not taken on this purchase because: Prior Committee Actions (Dates): Please check the following box(es) as appropriate to describe the funding for this expense: General Fund Bonds Road Use Tax n Sewer Sanitation FederaUothergrants n Other (specify) This expenditure is to be coded to the following budget line -item: 419-37-4500-2152 (Fund - Department - Activity - Account Number) (Project Code) in which the budgeted amount is $ 77,000.00✓ 27,607.5'Y QS5-2 ✓ and the current available balance is Respectfully submitted, / ?o '',7,0 74%.;-/„..il r . Wt two 7• 2k0 (Signature Dept. or Designee) Date (Signature Finance Dept. Review) Date K:\shared goodieslforms12020 Zam Room Garage Door Installation Pre-Authorization.xlsx (Mar 2010) City Clerk Use Only Finance Committee / Approval Date )-/ (T, City of Waterloo Expenditure Pre -Authorization Request Form The Finance Committee of the City Council is hereby requested to authorize the following purchase or expenditure submitted by the Police Department to expend $ 7,030.00 plus est. shipping costs of $ 0.00 to pay for or purchase renew of two year software contract for forensic recovery of cellular devices. This purchase or expenditure is being made because: this computer software allows for data to be removed from cellular devices. This expense has been appoved by the Tri-County Task Force board. Vendor selected for this purchase: Cellebrite Inc. ❑ Bids or written quotes were taken on this purchase, as follows: ❑x Bids or quotes were not taken on this purchase because: Cellebrite is the sole vendor for this software. Prior Committee Actions (Dates): Please check the following box(es) as appropriate to describe the funding for this expense: ❑X General Fund Bonds Road Use Tax n Sewer n Sanitation Federal/other grants ❑X Other (specify) TRI County Forfeiture This expenditure is to be coded to the following budget line -item: 010-11-1160-1512 TRIF (Fund - Department - Activity - Account Number) in which the budgeted amount is and the current available balance is Respectfully submitted, —y-z� y��,��, z) i i ,�- .2</A) (Signature Dept. Head or Designee) Date (Signature Finance Dept. Review) Date (Project Code) $ /to, co $ /e, (o/o `7 K:\shared goodies\forms\Expenditure Pre-Authorization.x sx (Mar 2010) City of Waterloo Expenditure Pre -Authorization Request Form The Finance Committee of the City Council is hereby requested to authorize the following purchase or expenditure submitted by the Police Department to expend $ 4,604.25 plus est. shipping costs of $ 0.00 to pay for or purchase renewal of one year software contract for forsenic data recovery. City Clerk Use Only Finance Committee /�/ Approval Date •f (b / Z0 2-6 This purchase or expenditure is being made because: this computer software allows for data to be removed from cellular devices. This expense has been appoved by the Tri-County Task Force board. Vendor selected for this purchase: Magnet Forensics n Bids or written quotes were taken on this purchase, as follows: Qx Bids or quotes were not taken on this purchase because: Magnetic Forensics is the sole provider for the software and proprietary to the department forensic recovery system Prior Committee Actions (Dates): Please check the following box(es) as appropriate to describe the funding for this expense: ElGeneral Fund Bonds Road Use Tax n Sewer 0 Sanitation Federal/other grants n Other (specify) TRI County Forfeiture This expenditure is to be coded to the following budget line -item: 010-11-1160-1512 TRIF (Fund - Department - Activity - Account Number) (Project Code) in which the budgeted amount is and the current available balance is Respectfully submitted, $ /tU;000 (Sign ture Dept. Head or Designee) Date (signature Finance Dept. Review) Date K:lshared goodieslforms\Expenditure Pre-Authorization.xlsx (Mar 2010) City Clerk Use Only Finance Committee Approval Date �ic/2- 2' City of Waterloo Expenditure Authorization Request Form The Finance Committee of the City Council is here by requested to authorize the following purchase or expenditure submitted by the SEWER $ 10,555.74 plus ext. shipping cost of $ 0.00 TROJAN BALLAST REPLACEMENT UV LAMPS Department to expend to pay for or purchase This purchase or expenditure is being made because: REPLACEMENT BALLAST NEEDED FOR UV LAMPS IN UV BUILDING Vendor selected for this purchase: MC2 1 Bids or written quotes were taken on this purchase, as follows Bids or quotes were not taken on this purchase because: MC2 IS THE SOLE COMPANY FOR UV BALLAST REPLACEMENTS Prior Committee Actions (Dates): Please check the following box(es) as appropriate to describe the funding for this expense: nGeneral Fund: []Road Use Tax: []Sewer: []Sanitation: Bonds: ❑Federal/other grants: DOther(specify): This expenditure is to be coded to the following budget line -item: 520-14-5200-1522 (Fund - Department - Activity - Account Number) in which budgeted amount is and the cu ai a • e . _ nce is (Project Code) $ 61 100.00 ✓ $ 62.100.00 //g� �, �.r,�GuGCc- (,r%(,c�f'iywsr �F ' r Designee) ate (Signature Finance Dept. Review) Date Page: Art Electric Pump Company QUOTED TO: CITY OF WATERLOO 3505 EASTON AVE WATERLOO, IA 50702 CONFIRM TO: BRAD CUSTOMER P.O. BRAD SHIP VIA BESTWAY QUOTATION 4280E 14th Street Des Moines, IA 50313 USA Telephone. (800) 383-7867 / FAX (515) 265-8079 www.mc2h2o.com F.O.B. ORIGIN QUOTE NUMBER: QUOTE DATE: EXPIRE DATE SALESPERSON: CUSTOMER NO: QUOTED BY: JOB LOCATION: CITY OF WATERLOO 3505 EASTON AVE WATERLOO, IA 50702 0006523 1/30/2020 2/28/2020 MARCI WHITAKER 2914553 MJU MARQUITA *** QUOTE ORDER - DO NOT PAY*** TERMS Net 30 Days ITEM NUMBER UNIT ORDERED SHIPPED BACK ORDER PRICE AMOUNT •490291 /FR BRAD, PLEASE FIND BELOW OUR OFFER ON TIIE BALLAST FOR YOUR TROJAN UNIT. EACH 6.00 0.00 TROJAN BALLAST REPLACEMENT KIT EACH 1.00 0.00 FREIGHT INCLUDED mutter@„%electricpump.com TIIANK YOU, MARQUITA UTTER All return goods must have written approval from MC2, Inc. before returning. Credit will not be issued without written approval and if applicable there will be a Restock Fee. ABOVE PRICING EFFECTIVE FOR 30 DAYS 0.00 0.00 1,734.29 150.00 Net Order: Less Discount: Freight: Sales Tax: Order Totah 10,405.74 150.00 10,555.74 0.00 0.00 0.00 10,555.74 City Clerk Use Only Finance Committ 'Approval Date / 7 Z0 City of Waterloo Expenditure Authorization Request Form The Finance Committee of the City Council is here by requested to authorize the following purchase or expenditure submitted by the SEWER $ 1.270.96 plus ext. shipping cost of $ 0.00 EXCAVATOR RENTAL Department to expend to pay for or purchase This purchase or expenditure is being made because: REPAIR SEWER ON BLACK HAWK RD. SIGNIFICANT SAVINGS BY UTILIZING IN HOUSE MANPOWER Vendor selected for this purchase: UNITED RENTAL Bids or written quotes were taken on this purchase, as follows Bids or quotes were not taken on this purchase because: ONLY EXCAVATOR AVAILABLE AT TIME OF REPAIR Prior Committee Actions (Dates): Please check the following box(es) as appropriate to describe the funding for this expense: [] General Fund: EIRoad Use Tax: []Sewer: Sanitation: []Bonds: []Federal/other grants: 0Other(specify): This expenditure is to be coded to the following budget line -item: 5'0-14-5200-1.frrszr 1ST (Fund - Department - Activity - Account Number) in which budgeted amount is and the current available balance is tfullbmi ► • ature • mad Or Designee) (Project Code) $ 7,000.00 Vie $ 742 98 1s10 kb Z0z1'- f,Je. Date (Signature Finance Dept. Review) Date W 2 call N a;. 1 S9 n 6 qi Y Y ;j W W C J J 8e 2 o a g w E E.�y 4 G 5 pv 4 n gag & pr V. 1 " m N P A J 0 p 1 0• A rt Job Site7 HcnyHy MHO L�7 VI 8° eod W HOH I-H ID d 1 N Mtn oy0 ~o w JAI-. 1 H N o 0 m m w n e f+ N g. 0o 1{� N b 0 at at In 4444 NOYY F'Y (0p00 NQNNNA iC W R1ZPOPO 14 (10.1J ^jO^�1\+NF\+m Llt"�N 0www w00 OJJ Eo bbo mg CITY OF WATERLOO Committee Communication Finance Committee Meeting: 2/10/2020 Prepared: Nancy Higby Dept. Head Signature: Kelley Felchle SUBJECT: Refunds Submitted by: Kelley Felchle, City Clerk Recommended Committee Action: Approval of the following refunds: Refund request in the amount of $188.13 for garbage collection fees billed in error on a property located at 930 E. Orange Road. Summary Statement: This property uses a private hauler and was billed erroneously for garbage services during the billing periods submitted. Waterloo Water Works and Public Works have confirmed private hauler and the amount of refund due. Expenditure Required: As indicated above Source of Funds: GARBAGE REFUND 525-15-5400-1785 Policy Issue: None Alternative: Not give the reimbursement. Background Information: file:///K:AC LERKD ATv.Council& F i nanceCommuni cations\CouncilCotmnunicationstoCouncil&OFinance\2015\FinanceCotmnuni cation\030915.earbage.retind.doe 325 Sycamore Street P.O. Box 27 Waterloo, Iowa 50704 STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Paee 1 of 1 :OUNT SUMMARY Customer Name: Account Number: Service Address: Coffey Jesse 120783-536340 930 E ORANGE RD Billing Frequency: Billing Date: Billing Due Date: Quarterly 04/26/2018 05/17/2018 Waterloo Water Works Services Water $5.13 Water Service Excise Tax $0.36 Water Works Subtotal $5.49 City of Waterloo Services Storm Water Fee $1.47 Garbage City of Waterloo Subtotal 6. 7 CHARGE SUMMARY Water Works Subtotal City of Waterloo Subtotal Total Current Service Charges Total Amount Due Amount Due After 05/17/2018 2_0 rY-03-AS 9 \ 3,33 L '.�202° Previous Read Date Current Read Dat PrcPow: Road Previous RcaJ T, 04/05/2018 04/06/2018 04/06/2018 04/20/2018 618 618 Actual Manual Estimat $5.49 $6.27 $11.76 $11.76 $11.83 ge: (CCF) 0 1 MEI Please detach and return the bottom portion with your payment. See reverse side for additional information MAKE CHECKS PAYABLE TO: P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ADDRESSEE. Coffey Jesse 930 E Orange Rd Waterloo, IA 50701 ❑ Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 120783-536340 Amount Due After : 11.83 Amount Enclosed: Total Amount Due will be withdrawn from your bank account on 05/17/2018 REMIT TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO. IOWA 50704 WATERLOO A [, W©RKS 325 Sycamore Street P.O. Box 27 Waterloo, Iowa 50704 STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Paee 1 of 1 ACCOUNT SUMMARY Customer Name: Account Number: Service Address: Coffey Jesse 120783-536340 930 E ORANGE RD Billing Frequency: Billing Date: Billing Due Date: Monthly 05/25/2018 06/18/2018 Waterloo Water Works Services Water $10.25 Water Service Excise Tax $0.72 Water Works Subtotal $10.97 City of Waterloo Services Storm Water Fee $2 75 Garbage �`$9.00) City of Waterloo Subtotal $11.75 CHARGE SUMMARY Previous Balance Credits/Payments Water Works Subtotal City of Waterloo Subtotal $11.75 $11.76 -$11.76 $10.97 Total Current Service Charges $22.72 Total Amount Due $22.72 Amount Due After 06/18/2018 $22.86 1ou5 Read Date Current Read Date Previous Read ewous Read Type Current Read Cur Rea. Typ; e (CCf)' 04/20/2018 05/18/2018 619 Actual z 012 0 Off' O1 O6 O5 O� ryo ryo o, 01' O6i O5 15q.O ryo ,v0 621 Actual 2 SPECIAL MESSAGES Please detach and return the bottom portion with your payment. See reverse side for additional information !AKE'CHECKS PAYABLE TO P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ADDRESSEE: Coffey Jesse 930 E Orange Rd Waterloo, IA 50701 ❑ Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 120783-536340 Amount Due After : 22.86 Amount Enclosed: Total Amount Due will be withdrawn from your bank account on 06/18/2018 REI T TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO. IOWA 50704 WATERLOO 325 Sycamore Street P.O. Box 27 Waterloo, Iowa 50704 CORKS STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Paee 1 of 1 ACCOUNT SUMMARY Customer Name: Account Number: Service Address: Coffey Jesse 120783-536340 930 E ORANGE RD Waterloo Water Works Services Water $10.25 Water Service Excise Tax $0.72 Water Works Subtotal $10.97 City of Waterloo Services Storm Water Fee Garbage City of Waterloo Subtotal SflTI5 Billing Frequency: Billing Date: Billing Due Date: Monthly 06/28/2018 07/20/2018 CHARGE SUIMMMA Previous Balance Credits/Payments Water Works Subtotal City of Waterloo Subtotal $11.75 $22.72 -$22.72 $10.97 Total Current Service Charges $22.72 Total Amount Due $22.72 Amount Due After 07/20/2018 $22.86 IOU Read Date Current Read Date Previous Read Previous Read Type Current RE Cur ent Read Type sage CCF'. 05/18/2018 06/21/2018 621 Actual 624 Actual 3 SPECIAL MESSAGE'. Please detach and return the bottom portion with your payment. See reverse side for additional information AKE CHECKS PAYABLE TO: P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ADDRESSEE: Coffey Jesse 930 E Orange Rd Waterloo, IA 50701 El Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 120783-536340 Amount Due After : 22.86 Amount Enclosed: Total Amount Due will be withdrawn from your bank account on 07/20/2018 REMIT TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO. IOWA 50704 WATERLOO W [WORKS 325 Sycamore Street P.O. Box 27 Waterloo, Iowa 50704 STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Page 1 of 1 ACCOUNT SUMMARY Customer Name: Account Number: Service Address: Coffey Jesse 120783-536340 930 E ORANGE RD Billing Frequency: Billing Date: Billing Due Date: Monthly 07/26/2018 08/16/2018 Waterloo Water Works Services Water $10.25 Water Service Excise Tax $0.62 Water Works Subtotal $10.87 City of Waterloo Services Storm Water Fee $2.75 Garbage C 549.00 City of Waterloo Subtotal $1i 7s CHARGE SUMMARY Previous Balance Credits/Payments $22.72 -$22.72 Water Works Subtotal $10.87 City of Waterloo Subtotal $11.75 Total Current Service Charges $22.62 Total Amount Due $22.62 Amount Due After 08/16/2018 $22.76 Previous Read Date Current Read Date Previous Raad Previous Read Type Current Read Ct ent Read Type Usage(CCF) 06/21/2018 07/20/2018 624 Auto Estimate 627 Auto Estimate 3 SPECIAL MESSAGES Please detach and return the bottom portion with your payment. See reverse side for additional information MAKE CHECKS PAYABLE TO: P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ADDRESSEE: Coffey Jesse 930 E Orange Rd Waterloo, IA 50701 ❑ Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 120783-536340 Amount Due After : 22.76 Amount Enclosed: Total Amount Due will be withdrawn from your bank account on 08/16/2018 REMIT TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO. IOWA 50704 325 Sycamore Street P.O. Box 27 Waterloo. Iowa 50704 STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Paee 1 of 1 ACCOUNT SUMMARY ustomer Name: ccount Number: ervice Address: Coffey Jesse 120783-536340 930 E ORANGE RD Waterloo Water Works Services Water $10.25 Water Service Excise Tax $0.62 Water Works Subtotal $10.87 City of Waterloo Services Storm Water Fee Garbage 9.00 City of Waterloo Subtotal $11. Billing Frequency: Billing Date: Billing Due Date: Monthly 08/27/2018 09/18/2018 CHARGE SUMMARY::' Previous Balance Credits/Payments Water Works Subtotal City of Waterloo Subtotal $11.75 $22.62 -$22.62 $10.87 Total Current Service Charges $22.62 Total Amount Due $22.62 Amount Due After 09/18/2018 $22.76 Previous Road Date = CurrentRead Date Previous Read Previous Read Type Current Read Cur ent Read Type U a CCF) 07/20/2018 08/20/2018 627 Auto Estimate 630 Auto Estimate 3 ESSAGES Please detach and return the bottom portion with your payment. See reverse side for additional information MA E CHECKS PAYABLE TO: P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ADDRESSEE: Coffey Jesse 930 E Orange Rd Waterloo, IA 50701 ❑ Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 120783-536340 Amount Due After : 22.76 Amount Enclosed: Total Amount Due will be withdrawn from your bank account on 09/18/2018 RE T TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO. IOWA 50704 325 Sycamore Street P.O. Box 27 Waterloo, Iowa 50704 STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Paee 1 of 1 ACCOUNT SUMMARY Customer Name: Account Number: Service Address: Coffey Jesse 120783-536340 930 E ORANGE RD Billing Frequency: Billing Date: Billing Due Date: Monthly 09/27/2018 10/18/2018 Waterloo Water Works Services Water $14.11 Water Service Excise Tax $0.85 Water Works Subtotal $14.96 City of Waterloo Services Storm Water Fee Garbage City of Waterloo Subtotal $11.7 $2.75 CHARGE SUMMARY Previous Balance Credits/Payments Water Works Subtotal City of Waterloo Subtotal $11.75 $22.62 -$22.62 $14.96 Total Current Service Charges $26.71 Total Amount Due $26.71 Amount Due After 10/18/2018 $26.85 Previous Read Cate =Current Read Date' Previous Re evious Rea Type Current Re Current Read Type Usage (CCF) 08/20/2018 09/18/2018 630 Actual s LL 4 U • 3 u 2 w w 1 • o III 01 00 o° oy ot, o1 0$ cfl ry° ry0 ry0 ry0 ,y0 v0 ,y0 ry0 re' ry° ry0 ry° ry° 635 Actual 5 SPECIAL MESSAGES Please detach and return the bottom portion with your payment. See reverse side for additional information AKI ECKS PAYABLE TO: WATERLOO AT P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ADORES E: Coffey Jesse 930 E Orange Rd Waterloo, IA 50701 ❑ Please check box if contact information requires updating and indicate the change(s) on reverse side CORKS Account Number: 120783-536340 W€ until w ve .,=rsir id ii i'ii' Amount Due After : 26.85 Amount Enclosed: Total Amount Due will be withdrawn from your bank account on 10/18/2018 REMIT TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO. IOWA 50704 WATERLOO WA 325 Sycamore Street P.O. Box 27 Waterloo. Iowa 50704 ORKS STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Paee 1 of 1 ACCOUNT SUMMARY Customer Name: Account Number: Service Address: Coffey Jesse 120783-536340 930 E ORANGE RD Billing Frequency: Billing Date: Billing Due Date: Monthly 10/26/2018 11/19/2018 Waterloo Water Works Services Water $12.18 Water Service Excise Tax $0.74 Water Works Subtotal $12.92 City of Waterloo Services Storm Water Fee Garbage City of Waterloo Subtotal $11.75 CHARGE SLIT MARY Previous Balance Credits/Payments Balance Forward Water Works Subtotal City of Waterloo Subtotal $11.75 $26.71 -$55.97 -$29.26 $12.92 Total Current Service Charges $24.67 Total Amount Due -$4.59 Previous Read 0 Curren: Read Date' Previous Read Previous Read Type Current Read: Current Read Type; sage (CCF) 09/18/2018 10/18/2018 635 Auto Estimate 1 LL O.B VOfi mo wo w 0.2 ON Off' 6.5 4' 05 °\ O� ,y0 ry0 ry0 ,y0 ry0 ,y0 ,19 ,, re 639 Auto Estimate 4 SPECIAL MESSAGES;, Please detach and return the bottom portion with your payment. See reverse side for additional information MAKE CHECKS PAYABLE TO: P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ADDRESSEE: Coffey Jesse 930 E Orange Rd Waterloo, IA 50701 ❑ Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 120783-536340 Amount Due After : -4.59 Amount Enclosed: Total Amount Due will be withdrawn from your bank account on 11/19/2018 T TO:i'. WATERLOO WATER WORKS P.O. BOX 27 WATERLOO. IOWA 50704 325 Sycamore Street P.O. Box 27 Waterloo. Iowa 50704 STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Paee 1 of 1 ACCOUNT SUMMARY Customer Name: Account Number: Service Address: Coffey Jesse 120783-536340 930 E ORANGE RD Billing Frequency: Billing Date: Billing Due Date: Monthly 11/26/2018 12/17/2018 Waterloo Water Works Services Water $12.18 Water Service Excise Tax $0.74 Water Works Subtotal $12.92 City of Waterloo Services Storm Water Fee 75 Garbage 9.00 City of Waterloo Subtotal $11.7 CHARGE SUI\ AR Previous Balance Balance Forward -$4.59 -$4.59 Water Works Subtotal $12.92 City of Waterloo Subtotal $11.75 Total Current Service Charges $24.67 Total Amount Due $20.08 Amount Due After 12/17/2018 $20.22 Previous Read Date Current ead Date' PreviousRead VI us Read Type Read Curren' d Type Usage(CCF)' 10/18/2018 11/18/2018 639 Auto Estimate Off' O� 05 00 01 00 10 ryo ry0 ,v0 ry0 ,10 e 643 Auto Estimate 4 SPECIAL MESSAGES Please detach and return the bottom portion with your payment. See reverse side for additional information E CHECKS PAYABLE TO: WATERLOO W ViVelaW P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ADDRESSEE: Coffey Jesse 930 E Orange Rd Waterloo, IA 50701 ❑ Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 120783-536340 Amount Due After : 20.22 Amount Enclosed: Total Amount Due will be withdrawn from your bank account on 12/17/2018 T:TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO. IOWA 50704 325 Sycamore Street P.O. Box 27 Waterloo, Iowa 50704 STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Paee 1 of 1 ACCOUNT SUMMARY Customer Name: Account Number: Service Address: Coffey Jesse 120783-536340 930 E ORANGE RD Billing Frequency: Billing Date: Billing Due Date: Monthly 12/27/2018 01/18/2019 Waterloo Water Works Services Water $10.25 Water Service Excise Tax $0.62 Water Works Subtotal $10.87 City of Waterloo Services Storm Water Fee 2.75 Garbage $9.00 City of Waterloo Subtotal $ CHARGE SUMMA $20.08 -$20.08 Water Works Subtotal $10.87 City of Waterloo Subtotal $11.75 Total Current Service Charges $22.62 Total Amount Due $22.62 Amount Due After 01/18/2019 $22 76 Previous Balance Credits/Payments Previous Read D 11/18/2018 Current Read Date ' P 12/19/2018 Re 643 P Lis Read Type Actual Current R 642 Current Read Type Actual e (CCF) 1 SPECIAL MESSAGE. Please detach and return the bottom portion with your payment. See reverse side for additional information LAKE -CHECKS PAYABLE TO: WATERLOO WA P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 0RKS ADDRESSEE: Coffey Jesse 930 E Orange Rd Waterloo, IA 50701 EJ Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 120783-536340 Amount Due After : 22.76 Amount Enclosed: Total Amount Due will be withdrawn from your bank account on 01/18/2019 T TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO. IOWA 50704 325 Sycamore Street P.O. Box 27 Waterloo, Iowa 50704 STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Page 1 of 1 ACCOUNT SUMMARY Customer Name: Account Number: Service Address: Coffey Jesse 120783-536340 930 E ORANGE RD Waterloo Water Works Services Water $10.70 Water Service Excise Tax $0.65 Water Works Subtotal $11.35 City of Waterloo Services Storm Water Fee Garbage City of Waterloo Subtotal $2.75 Billing Frequency: Billing Date: Billing Due Date: Monthly 01/25/2019 02/15/2019 HAR SUMMARY Previous Balance Credits/Payments Water Works Subtotal City of Waterloo Subtotal $11.75 $22.62 -$22.62 $11.35 Total Current Service Charges $23.10 Total Amount Due $23.10 Amount Due After 02/15/2019 $23.24 Previous Read Dat Cu Read Date Previous Read vious Read Type Current Read Cur en Read Type Usage(CCFk 12/19/2018 01/18/2019 642 Auto Estimate o^ Off' OP Oh 43 6\ 0 lP' ^ ^^ ^ti O^ ry0 99' ry0 19 ,LO ry0 gO ry0 ry0 ry0 ,O ry0 h0 645 Auto Estimate 3 SPECIAL MESSAGES Please detach and return the bottom portion with your payment. See reverse side for additional information AKE CHECKS PAYABLE TO P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ADDRESSEE:. Coffey Jesse 930 E Orange Rd Waterloo, IA 50701 ❑ Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 120783-536340 To i �� �r- Amount Due After : 23.24 0IEltai � 01 Amount Enclosed: Total Amount Due will be withdrawn from your bank account on 02/15/2019 REMIT TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO. IOWA 50704 WATERLOO WA [ WORKS 325 Sycamore Street P.O. Box 27 Waterloo. Iowa 50704 STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Paee 1 of 1 ACCOUNT SUMMARY Customer Name: Account Number: Service Address: Coffey Jesse 120783-536340 930 E ORANGE RD Waterloo Water Works Services Water $10.70 Water Service Excise Tax $0.65 Water Works Subtotal $11.35 City of Waterloo Services Storm Water Fee $2.75 Garbage 9.00 City of Waterloo Subtotal $11.75 Billing Frequency: Billing Date: Billing Due Date: Monthly 02/25/2019 03/18/2019 CHARGE SUMMARY Previous Balance Credits/Payments Water Works Subtotal City of Waterloo Subtotal $11.75 $23.10 -$23.10 $11.35 Total Current Service Charges $23.10 Total Amount Due $23.10 Amount Due After 03/18/2019 $23.24 Previous Read Date Current Read Date Previeus,Re d Previous Read Type urrentRead Current ReadTyp Usage (CCF) 01/18/2019 02/18/2019 645 Auto Estimate 648 Auto Estimate 3 PECIAL MESSAGES Please detach and return the bottom portion with your payment. See reverse side for additional information HECKS PAYABLE TO P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ADDRESSEE: Coffey Jesse 930 E Orange Rd Waterloo, IA 50701 ❑ Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 120783-536340 Amount Due After : 23.24 Amount Enclosed: Total Amount Due will be withdrawn from your bank account on 03/18/2019 REMIT TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO. IOWA 50704 325 Sycamore Street P.O. Box 27 Waterloo. Iowa 50704 STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Paee 1 of 1 ACCOUNT SUMMARY Customer Name: Account Number: Service Address: Coffey Jesse 120783-536340 930 E ORANGE RD Billing Frequency: Billing Date: Billing Due Date: Monthly 03/26/2019 04/16/2019 Waterloo Water Works Services Water $10.70 Water Service Excise Tax $0.65 Water Works Subtotal $11.35 City of Waterloo Services Storm Water Fee $2.75 Garbage City of Waterloo Subtotal $11. HAI E SUMMARY, Previous Balance Credits/Payments Water Works Subtotal City of Waterloo Subtotal $11.75 $23.10 -$23.10 Total Current Service Charges Total Amount Due Amount Due After 04/16/2019 $11.35 $23.10 $23.10 $23.24 Previous Read Date Current Read Date. Previous Re Previous Read Type Current Read Current Read Type CCF) 02/18/2019 03/19/2019 648 Actual 650 Actual 2 PECIAL MESSAGES Please detach and return the bottom portion with your payment. See reverse side for additional information AKE CHECKS PAYABLE TO: WATERLOO W 1 P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ORKS ADDRESSEE: Coffey Jesse 930 E Orange Rd Waterloo, IA 50701 ❑ Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 120783-536340 Amount Due After : 23.24 Amount Enclosed: Total Amount Due will be withdrawn from your bank account on 04/16/2019 REMIT TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO. IOWA 50704 WATERLOO 325 Sycamore Street P.O. Box 27 Waterloo, Iowa 50704 WORKS STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Paee 1 of 1 ACCOUNT SUMMARY Customer Name: Account Number: Service Address: Coffey Jesse 120783-536340 930 E ORANGE RD Billing Frequency: Billing Date: Billing Due Date: Monthly 04/25/2019 05/16/2019 Waterloo Water Works Services Water $10.70 Water Service Excise Tax $0.65 Water Works Subtotal $11.35 City of Waterloo Services Storm Water Fee $2.75 Garbage City of Waterloo Subtotal $11.7 CHARGE SUMMARY Previous Balance Credits/Payments Water Works Subtotal City of Waterloo Subtotal $11.75 $23.10 -$23.10 $11.35 Total Current Service Charges $23.10 Total Amount Due $23.10 Amount Due After 05/16/2019 $23.24 Previau Date Curre lead Date Previous Read Previous Read Type Current Read Cur R ad Typ Us CCF) 03/19/2019 04/15/2019 650 Auto Estimate 653 Auto Estimate 3 SPECIAL MESSAGES Please detach and return the bottom portion with your payment. See reverse side for additional information AKE CHECKS PAYABLE TO: P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ADDRESSEE: Coffey Jesse 930 E Orange Rd Waterloo, IA 50701 El Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 120783-536340 Amount Due After : Amount Enclosed: Total Amount Due will be withdrawn from your bank account on 05/16/2019 REMIT TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO. IOWA 50704 23.24 WATERLOO' 325 Sycamore Street P.O. Box 27 Waterloo, Iowa 50704 ORKS STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Page 1 of 1 ACCOUNT SUMMARY Customer Name: Account Number: Service Address: Coffey Jesse 120783-536340 930 E ORANGE RD Waterloo Water Works Services Water $10.70 Water Service Excise Tax $0.65 Water Works Subtotal $11.35 City of Waterloo Services Storm Water Fee $2.75 Garbage 9.00 City of Waterloo Subtotal $11.75 Billing Frequency: Billing Date: Billing Due Date: Monthly 05/23/2019 06/14/2019 CHARGE SUMMARY Previous Balance Credits/Payments $23.10 -$23.10 Water Works Subtotal $11.35 City of Waterloo Subtotal $11.75 Total Current Service Charges $23.10 Total Amount Due $23.10 Amount Due After 06/14/2019 $23.24 Previous Read Date Current Read Date ious'Read evio Read Type Current Read: Current Read Type age (CCF), 04/15/2019 05/15/2019 653 Auto Estimate 656 Auto Estimate 3 SPECIAL MESSAGES Please detach and return the bottom portion with your payment. See reverse side for additional information AKE CHECKS PAYABLE TO: P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ADDRESSEE: Coffey Jesse 930 E Orange Rd Waterloo, IA 50701 ❑ Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 120783-536340 Amount Due After : 23.24 Amount Enclosed: Total Amount Due will be withdrawn from your bank account on 06/14/2019 REMIT TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO, IOWA 50704 325 Sycamore Street P.O. Box 27 Waterloo, Iowa 50704 STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Page 1 of 1 ACCOUNT SUMMARY Customer Name: Account Number: Service Address: Coffey Jesse 120783-536340 930 E ORANGE RD Billing Frequency: Billing Date: Billing Due Date: Monthly 06/26/2019 07/18/2019 Waterloo Water Works Services Water $10.70 Water Service Excise Tax $0.65 Water Works Subtotal $11.35 City of Waterloo Services Storm Water Fee $2.75 Garbage (` $9,00 City of Waterloo Subtotal $11. 5 AR SUMMARY Previous Balance Credits/Payments Water Works Subtotal City of Waterloo Subtotal $11.75 $23.10 -$23.10 $11.35 Total Current Service Charges $23.10 Total Amount Due $23.10 Amount Due After 07/18/2019 $23.24 Previous Read Date Cu Read Date Previous Read Pr vious R ad Type Current Read Current Read Type Usage (CCP) 05/15/2019 06/18/2019 656 Actual 658 Actual 2 SPECIAL MESSAGES Please detach and return the bottom portion with your payment. See reverse side for additional information AKE CHECKS PAYABLE TO: P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ADDRESSEE: Coffey Jesse 930 E Orange Rd Waterloo, IA 50701 ❑ Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 120783-536340 Amount Due After : 23.24 Amount Enclosed: Total Amount Due will be withdrawn from your bank account on 07/18/2019 REMIT TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO. IOWA 50704 WATERLOO WA WORKS 325 Sycamore Street P.O. Box 27 Waterloo, Iowa 50704 Customer Name: Account Number: Service Address: Coffey Jesse 120783-536340 930 E ORANGE RD STATEMENT OF SERVICES ACCOUNT SUMMARY Waterloo Water Works Services Water $10.70 Water Service Excise Tax $0.65 Water Works Subtotal $11.35 City of Waterloo Services Storm Water Fee $4.00 Garbage $9 0-5) City of Waterloo Subtotal $13.00 Billing Frequency: Billing Date: Billing Due Date: Monthly 07/25/2019 08/15/2019 Phone: (319) 232-6280 www.waterloowater.org Paee 1 of 1 CHARGE SUf ARY Previous Balance Credits/Payments Water Works Subtotal City of Waterloo Subtotal $13.00 $23.10 -$23.10 $11.35 Total Current Service Charges $24.35 Total Amount Due $24.35 Amount Due After 08/15/2019 $24.55 Previous ead Date Current Read Date us Read' v¢ous Read Type Current Read ent Read Type Usage (CCF); 06/18/2019 07/15/2019 658 Auto Estimate 0 3 u 2 0 N o^ °1' °° M1 M1 M1 'L° M1 M1 M1 1 1M1 M1 M1 M1 661 Auto Estimate 3 SPECIAL MESSAGES. Please detach and return the bottom portion with your payment. See reverse side for additional information AKE CHECKS PAYABLE TO: P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ADDRESSEE Coffey Jesse 930 E Orange Rd Waterloo, IA 50701 ❑ Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 120783-536340 Amount Due After : 24. 55 Amount Enclosed: Total Amount Due will be withdrawn from your bank account on 08/15/2019 REMIT TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO. IOWA 50704 WATERLOO WA , C WORKS 325 Sycamore Street P.O. Box 27 Waterloo. Iowa 50704 Customer Name: Account Number: Service Address: Coffey Jesse 120783-536340 930 E ORANGE RD STATEMENT OF SERVICES ACCOUNT SUMMARY Waterloo Water Works Services Water $10.70 Water Service Excise Tax $0.65 Water Works Subtotal $11.35 City of Waterloo Services Storm Water Fee $4.00 Garbage c 1y 00 City of Waterloo Subtotal $13.00 Billing Frequency: Billing Date: Billing Due Date: Monthly 08/23/2019 09/16/2019 Phone: (319) 232-6280 www.waterloowater.org Paee 1 of 1 HARG Previous Balance UMMARY Credits/Payments Water Works Subtotal City of Waterloo Subtotal $13.00 $24.35 -$24.35 $11.35 Total Current Service Charges $24.35 Total Amount Due $24.35 Amount Due After 09/16/2019 $24.55 Pr s Read Date :Current Read Date ' Previous Re d Previous R ad Type Current Re Current ad Typ tJ e {CCF)' 07/15/2019 08/15/2019 661 Auto Estimate s LL 4 U 3 0 2 N 1 O^9 O^$ O^0 O. O^� O^5 O^°' O^9 'V 'L 'L '4 '4 'L 'I. 664 Auto Estimate 3 PE AL ESSAGES Please detach and return the bottom portion with your payment. See reverse side for additional information AKE CHECKS PAYABLE P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ADDRESSEE: Coffey Jesse 930 E Orange Rd Waterloo, IA 50701 0 Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 120783-536340 Amount Due After : 24.55 Amount Enclosed: Total Amount Due will be withdrawn from your bank account on 09/16/2019 REI IT TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO, IOWA 50704 325 Sycamore Street P.O. Box 27 Waterloo, Iowa 50704 STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Paae 1 of 1 ACCOUNT SUMMARY Customer Name: Account Number: Service Address: Coffey Jesse 120783-536340 930 E ORANGE RD Billing Frequency: Billing Date: Billing Due Date: Monthly 09/27/2019 10/18/2019 Waterloo Water Works Services Water $10.70 Water Service Excise Tax $0.65 Water Works Subtotal $11.35 City of Waterloo Services Storm Water Fee $4.00 Garbage City of Waterloo Subtotal '0 $13.00 CHARGE SOMMARY Previous Balance Credits/Payments Water Works Subtotal City of Waterloo Subtotal $13.00 $24.35 -$24.35 $11.35 Total Current Service Charges $24.35 Total Amount Due $24.35 Amount Due After 10/18/2019 $24.55 Previous Read Date Current Read Date vious Read Read Type Cu Read Current Read Type u (CCF) 08/15/2019 09/18/2019 664 Actual 663 Actual 0 SPECIAL MESSAGES Please detach and return the bottom portion with your payment. See reverse side for additional information AKE CHECKS PAYABLE TO: WATERLOO WA P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 IRKS ADDRESSEE: Coffey Jesse 930 E Orange Rd Waterloo, IA 50701 ❑ Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 120783-536340 Amount Due After : 24.55 Amount Enclosed: Total Amount Due will be withdrawn from your bank account on 10/18/2019 REMIT TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO. IO WA 50704 325 Sycamore Street P.O. Box 27 Waterloo. Iowa 50704 STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Paee 1 of 1 ACCOUNT SUMMARY Customer Name: Account Number: Service Address: Coffey Jesse 120783-536340 930 E ORANGE RD Billing Frequency: Billing Date: Billing Due Date: Monthly 10/25/2019 11/18/2019 Waterloo Water Works Services Water $10.70 Water Service Excise Tax $0.65 Water Works Subtotal $11.35 City of Waterloo Services Storm Water Fee $4.00 Garbage City of Waterloo Subtotal $13.00 CHA G SUMMARY' Previous Balance Credits/Payments Water Works Subtotal City of Waterloo Subtotal $13.00 $24.35 -$24.35 $11.35 Total Current Service Charges $24.35 Total Amount Due $24.35 Amount Due After 11/18/2019 $24.55 Previous Read Date Current Read Date Previous' Read Type Current Read Cut ad Type Usage (CCF), 09/18/2019 10/15/2019 663 Auto Estimate 665 Auto Estimate 2 SPECIAL ESSAGES Please detach and return the bottom portion with your payment. See reverse side for additional information MAKE CHECKS PAYABLE TO:'. P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ADDRESSEE: Coffey Jesse 930 E Orange Rd Waterloo, IA 50701 ❑ Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 120783-536340 Amount Due After : 24.55 Amount Enclosed: Total Amount Due will be withdrawn from your bank account on 11/18/2019 MIT TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO. IOWA 50704 325 Sycamore Street P.O. Box 27 Waterloo. Iowa 50704 STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Paee 1 of 1 ACCOUNT SUMMARY Customer Name: Account Number: Service Address: Coffey Jesse 120783-536340 930 E ORANGE RD Billing Frequency: Billing Date: Billing Due Date: Monthly 11/25/2019 12/18/2019 Waterloo Water Works Services Water $10.70 Water Service Excise Tax $0.65 Water Works Subtotal $11.35 City of Waterloo Services Storm Water Fee $4.00 Garbager�$9_00_ City of Waterloo Subtotal $13.00 CHARGE SUMMARY Previous Balance Credits/Payments Water Works Subtotal City of Waterloo Subtotal $13.00 $24.35 -$24.35 $11.35 Total Current Service Charges $24.35 Total Amount Due $24.35 Amount Due After 12/18/2019 $24.55 Previous Read Date) rent ad Date Previous Read previous Read Type Current Read'. Ci ent Read Type ge (CCF) 10/15/2019 11/16/2019 665 Auto Estimate 667 Auto Estimate 2 SPECIAL. MESSAGES Please detach and return the bottom portion with your payment. See reverse side for additional information MAKE CHECKS PAYABLE TO: P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ADDRESSEE. Coffey Jesse 930 E Orange Rd Waterloo, IA 50701 ❑ Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 120783-536340 «'r 1 Amount Due After : 24.55 Amount Enclosed: Total Amount Due will be withdrawn from your bank account on 12/18/2019 EMIT TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO. IOWA 50704 WATERLOO 325 Sycamore Street P.O. Box 27 Waterloo. Iowa 50704 iORKS STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Page 1 of 1 ACCOUNT SUMMARY Customer Name: Account Number: Service Address: Coffey Jesse 120783-536340 930 E ORANGE RD Billing Frequency: Billing Date: Billing Due Date: Monthly 12/30/2019 01/22/2020 Waterloo Water Works Services Water $10.70 Water Service Excise Tax $0.65 Water Works Subtotal $11.35 City of Waterloo Services Storm Water Fee Garbage City of Waterloo Subtotal $13.00 CHARGE SUMMARY Previous Balance Credits/Payments Water Works Subtotal City of Waterloo Subtotal $13.00 $24.35 -$24.35 $11.35 Total Current Service Charges $24.35 Total Amount Due $24.35 Amount Due After 01/22/2020 $24.55 Previous Read Date Current ead Date Re'. Previous Read Type Cur Cu Read Type usage (CCF) 11/16/2019 12/23/2019 667 Actual \0 \0 1 . \ \' NA NZ 19 ^9. \A ^9 9 667 Actual 0 PECIAL MESSAGES Please detach and return the bottom portion with your payment. See reverse side for additional information FAKE CIiECKCS PAYABLE TO: P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ADDRESSEE: Coffey Jesse 930 E Orange Rd Waterloo, IA 50701 ❑ Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 120783-536340 Amount Due After : 24.55 Amount Enclosed: Total Amount Due will be withdrawn from your bank account on 01/22/2020 RE T;TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO, IOWA 50704 WATERLOO W ; [ WORKS 325 Sycamore Street P.O. Box 27 Waterloo. Iowa 50704 STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Paee 1 of 1 ACCOUNT SUMMARY Customer Name: Account Number: Service Address: Coffey Jesse 120783-536340 930 E ORANGE RD Billing Frequency: Billing Date: Billing Due Date: Monthly 01/24/2020 02/14/2020 Waterloo Water Works Services Water $10.89 Water Service Excise Tax $0.66 Water Works Subtotal $11.55 City of Waterloo Services Storm Water Fee $4.00 Garbage $1 00 Yard Waste / Recycle Site Maintenance Fee City of Waterloo Subtotal $17.33 CHARGE St)t iARY' Previous Balance Credits/Payments Water Works Subtotal City of Waterloo Subtotal $17.33 $24.35 -$24.35 $11.55 Total Current Service Charges $28.88 Total Amount Due $28.88 Amount Due After 02/14/2020 $29.08 Previous Read Date Current Read Date Previous Read Previous Read Type Current Read Current Read Type Usage (CCF) 12/23/2019 01/20/2020 667 Auto Estimate 668 Auto Estimate 1 3.2 SPECIAL MESSAGES Yard Waste/Recycling rate increased $3/mo to $4/mo **Mandatory Yard Waste/Recycling Site Maint Fee $5/ mo prorated effective 1/1/20 on this bill** Questions -call Garbage- Sanitation @291-4455 z.e „, a g'? m0.8 4 °a o^ oti d> d• do do 6 os Q2 0 .. . o^ Please detach and return the bottom portion with your payment. See reverse side for additional information MAI<E CHECKS PAYABLE TO: P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 A FDRESSEE:' Coffey Jesse 930 E Orange Rd Waterloo, IA 50701 Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 120783-536340 Amount Due After : 29.08 Amount Enclosed: Total Amount Due will be withdrawn from your bank account on 02/14/2020 REMIT TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO. IOWA 50704 1/28/2020 20200128_085422_55300.html Rite Environment,/, Inc 110 Dunham P1. Waterloo, IA 50703 319-235-7401 BILL TO: COFFEY, JESSE 930 E ORANGE RD WATERLOO, IA 50701 DATE DESCRIPTION Invoice History INVOICE it TOTAL BALANCE 01/01/20 QUARTERLY WASTE HAULING S 31657 46.50 10/10/19 QUARTERLY WASTE HAULING S 28636 46.50 07/15/19 THIRD QUARTER WASTE HAULI 24687 46.50 04/09/19 QUARTERLY WASTE HAULING S 20742 46.50 01/01/19 QUARTERLY WASTE HAULING 5 17721 46.50 10/31/18 QUARTERLY WASTE HAULING S 13999 46.50 06/30/18 QUARTERLY WASTE HAULING S 8310 46.50 04/10/18 QUARTERLY WASTE HAULING 5 7447 46.50 DESCRIPTION Services History COUNT TOTAL PAYMENT - THANK YOU RESIDENTIAL MSW 9-372.00 20 372.00 Generated on Jan 28 2020 9:54AM by COREASP\REI User1 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 file:///C:/Users/jc24762/Downloads/20200128_085422_55300.html 1/1 Exemption year: 2020 PRIVATE HAULER GARBAGE EXEMPTION APPLICATION RESIDENTIAL CUSTOMERS ONLY CITY OF WATERLOO, IOWA Date Jan 28 2020 Applicant's Name: Jesse Coffey Telephone N Billing Address: 930 E Orange Rd. Waterloo, Iowa 50701 Address of Exemption: 930 E Orange Rd. Waterloo, Iowa 50701 Water Works Account No.: 120783-536340 I request an exemption from Garbage Fees during the current Calendar Year. I employ the services of a licensed trash haule Only the location where the trash hauler picks up garbage and trash will q alif the exemption. gnature Company Name a licensed trash hauler in the City of Waterloo, Iowa, and that we pick up garbage and refuse at the following location: TO BE COMPLETED BY LICENSED GARBAGE AND TRASH HAULER: (we) Tik.AvfrOnmeAtodi, hereby declare that we are Beginning Ending Address Location of Date of Date of Customer's Name Garbage/Trash Pick-U Contract Contract (jeSsc. al.50 uC -f-°I CONT PERIOD 0 MUST COVER AT CURRENT CALENDAR YEAR We understand that the above information is used by the Clerk's Office in Waterloo, City Hall, 715 Mulberry Street, to determine eligibility for exemption from garbage fees for the current calendar year. I, the undersigned, declare under penalty of perjury that I have examined this claim, including all statements and above schedule, and to the best of my knowledge and belief, it is a TRUE, CORRECT AND COMPLETE claim, and that I agree to comply with all ordinances and policies of the City of Waterloo and the Black Hawk County Solid Waste Commission. In the event that the above person discontinues service with said company during the current calendar year, we hereby agree to notify the Clerk's Office of this event by call4.ng 291-4323. Dat YJ ignature orized Company Representative Company's Address " /i W1/50?03 Garbage & Trash Hauler's Permit License (issued by Black Hawk County) PLEASE RETURN TO: CITY CLERK & FINANCE OFFICE 715 MULBERRY STREET WATERLOO, IOWA 50703 City Clerk's Copy - white Customer's Copy - yellow CITY OF WATERLOO Committee Communication Finance Committee Meeting: 02/10/2020 Prepared: Nancy Higbv Dept. Head Signature: Kelley Felchle SUBJECT: Refunds Submitted by: Kelley Felchle, City Clerk Recommended Committee Action: Approval of the following refunds: Refund request in the amount of $360 for duplicate yard waste service fees paid in error on a property located at 1617 Bertch Avenue. Summary Statement: This property was erroneously charged for two yard waste cans. The Sanitation Department has confirmed this and recommends approval of refund request. Expenditure Required: As indicated above Source of Funds: GARBAGE REFUND 525-15-5400-1785 Policy Issue: None Alternative: Not give the reimbursement. Background Information: file:/Ili{:ACLERKDAT\Council&FinanceCommunicationslCouncilCommunieationstoCouncil&OFinancey2015\Fi,nanceConununi cation\ 030915.garbage.refund. doe 10/29/2019 Attention: Finance Committee I was charged for 2 blue carts in error by the Waterloo Water Works. I've only had 1 blue cart at my residence since 2004 (can # 04 005116). 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Box 27 Waterloo, Iowa 50704 Customer Name: Account Number: Service Address: Hamlyn Brad 119683-514478 1617 BERTCH AVE STATEMENT OF SERVICES ACCOUNT'SUMMARY Waterloo Water Works Services Water $31.45 Water Service Excise Tax Water Works Subtotal 33.66 $33.66 City of Waterloo Services Sanitary Sewer Storm Water Fee Garbage Yard Waste City of Waterloo Subtotal ro Previous Read Date Current Read Date 09/09/2015 12/09/2015 $51.95 $8.25 $31.50 $18.00 $109.70 Billing Frequency: Billing Date: Billing Due Date: Quarterly 01/06/2016 01/27/2016 Phone: (319) 232-6280 www.waterloowa ter. o rg Paee l of l CHARGE SUMMARY Previous Balance Credits/Payments Water Works Subtotal City of Waterloo Subtotal $109.70 $145.14 -$145.14 $33.66 Total Current Service Charges $143.36 Total Amount Due $143.36 Amount Due After 01/27/2016 $143.36 Previous Read ' Previous Read Type 131 Actual Current Read Curren 145 Read Type Usage(CCF.) Actual 14 SPECIAL MESSAGES Please detach and return the bottom portion with your payment. See reverse side for additional information MAKE CHECKS PAYABLE TO: WATERLO0 WATER WORKS P.O. Box 27 Waterloo, Iowa 50704 Phone. (319) 232-6280 ADDRESSEE: Hamlyn Brad 1617 Bertch Ave Waterloo, IA 507021707 Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: Amount Due After : PPOWWWWW Amount Enclosed: 119683-514478 REMIT TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO, I O WA 50704 43.36 143.36 _7/2016 WATERLOO WATialC3RK5 325 Sycamore Street P.O. Box 27 Waterloo, Iowa 50704 STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Paee 1 of 1 ACCOUNT SUMMARY Customer Name: Account Number: Service Address: Hamlyn Brad 119683-514478 1617 BERTCH AVE Waterloo Water Works Services Water $35.70 Water Service Excise Tax $2.50 Water Works Subtotal $38.20 City of Waterloo Services Sanitary Sewer $56.55 Storm Water Fee $8.25 Garbage $31.50 Yard Waste $18.00 City of Waterloo Subtotal $114.30 C; r`L \. C c. l.C'u Billing Frequency: Billing Date: Billing Due Date: Quarterly 03/30/2016 04/20/2016 CHARGE SUMMARY Previous Balance Credits/Payments Water Works Subtotal City of Waterloo Subtotal $114.30 $143.36 -$143.36 $38.20 Total Current Service Charges $152.50 Total Amount Due $152.50 Amount Due After 04/20/2016 $152.50 Pr i0us Read Date Current Read Date Previous Read Previous Read Type Current Read Cu ent ReadType. Usage (CCF) 12/09/2015 03/08/2016 145 Actual 160 Actual 15 SPECIAL MESSAGES Please detach and return the bottom portion with your payment. See reverse side for additional information MAKE CHECKS PAYABLE TO: WATERLOO A P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ORKS ADDRESSEE: Hamlyn Brad 1617 Bertch Ave Waterloo, IA 507021707 ❑ Please check box if contact Information requires updating and indicate the change(s) on reverse side Account Number: 119683-514478 Tota)Amount Due: "' 152.50 Amount Due After : 152.50 BillingfluaDate:. IM/20/20 6 Amount Enclosed: REMIT TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO, IOWA 50704 WATERLOO WA ER' ORKS 325 Sycamore Street P.O. Box 27 Waterloo, Iowa 50704 STATEMENT OF SERVICES Phone: (319) 232-6280 www,wate rloowate r. o rg Page 1 of 1 ACCOUNT SUMMARY Customer Name: Account Number: Service Address: Hamlyn Brad 119683-514478 1617 BERTCH AVE Billing Frequency: Billing Date: Billing Due Date: Quarterly 06/28/2016 07/20/2016 Waterloo Water Works Services Water $33.95 Water Service Excise Tax $2.38 Water Works Subtotal $36.33 City of Waterloo Services Sanitary Sewer $54.25 Storm Water Fee $8.25 Garbage $31.50 Yard Waste $18.00 City of Waterloo Subtotal $112.00 C L CHARGE SUMMARY Previous Balance Credits/Payments Water Works Subtotal City of Waterloo Subtotal $112.00 $152.50 -$152.50 $36.33 Total Current Service Charges $148.33 Total Amount Due $148.33 Amount Due After 07/20/2016 $155.63 Pre. ious Read Date Current Read Date Previous Read Previous Read Type Current Read Cur'rent•Read Type Usage (CCF) 03/08/2016 06/09/2016 160 Actual 174 Actual 14 SPECIAL MESSAGES Please detach and return the bottom portion with your payment. See reverse side for additional information MANE CHECKS PAYABLE TO: WATERLOO WATER WORKS P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ADDRESSEE! Hamlyn Brad 1617 Bertch Ave Waterloo, IA507021707 ❑ Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 119683-514478 Total Amount Due: 148.33 Amount Due After : 155.63 Billing Due Date: 07/2O/2416 Amount Enclosed: REMIT TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO. IOWA 50704 325 Sycamore Street P.O. Box 27 Waterloo, Iowa 50704 STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Paee 1 of 1 ACCOUNT SUMMARY' Customer Name: Account Number: Service Address: Hamlyn Brad 119683-514478 1617 BERTCN AVE Billing Frequency: Billing Date: Billing Due Date: Quarterly 09/28/2016 10/20/2016 Waterloo Water Works Services Water $39.20 Water Service Excise Tax $2.75 Water Works Subtotal $41.95 City of Waterloo Services Sanitary Sewer $56.55 Storm Water Fee $8.25 Garbage $31.50 Yard Waste $18.00 City of Waterloo Subtotal $114.30 CHARGE SUMMARY Previous Balance Credits/Payments Water Works Subtotal City of Waterloo Subtotal $114.30 $148.33 -$148.33 $41.95 Total Current Service Charges $156.25 Total Amount Due $156.25 Amount Due After 10/20/2016 $163.93 Pre'Vious'Read Date Current Read -Date Previous Read Previous Read Type Current Read. Current Read Type Usage (CCF) 06/09/2016 09/08/2016 174 Actual 10 u MIN OEM MN M E M M EOM WM WM ♦e �p �5 �y �5 �5 �� ^� ry0 �O ,�O ,�0 ,�O ,y0 ry0 h0 ,�O 191 Actual 17 SPECIAL MESSAGES Please detach and return the bottom portion with your payment. See reverse side for additional information MAKE CHECKS PAYABLE TO. WATERLOO WA ER W?RKS >�---.r-ter P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ADDRESSEE: Hamlyn Brad 1617 Bertch Ave Waterloo, IA 507021707 ❑ Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 119683-514478 Total Amount Due: 156.25 Amount Due After: 163.93 Billing Dua Date: 30/20/2016 Amount Enclosed: REMIT To WATERLOO WATER WORKS P.O. BOX 27 WATERLOO, I0 WA 50704 WATERLOO WA WORKS 325 Sycamore Street P.O. Box 27 Waterloo. Iowa 50704 STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Paee1of1 ACCOUNVSUMMARY Customer Name: Account Number: Service Address: Hamlyn Brad 119683-514478 1617 BERTCH AVE Billing Frequency: Billing Date: Billing Due Date: Quarterly 12/29/2016 01/23/2017 Waterloo Water Works Services Water $35.70 Water Service Excise Tax $2.50 Water Works Subtotal $38.20 City of Waterloo Services Sanitary Sewer $56.55 Storm Water Fee $8.25 Garbage 531.50 Yard Waste $18.00 City of Waterloo Subtotal $114.30 • wus ead Date Current Redd Date CHARGE SUMMARY �cvwu] omauLC y156.15 Credits/Payments -$156.25 Water Works Subtotal City of Waterloo Subtotal $114.30 $38.20 Total Current Service Charges $152.50 Total Amount Due $152.50 Amount Due After 01/23/2017 $160.01 Previous Read Previous Read Type Current Read Current Read Type Usage (CCF) 09/08/2016 12/13/2016 191 Actual 18 014 G 12 tl 10 m M 111111111 d• 0 206 Actual 15 SPECIAL MESSAGES Please detach and retum the bottom portion with your payment. See reverse side for additional information MAKE CHECKS PAYABLE TO: WATERLOO WATER 1loRKS P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ADDRESSEE: Hamlyn Brad 1617 Bertch Ave Waterloo, IA 507021707 ❑ Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 114683-514478 Total Amount Due: 152.50 Amount Due After : 160.01 Biil rWM*1* -7,1 `#$ # - 1/23/2D17 Amount Enclosed: REMIT TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO, IOWA 50704 WATERLOO WA C WORKS 325 Sycamore Street P.O. Box 27 Waterloo. Iowa 50704 STATEMENT OF SERVICES Phone: (315) 232-6280 www.waterloowater.org Paee 1 of 1 ACCOUNT SUMMARY Customer Name: Account Number: Service Address: Hamlyn Brad 119683-514478 1617 BERTCH AVE Billing Frequency: Billing Date: Billing Due Date: Quarterly 03/28/2017 04/18/2017 Waterloo Water Works Services Water $32.20 Water Service Excise Tax $2.26 Water Works Subtotal $34.46 City of Waterloo Services Sanitary Sewer $51.95 Storm Water Fee 58.25 Garbage $31.50 Yard Waste $18.00 City of Waterloo Subtotal $109.70 — ) CHARGE SUMMARY Previous Balance Credits/Payments Water Works Subtotal City of Waterloo Subtotal $109.70 $152.50 -$152.50 $34.46 Total Current Service Charges $144.16 Total Amount Due $144.16 Amount Due After 04/18/2017 $151.26 D.t- L r P -\IGU R P •vi. R- T Lot R . Current Read Type Usage (CCF) 12/13/2016 03/14/2017 206 Actual 219 Actual 13 SPECIAL MESSAGES Please detach and retum the bottom portion with your payment. See reverse side for additional information MAKE CHECKS PAYABLE TO: WATERLOO W�tEtRKS P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ADDRESSEE: Hamlyn Brad 1617 Bertch Ave Waterloo, IA 507021707 ❑ Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 119683-514478 Tutu WOUnt Due: 144.16 Amount Due After : 151.26 BillIng lkiti' , 04/18/2017 Amount Enclosed: REMIT TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO. IOWA 50704 WATERLOO WA' 325 Sycamore Street P.O. Box 27 Waterloo, Iowa 50704 WORKS STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Pate 1 of 1 ACCCUNT.SUMMARY Customer Name: Account Number: Service Address: Hamlyn Brad 119683-514478 1617 BERTCH AVE Billing Frequency: Billing Date: Billing Due Date: Quarterly 06/28/2017 07/20/2017 Waterloo Water Works Services Water Water Service Excise Tax Water Works Subtotal $30.45 $2.14 $32.59 City of Waterloo Services Sanitary Sewer $49.65 Storm Water Fee $8.25 Garbage $31.50 Yard Waste $18.00 City of Waterloo Subtotal $107.40 CHARGE SUMMARY., Previous Balance Credits/Payments Water Works Subtotal City of Waterloo Subtotal $107.40 $144.16 -$144.16 $32.59 Total Current Service Charges $139.99 Total Amount Due $139.99 Amount Due After 07/20/2017 $146.88 Pr gysRe-. D- !'. Ct P •vious R- d P_ l''R- T' i.R . .Current Read Type Usage (CCF)" 03/14/2017 06/12/2017 219 Actual 231 Actual 12 SPECIAL MESSAGES Please detach and return the bottom portion with your payment. See reverse side for additional information MAKE,CHECKS PAYABLE TO: WATERLOO " VAJ R W{3RKS P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ADDRESSEE: Hamlyn Brad 1617 Bertch Ave Waterloo, IA 507021707 ❑ Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 119683-514478 Total Amount Due; ° 139.99 Amount Due After : 146.88 Billing Due Date O7/,2Of2017 Amount Enclosed: REMIT TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO, IOWA 50704 WATERLOO WA t Vv`0RK5 325 Sycamore Street P.O. Box 27 Waterloo, Iowa 50704 STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Page 1 of 1 AecOUNT`SI 1 RY Customer Name: Account Number: Service Address: Hamlyn Brad 119683-514478 1617 BERTCH AVE Billing Frequency: Billing Date: Billing Due Date: Quarterly 09/28/2017 10/20/2017 Waterloo Water Works Services Water $39.20 Water Service Excise Tax $2.75 Water Works Subtotal $41.95 City of Waterloo Services Sanitary Sewer $51.95 Storm Water Fee $8,25 Garbage $31.50 Yard Waste $18.00 City of Waterloo Subtotal $109.70 l 1 C . CHARGE SUMMARY rrevious balance Credits/Payments Water Works Subtotal City of Waterloo Subtotal $109.70 5139.99 -$139.99 $41.95 Total Current Service Charges $151.65 Total Amount Due $151.65 Amount Due After 10/20/2017 5159.1.0 Ydt•u R-.. D.te Cur tR•..D.t- P cvi.0 R .. •P .vi. i R Current Read Type Usage (CCF) 06/12/2017 09/12/2017 231 Actual 248 Actual 17 SPECIAL MESSAGES Please detach and return the bottom portion with your payment. See reverse side for additional information MAKE CHECKS PAYABLE TO: WATERLOO WATER WORKS P.D. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ADDRESSEE:. Hamlyn Brad 1617 Bertch Ave Waterloo, IA 507021707 ❑ Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 119683-514478 Total Amount Due: 151.65 Amount Due After : 159.10 8illingflue Date: 0/2012017 Amount Enclosed: REMIT. TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO, IOWA 50704 WATERLOO WA C .WORKS 325 Sycamore Street P.O. Box 27 Waterloo, Iowa 50704 STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Paae 1 of 1 ACCI»IVTSUMMARY " Customer Name: Account Number: Service Address: Hamlyn Brad 119683-514478 1617 BERTCH AVE Waterloo Water Works Services Water $28.70 Water Service Excise Tax $2.01 Water Works Subtotal $30.71 City of Waterloo Services Sanitary Sewer $47.35 Storm Water Fee $8.25 Garbage $31.50 Yard Waste $18.00 City of Waterloo Subtotal $105.10 Billing Frequency: Billing Date: Billing Due Date: Quarterly 12/29/2017 01/22/2018 CHARGESUMMARY r, CVIUU oaiau Lc $151.65 Credits/Payments Water Works Subtotal City of Waterloo Subtotal $105.10 -$151.65 $30.71 Total Current Service Charges $135.81 Total Amount Due $135.81 Amount Due After 01/22/2018 $142.51 iousRead Date Current Read Date Previous Read' Previous'Read Type Current Read Current•Read.Type, Usage(CCF). 09/12/2017 12/11/2017 248 Actual 259 Actual 11 SPECIACMESSAGES . Please detach and return the bottom portion with your payment. See reverse side for additional information MAKE CHECKS PAYABLE TO: WATERLOO? WATZZORKS P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ADDRESSEE: Hamlyn Brad 1617 Bertch Ave Waterloo, IA 507021707 ❑ Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 119683-514478 Total Amount Dues 135.81 Amount Due After : 142.51 Etiiling Due Date• 01/22/2018 Amount Enclosed: REMIT TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO, IOWA 50704 WATERLOO WA WORKS 325 Sycamore Street P.O. Box 27 Waterloo, Iowa 50704 STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Paee 1 of 1 ACCOUNT SUMMARY Customer Name: Account Number: Service Address: Hamlyn Brad 119683-514478 1617 BERTCH AVE Waterloo Water Works Services Water $33.49 Water Service Excise Tax $2.35 Water Works Subtotal $35.84 City of Waterloo Services Sanitary Sewer $49.65 Storm Water Fee $8.25 Garbage $31.50 Yard Waste $18.00 City of Waterloo Subtotal $107.40 fr- I Billing Frequency: Billing Date: Billing Due Date: Quarterly 03/27/2018 04/17/2018 CHARGE SUMMARY rlevlous Dara11LC Credits/Payments Water Works Subtotal City of Waterloo Subtotal $107.40 a135.2f1 -$135.81 $35.84 Total Current Service Charges $143.24 Total Amount Due $143.24 Amount Due After 04/17/2018 $150.28 r Pr sous Read Date CurrentRead Date Previous Read Previous Read Type ' ' Current Read Current Read Type Usage (CCF) 12/11/2017 03/12/2018 259 Actual 271 Actual 12 SPECIAL MESSAGES Please detach and return the bottom portion with your payment. See reverse side for additional Information MAKE CHECKS PAYABLE TO: WATERLOO WATWORKS P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ADDRESSEE: Hamlyn Brad 1617 Bertch Ave Waterloo, IA 507021707 ❑ Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 119683-514478 Total Amount Due: 143.24 Amount Due After : 150.28 Billing Due Date:1/17/2018 Amount Enclosed: REMIT TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO, IOWA 50704 325 Sycamore Street P.O. Box 27 Waterloo, Iowa 50704 Customer Name: Account Number: Service Address: Hamlyn Brad 119683-514478 1617 BERTCH AVE STATEMENT OF SERVICES ACCOUNT SUMMARY Waterloo Water Works Services Water $33.49 Water Service Excise Tax $2.35 Water Works Subtotal $35.84 City of Waterloo Services Sanitary Sewer $49.65 Storm Water Fee $8.25 Garbage $31.50 Yard Waste $18.00 City of Waterloo Subtotal $107.40 Billing Frequency: Billing Date: Billing Due Date: Quarterly 06/28/2018 07/20/2018 Phone: (319) 232-6280 www.waterloowater.org Paae 1 of 1 CHARGE SUMMARY Previous Balance 5143.24 Credits/Payments -$143.24 Water Works Subtotal City of Waterloo Subtotal $107.40 $35.84 Total Current Service Charges $143.24 Total Amount Due $143.24 Amount Due After 07/20/2018 $150.28 Previous Read Date Current Read Date Previous Read - 8rewous Read Type Current Read' Current R2ad Type Usage (CCF) 03/12/2018 06/12/2018 271 Actual 283 Actual 12 SPECIAL MESSAGES Please detach and retum the bottom portion with your payment. See reverse side for additional information MAKE CHECKS PAYABLE TO: WATERLOOW RKS P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ADDRESSEE: Hamlyn Brad 1617 Bertch Ave Waterloo, IA 507021707 ❑ Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 119683-514478 Total Amount Dues`` 143,2.4 Amount Due After : 150.28 Billing Due Date: 07/20/2018 Amount Enclosed: REMITTO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO. IOWA 50704 WATERLOO WA c WORKS 325 Sycamore Street P.O. Box 27 Waterloo, Iowa 50704 STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Page 1 of 1 ACCOUNT SUMMARY Customer Name: Account Number: Service Address: Hamlyn Brad 119683-514478 1617 BERTCH AVE Billing Frequency: Billing Date: Billing Due Date: Quarterly 09/27/2018 10/18/2018 Waterloo Water Works Services Water $35.42 Water Service Excise Tax $2.13 Water Works Subtotal $37.55 City of Waterloo Services Sanitary Sewer $49.65 Storm Water Fee $8.25 Garbage $31.50 Yard Waste $18.00 City of Waterloo Subtotal $107.40 CHARGE. SUMMARY Previous Balance Credits/Payments Water Works Subtotal City of Waterloo Subtotal $107.40 $143.24 -$143.24 $37.55 Total Current Service Charges $144.95 Total Amount Due $144.95 Amount Due After 10/18/2018 $152.09 Pre$ipusRead Date, Current Read Date Previous Read Previous'Read Type Current Read Current Read Type 'Usage (CCF) 06/12/2018 09/11/2018 283 Actual 296 Actual 13 SPECIAL MESSAGES Please detach and return the bottom portion with your payment. See reverse side for additional information MAKE CHECKS PAYABLE TO: WATERLOG) WAT WORKS P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ADDRESSEE: Hamlyn Brad 1617 Bertch Ave Waterloo, IA 507021707 ❑ Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 119683-514478 Total Amount Due: 144.95 Amount Due After : 152.09 Billing Due Dats;;--:' 1/18f20j8 Amount Enclosed: REMIT T0: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO, IOWA 50704 WATERLOO WA 325 Sycamore Street P.O. Box 27 Waterloo, Iowa 50704 DORM STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Paee 1 of 1 'ACZOUNT SUMMARY ;ustomer Name: ccount Number: ervice Address: Hamlyn Brad 119683-514478 1617 BERTCH AVE Waterloo Water Works Services Water Water Service Excise Tax Water Works Subtotal City of Waterloo Services Sanitary Sewer Storm Water Fee Garbage Yard Waste City of Waterloo Subtotal $33.49 $2.01 $35.50 $49.65 $8.25 $31.50 $18.00 $107.40 Billing Frequency: Billing Date: Billing Due Date: Quarterly 12/27/2018 01/18/2019 CHARGE SUMMARY rreviuus oaiance Credits/Payments Water Works Subtotal City of Waterloo Subtotal $107.40 5144.y5 -$144.95 $35.50 Total Current Service Charges $142.90 Total Amount Due $142.90 Amount Due After 01/18/2019 $149.94 PreviouSRead Date Current Read Date - •Previous Read Previous Read Type Current Read Crkrrent Read Type Usage (CCF) 09/11/2018 12/12/2018 296 Actual 308 Actual 12 SPECIAL MESSAGES Please detach and return the bottom portion with your payment. See reverse side for additional information MAKE CHECKS PAYABLE TO: WATERLOO WATZE WORKS P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ADDRESSEE: Hamlyn Brad 1617 Bertch Ave Waterloo, IA 507021707 ❑ Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 119683-514478 Total Amount Due: < 142.90 Amount Due After : 149.94 Billing Dle Date: 01/i8/019 Amount Enclosed: REMIT TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO. IOWA 50704 WATERLOO WA Wt RKS 325 Sycamore Street P.O. Box 27 Waterloo, Iowa 50704 STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Page 1 of 1 ACCOUNT SUMMARY Customer Name: Account Number: Service Address: Hamlyn Brad 119683-514478 1617 BERTCH AVE Waterloo Water Works Services Water $29.10 Water Service Excise Tax $1.99 Water Works Subtotal $31.09 City of Waterloo Services Sanitary Sewer $49.80 Storm Water Fee $8.25 Garbage $31.50 Yard Waste $18.00 City of Waterloo Subtotal $107.55 Billing Frequency: Quarterly Billing Date: 03/26/2019 Billing Due Date: 04/16/2019 CHARGE SUMMARY rrevious oiiance Credits/Payments Water Works Subtotal City of Waterloo Subtotal $107.55 5142.90 -$142.90 $31.09 Total Current Service Charges $138.64 Total Amount Due $138.64 Amount Due After 04/16/2010 $145.68 Previous Read Date Current Read, Date Previous. Read Previous Read Type : `. Current Read Current Read Type Usage(CCF) 12/12/2018 03/12/2019 308 Actual 16 16 lL 1< 012 10 v 9 m 4 0t) Lamb ho�B 319 Actual 11 SPECIAL MESSAGES Please detach and return the bottom portion with your payment. See reverse side for additional information MAKE CHECKS PAYABLE TO: WATERLOO WA WORKS P.O. Box 27 Waterloo, Iowa 50704 Phone. (319) 232-6280 ADDRESSEE: Hamlyn Brad 1617 Bertch Ave Waterloo, IA 507021707 ❑ Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 119683-514478 Total Amount Due: 138.64 Amount Due After : 145.68 Billing Due Date:y -? r 04/16/2019 Amount Enclosed: REMIT TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO. IOWA 50704 ATE RIt� ORKS 325 Sycamore Street P.O. Box 27 Waterloo, Iowa 50704 ustomer Name: Account Number: ervice Address: Hamlyn Brad 119683-514478 1617 BERTCH AVE STATEMENT OF SERVICES Waterloo Water Works Services Water $29.10 Water Service Excise Tax $1.99 Water Works Subtotal $31.09 City of Waterloo Services Sanitary Sewer $49.80 Storm Water Fee $8.25 Garbage $31.50 Yard Waste $18.00 City of Waterloo Subtotal $107.55 Billing Frequency: Billing Date: Billing Due Date: Quarterly 06/26/2019 07/18/2019 Phone: (319) 232-6280 www.waterloowater.org Paee 1 of 1 CHARGE SUMMARY Prnvinn< RaIa Credits/Payments a 14L./U -$142.70 Water Works Subtotal $31.09 City of Waterloo Subtotal $107.55 Total Current Service Charges $138.64 Total Amount Due $138.64 Amount Due After 07/18/2019 $145.68 `;Pr, ions Read Date6 Current Read Dale Previbus Read Previous Read Type Current Read j Current Read Type Usage(CCF) 03/12/2019 06/11/2019 319 Actual 330 Actual 11 SPECIAL MESSAGES Please detach and return the bottom portion with your payment. See reverse side for additional information MAKE CHECKS PAYABLE TO: WATERLOO W , - f RKS P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ADDRESSEE: Hamlyn Brad 1617 Bench Ave Waterloo, IA 507021707 ❑ Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 119683-514478 Total Amount Due: 138.64 Amount Due After : 145.68 ellling Due Date„ '= 07/18/2019 Amount Enclosed: REMIT TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO. I O W A 50704 WATERLOO WA :[ WORKS 325 Sycamore Street P.O. Box 27 Waterloo. Iowa 50704 STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Paee 1 of 1 Customer Name: Account Number: Service Address: Hamlyn Brad 119683-514478 1617 BERTCH AVE :4C�QUNT SUMIy1ARY Billing Frequency: Billing Date: Billing Due Date: Quarterly 09/27/2019 10/18/2019 Waterloo Water Works Services Water $39.25 Water Service Excise Tax $2.36 Water Works Subtotal $41.61 City of Waterloo Services Sanitary Sewer $52.29 Storm Water Fee $12.00 Garbage $31.50 Yard Waste $18.00 City of Waterloo Subtotal $113.79 CHARGE SUMMARY ri CVIUUO oma}ILt Credits/Payments Water Works Subtotal City of Waterloo Subtotal $113.79 5142.70 -$142.70 $41.61 Total Current Service Charges $155.40 Total Amount Due $155.40 Amount Due After 10/18/2019 $163.05 Pc-+ipys'Read Date Current Read bate Previous Read Previous Read Type Current Read ' Current Read Type t sage (CCF) 06/11/2019 09/13/2019 330 Actual 344 Actual 14 SPECIAL MESSAGES Please detach and return the bottom portion with your payment. See reverse side for additional information MAKE CHECKS PAYABLE TO:. WATERLOO WA.46LVORKS P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ADDRESSEE: Hamlyn Brad 1617 Bertch Ave Waterloo, IA 507021707 0 Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 119683-514478 Total Amount Due: ' 155.40 Amount Due After : 163.05 Billing a Oaten' ; a;' 10/18/2019 Amount Enclosed: REMIT TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO, IOWA50704 CITY OF WATERLOO Committee Communication Finance Committee Meeting: 02/10/2020 Prepared: Nancy Higby Dept. Head Signature: Kelley Felchle SUBJECT: Refunds Submitted by: Kelley Felchle, City Clerk Recommended Committee Action: Approval of the following refunds: Refund request in the amount of $45 for duplicate yard waste service fees paid in error on a property located at 617 W 11t Street. Summary Statement: This property was erroneously charged for two yard waste cans. The Sanitation Department has confirmed this and recommends approval of refund request. Expenditure Required: As indicated above Source of Funds: GARBAGE REFUND 525-15-5400-1785 Policy Issue: None Alternative: Not give the reimbursement. Background Information: file:///K:ACLERKDAT\Council&FinanceCommun ications\CouncileomtnunicationstoCouncil&OF finance\2015\FinanceCommuni cation \030915.earbage.refund.doc Transactions Services Equipment ri File Edit Tools Additional Help W Save 10 Clear Next ID " Redisplay Bills Account Search Cashiering Location 118770 Credit Memos Description 13300580 Customer Contact Log Company Deposits Location Clan I RES-WATERLOO Account Write Letters Messages CitvP'W Waterloo Water Works Past Due $0.00 B17 W 11TH ST WATERLOO IA 50702-1623 ';' Current $0.00 Unposted $0.00 Account Balance $0.00 +j one CENTRAL Meter Reading Adjustment Customer 5080M-Zona Richards Meter Readings Maiing Addre Meter Switch Credit Retina Miscellaneous Charges _.. New Connection Payments "I. Service Orders Service No Meter Spec Pymt Arrange (SPA) WATERL.-. 1 68772513 Voids WATERL... 2 68722513 Capacity Calculation '*WATERL... 3 Change Route If WATERL.-. 4 WATERL-.. 5 Meter / Eq uipment Meter History WATERL.. 7 WATERL... 6 Meter Manager Meter Reading Hist. Adjust < L Piping Reactivate Service Equipment 62476667R Disconnect... 617 W 11 th St Waterloo IA USA 50702-1623 P1+1(319) 233.2472 Ext. 0000 Call. Agency Balance $0.00 SSN >OCSM-9814 Consumption Analysis Remote ID Rate 62476667 WWW-WATER W W W-SEWER W W W-STORM 4WWV-GARB-A wwW-raw WWW-YWM W WW-YW Statements m MuhipL.. 1.00000 1.00000 1.00000 1.00000 1.00000 1.00000 1.00060 Services Last Payment 1/9/2029 $126.101 Deposits 80.00 -,4 Additional Route Sequ-.. Connected ROUTE53 1330... 3/13/1969 ROUTE53 3/13/1969 ROUTE53 3/13/1969 ROUTE53 3/13/1969 ROUTE53 7/18/2003 ROUTE53 1/1/2020 ROUTE53 6/1/2018 II Refresh St A A A A A A 9/10/2019 In Equipment Type Connected Disconnect... Service Category Base Meter Model Serial Num.. Other 6/9/2008 Water REGISTER 62476667 14 / a :118770-> 617W 11TH ST WATERLOO IA 50702-1E23 ->Zona Richards 3012020 Re Show History Seaaer Srormorater Fire Protection SanliatIon Non 5 ,ecitic 39(a° b U d2- ha b tr Nticire Witteo iekt gee Thursday, Jan 30, 2020 10:25 AM WATERLOG W WORKS 325 Sycamore Street P.O. Box 27 Waterloo, Iowa 50704 STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Pace 1 of 1 ACCOUNT SUMMARY Customer Name: Account Number: Service Address: Richards Zona 118770-508088 617 W 11TH ST Billing Frequency: Billing Date: Billing Due Date: Quarterly 03/22/2019 04/12/2019 Waterloo Water Works Services Water Water Service Excise Tax Water Works Subtotal $29.10 $1.75 $30.85 City of Waterloo Services Sanitary Sewer $45.00 Storm Water Fee $8.25 Garbage $27.00 Yard Waste $18.00 City of Waterloo Subtotal $98.25 CHARGE SUMMARY Previous Balance Credits/Payments Water Works Subtotal City of Waterloo Subtotal $125.37 -$125.37 $30.85 $98.25 Total Current Service Charges $129.10 Total Amount Due $129.10 Amount Due After 04/12/2019 $135.47 Previous Read Date Current Read Date Previous Read Pre ous Read Tepe Current Read Current Read Type Usage(CCF) 12/07/2018 03/08/2019 262 Actual LL 4 8 3 • 2 1 1 1 0 • • — - • - IIII ■ ■ ■ ■ NMI • ^ti 266 Actual 4 SPECIAL MESSAGES Please detach and return the bottom portion with your payment. See reverse side for additional information MAKE CHECKS PAYABLE TO: WATERLOO WATQX 0 RKS P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ADDRESSEE: Richards Zona 617 W llth St Waterloo, IA 507021623 ❑ Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 118770-508088 Total Amount Due: 129.10 Amount Due After : 135.47 Billing Due Date: 04/12/2019 Amount Enclosed: REMIT TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO, IOWA 50704 WATERLOO WATER WORKS 325 Sycamore Street P.O. Box 27 Waterloo, Iowa 50704 STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Page 1 of 1 ACCOUNT SUMMARY Customer Name: Account Number: Service Address: Richards Zona 118770-508088 617 W 11TH ST Waterloo Water Works Services Water Water Service Excise Tax Water Works Subtotal City of Waterloo Services $27.70 $1.67 $29.37 Sanitary Sewer $42.75 Storm Water Fee $8.25 Garbage $27.00 Yard Waste $18.00 City of Waterloo Subtotal $96.00 Billing Frequency: Billing Date: Billing Due Date: Quarterly 12/21/2018 01/16/2019 CHARGE SUMMARY Previous Balance Credits/Payments Water Works Subtotal City of Waterloo Subtotal $93.31 -$93.31 $29.37 $96.00 Total Current Service Charges $125.37 Total Amount Due $125.37 Amount Due After 01/16/2019 $131.56 Previous Read Date Current Read Date Previous Read Previous Read Type Current Read Current Read Type Usage(CCF) 09/07/2018 12/07/2018 258 Actual 262 Actual 4 SPECIAL MESSAGES Please detach and return the bottom portion with your payment. See reverse side for additional information MAKE CHECKS PAYABLE TO: WATERLOO WA WORKS P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ADDRESSEE: Richards Zona 617 W llth St Waterloo, IA 507021623 Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 118770-508088 Total Amount Due: 125.37 Amount Due After : 131.56 Billing Due Date: 01/16/2019 Amount Enclosed: REMIT TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO, IOWA 50704 WATERLOO WA: WORKS 325 Sycamore Street P.O. Box 27 Waterloo, Iowa 50704 STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Pace 1 of 1 ACCOUNT SUMMARY Customer Name: RichardsZona Account Number: 118770-508088 Service Address: 617 W 11TH ST Billing Frequency: Billing Date: Billing Due Date: Quarterly 09/21/2018 10/12/2018 Waterloo Water Works Services Water Water Service Excise Tax Water Works Subtotal $27.70 $1.67 $29.37 City of Waterloo Services Sanitary Sewer $42.75 Storm Water Fee $8.25 Garbage $27.00 Yard Waste $18.00 City of Waterloo Subtotal $96.00 CHARGE SUMMARY Previous Balance Balance Forward Water Works Subtotal City of Waterloo Subtotal -$32.06 -$32.06 $29.37 $96.00 Total Current Service Charges $125.37 Total Amount Due $93.31 Amount Due After 10/12/2018 $97.89 Previous Read Date Current Read Date Previous Read Previous Read Type Current Read Current Read Type Usage (CCF) 06/05/2018 09/D7/2018 254 Actual 5 6' U 3 m r a . MI . NM INN `L ti d & ti�^� tio,1 CS 258 Actual 4 SPECIAL MESSAGES Please detach and return the bottom portion with your payment. See reverse side for additional Information MAKE CHECKS PAYABLE TO: WATERLOO WAORKS P.O. Box 27 Waterloo, Iowa 50704 Phone: (319)232-6280 ADDRESSEE: Richards Zona 617 W llth St Waterloo, IA 507021623 ❑ Please check box if contact Information requires updating and indicate the change(s) on reverse side Account Number: 118770-508088 Total Amount Due: 93.31 Amount Due After : 97.89 Billing Due Date: 10/12/2018 Amount Enclosed: REMIT TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO, IOWA 50704 WATERLOO WA WORKS 325 Sycamore Street P.O. Box 27 Waterloo, Iowa 50704 STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Page 1 of 1 ACCOUNT SUMMARY Customer Name: Account Number: Service Address: Richards Zona 118770-508088 617 W 11TH ST Waterloo Water Works Services Water Water Service Excise Tax Water Works Subtotal City of Waterloo Services $29.10 $1.75 $30.85 Sanitary Sewer $47.25 Storm Water Fee $12.00 Garbage $27.00 Yard Waste $18.00 City of Waterloo Subtotal $104.25 Billing Frequency: Quarterly Billing Date: 09/23/2019 Billing Due Date: 10/14/2019 CHARGE SUMMARY Previous Balance Credits/Payments Water Works Subtotal City of Waterloo Subtotal $129.10 -$129.10 $30.85 $104.25 Total Current Service Charges $135.10 Total Amount Due $135.10 Amount Due After 10/14/2019 $141.77 Previous Read Date Current Read Date Previous Read Previous Read Type Current Read Current Read Type Usage (CCF) 06/06/2019 09/11/2019 270 Actual 275 Actual 5 SPECIAL MESSAGES Please detach and return the bottom portion with your payment. See reverse side for additional information MAKE CHECKS PAYABLE TO: WATERLOO WA P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 WORKS ADDRESSEE: Richards Zona 617 W 11th St Waterloo, IA 507021623 Please check box if contact information requires updating and indicate the change(s) on reverse side Account Number: 118770• 508088 Total Amount Due: 135.10 Amount Due After : 141.77 Billing Due Date: 10/14/2019 Amount Enclosed: REMIT TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO, IOWA 50704 WATERLOO WA c WORKS 325 Sycamore Street P.O. Box 27 Waterloo, Iowa 50704 STATEMENT OF SERVICES Phone: (319) 232-6280 www.waterloowater.org Page 1 of 1 ACCOUNT SUMMARY Customer Name: Account Number: Service Address: Richards Zona 118770-508088 617 W 11TH ST Waterloo Water Works Services Water Water Service Excise Tax Water Works Subtotal City of Waterloo Services $29.10 $1.75 $30.85 Sanitary Sewer $45.00 Storm Water Fee $8.25 Garbage $27.00 Yard Waste $18.00 City of Waterloo Subtotal $98.25 Billing Frequency: Billing Date: Billing Due Date: Quarterly 06/21/2019 07/15/2019 CHARGE SUMMARY Previous Balance Credits/Payments Water Works Subtotal City of Waterloo Subtotal $129.10 -$129.10 $30.85 $98.25 Total Current Service Charges $129.10 Total Amount Due $129.10 Amount Due After 07/15/2019 $135.47 Previous Read Date Current Read Date Previous Read Previous Read Type Current Read Current Read Type Usage (CCF) 03/08/2019 06/06/2019 266 Actual 5 fr. 4 U 3 a 2 = a ■MN MI IIIE ■ ■ Oa' 01^ ti �^1 CQ' 0 8' p9 '4 qs,e O' 8' 270 Actual 4 SPECIAL MESSAGES Please detach and return the bottom portion with your payment. See reverse side for additional information MAKE CHECKS PAYABLE TO: WATERLOO WAT 9 RK5 P.O. Box 27 Waterloo, Iowa 50704 Phone: (319) 232-6280 ADDRESSEE: Richards Zona 617 W 11th St Waterloo, IA 507021623 Please check box if contact information requires updating and indlcate the change(s) on reverse side Account Number: 118770-508088 Total Amount Due: 129.10 Amount Due After : 135.47 Billing Due Date: 07/15/2019 Amount Enclosed: REMIT TO: WATERLOO WATER WORKS P.O. BOX 27 WATERLOO, IOWA 50704 Completed forms should be routed directly to the Finance Dept. FINANCE DEPT. ONLY Finance Committee approval required? YES NO If so, date approved: 10 / � City of Waterloo Line -Item Budget Amendment Request Form The Finance Committee of the City Council and/or Finance Dept. is hereby requested to authorize the following line -item budget amendment for FYE 2020 submitted by the Leisure Services Department: EXPENSES/REVENUE DECREASE EXPENDITURES (INCREASE REVENUE) INCREASE EXPENDITURES (DECREASE REVENUE) Fund Dept Activity Acct # Acct Name Proj Code Amount Fund Dept Activity Acct # Acct Name Proj Code Amount 010 37 4105 3720 restricted dona 7GFT.TREE2 4,800./010 37 4105 1536 trees 7GFT.TREE2 4,800.00 TOTAL This amendment is being requested because: $4,800.00 TOTAL $4,800.00 to budget for trees to be sold in the Plant Waterloo! Tree progam Prior Committee Actions (Dates): (Signature a ad p or Designee) Date • (Signature Finance Dept. Review) Date Date Posted (Finance Dept.) K:\users\shared goodies\forms\Budget Amendment Request Form (002).xls (Apr 2003) PROJECT BUDGET WORKSHEET - ALL PROJECTS PAGE ONE Project Name Plant Waterloo tree planting program AMENDED City Contract No. Project Manager Project Budget Total Todd Derifield $ 24,800.00 1. How will this project be funded? A. Federal Grant Yes No Grant Name CFDA # B. State Grant Yes No Grant Name C. City Match Source of Funding D. Other Entities Yes X No Name residents that purchase trees, donation. % Paid by federal grant Grant Agreement Number % Paid by state grant Grant Agreement Number % Paid by City % Paid by other entity 2. Attach copies of any grant agreements that will fund the project (REQUIRED) 3. Does the project include the purchase of right of way or other real property? If yes, will real property purchases be reimbursable under the grant? If yes, have you attached authorization to purchase real property to this document? 4. Will this project include any non -participating expenses, such as: A. Stormwater permit fees B. Publication, or printing costs C. Others, list 5. Does this project cover any regular full-time salaries or benefits? If yes, employee/position to be covered. 6. Include a brief description of the project in the space below: (REQUIRED) Done None ❑ ❑X Yes No ❑ ❑X ❑ ❑ ❑ ❑ ❑ ❑X ❑ ❑X ❑ Q ❑ ❑ A $20,000 donation was received from the Young Family Foundation to set up a program where residents can purchase trees at a reduced rate. Program will be based on the Plant Some Shade Program. The Plant Some Shade program was discontinued by MidAmerican Energy. Distribution date tentatively set April 30, 2020 Advertising will be targeted to residents that have had ash trees removed from City property. Selling 240 trees at $20 ***Any balance left in the donated money will be spent on planting trees in City Parks. Page 2 must be attached and signed. K:\shared goodies \forms\PSS Project Budget Plant Waterloo 2020.xls\Page 1 All Projects (Mar 2010) PROJECT BUDGET WORKSHEET- NON -CONSTRUCTION PAGE TWO City Clerk Use Only Finance Committee Approval Date Project Name (from page one) Plant Waterloo tree planting program. AMENDED Department No. project will be budgeted under Activity No. project will be budgeted under REVENUES: 3000 Cash on Hand 3350 Federal Grant 3352 Federal HUD Grant 3354 Shared Program - Local 3357 Shared Program - County 3358 Shared Program - City 3360 Shared Program - State 3361 State Grant 3720 Donations - Restricted 3750 Sale of Bonds 37 Leisure ServicE 010 37 4105 To be assigm Project No. Subproject No it by the Finance Dept. 37GFT TREE20 (Each column should only include amounts by fund) Fund: 010 Fund: Fund: Fund: 3712 Sale of Trees 4,800.00 EXPENDITURES: TOTALS $ 4,800.00 $ 1111 Salaries - Regular 1112 Salaries - Part Time 1315 Education & Training 1345 Travel - Official City 1346 Travel - Prof Training 1390 Contractual Services 1536 Trees 1541 Cleaning Supplies Total 4,800.00 $ $ 4,800.00 4,800.00 4,800.00 TOTALS $ 4,800.00 $ - $ - $ - $ 4,800.00 (Signature Dept. Flea' Date (Signature Finance Dept. Review) Date K:\shared goodies\forms\PSS Project Budget Plant Waterloo 2020.xls\Page 2 (Donat or NON-constr) (Mar 2010) CONSTRUCTION PROJECT BUDGET WORKSHEET PAGE TWO Project Name (from page one) Project Safe Neigborhoods Department No. project will be budgeted under 11 GRT Activity No. project will be budgeted under 010 11 1150 REVENUES: 3000 Cash on Hand 3112 Local Option Sales Tax 3350 Federal Grant—I-4;900. -44,000.00 3357 Shared Program - County 3358 Shared Program - City 3360 Shared Program - State 3361 State Grant 3373 Fed Pass thru for Iowa /*Xd, o° /41Ol7l1 .4— 3111 Hotel Motel Tax 3377 EDA Grant 3720 Donations - Restricted 3721 Service Charges 3750 Sale of Bonds City Clerk Use Only Finance Committee Approval Date -1/ Io / Z-b To be assigned by the Finance Dept. Project No. 11GRT Subproject No. (Each column should only include amounts by fund) Fund: Fund: Fund: Fund: 1150 1160 Total 3873 Reimburse for services 3800 Misc. Rev. 3900 Seized Property EXPENDITURES: TOTALS $ 14,000.00 $ $ - $ 14,000.00 1111 Salaries - Regular 1112 Salaries - Part Time 1121 FICA 1122 IPERS 1123 Disability 1131 Health 1114 Overtime 1520 Computer Software 1710 Claims, Judgements 1346 Training 14,000.00 14,000.00 TOTALS $ 14,000.00 $ $ $ $ 14,000.00 �t�lf Y/I.bly� Of 2q-20 liter -tint (Signat re Dept. Head) Date (Signature Finance Dept. Review) Date K:\shared goodies\forms\cs Project Budget Worksheets 141PSN #18 PG2 (Mar 2010) PROJECT BUDGET WORKSHEET - ALL PROJECTS PAGE ONE Project Name Project Safe Neigborhoods City Contract No. Project Manager Project Budget Total Major Leibold $ 14,000.00 1. How will this project be funded? A. Federal Grant Yes Grant Name x No Project Safe Neigborhoods B. State Grant Yes Grant Name No CFDA # 16.609 C. City Match Source of Funding D. Other Entities Yes Name No To be assigned by the Finance Dept. Project No. 11GRT Subproject No. % Paid by federal grant Grant Agreement Number % Paid by state grant Grant Agreement Number % Paid by City % Paid by other entity 2. Attach copies of any grant agreements that will fund the project (REQUIRED) 3. Does the project include the purchase of right of way or other real property? If yes, will real property purchases be reimbursable under the grant? If yes, have you attached authorization to purchase real property to this document? 4. Will this project include any non -participating expenses, such as: A. Stormwater permit fees B. Publication, or printing costs C. Others, list 5. Does this project cover any regular full-time salaries or benefits? 6. Include a brief description of the project in the space below: (REQUIRED) The Waterloo Police Department will use these funds for Realistic De -Escalation Trainings. 100.00% 0.00% Done None ❑ ❑ Yes No ❑ ❑X ❑ ❑X ❑ El ❑ ❑X ❑ ❑X ❑ ❑X ❑ ❑X Page 2 must be attached and signed. K:\shared goodies\forms\cs Project Budget Worksheets 14\PSN #18 PG1 (Mar 2010) PROJECT SAFE NEIGBORHOODS Governor's Office of Drug Control Policy Pape State Office Bldg., 5th Floor 215 E. 7th Street, Des Moines, Iowa 50319 (515) 725-0300 Grantee: City of Waterloo 715 Mulberry St Waterloo, Iowa 50703-5714 Grant #18-PSN-01 Grant Period: November 1, 2019 - October 31, 2020 Federal: $14,000 Match: $0 Total: $14,000 ODCP Contact: Dennis Wiggins 515/725-0311 Legal Applicant: Quintin Hart Program Director: Joseph Leibold E-mail: leiboldj@waterloopolice.com This grant is subject to the terms and conditions incorporated either directly or indirectly by reference in the grant program legislation, the grant program request for proposal, and the stipulations, if any, noted under "Special Conditions." Except for any waiver granted explicitly elsewhere in this grant, this award does not constitute approval of waiver from any Federal or state statutory/regulatory requirements for a United States Department of Justice grant. The grantee agrees to perform all services and furnish all supplies set forth in the application of this grant award for the consideration stated herein. This grant consists of the application for funds, the grant award notice, the budget documents, the standard grant conditions, the reporting forms, and all approved grant revision documents. All parties to this grant award acknowledge that they have fully read and understand this contract, and agree to abide by the terms set forth within. SPECIAL CONDITIONS Sub -contracts for service must be submitted to ODCP for review and approval prior to expenditure of grant funding. On -site trainings (Realistic De -Escalation) require prior approval from the Bureau of Justice Assistance. Grantee must work with ODCP to submit a training plan and request for approval no less than 90 day prior to the scheduled training date. No grant funding may be obligated for this purpose prior to receiving written approval from the ODCP. In witness wherefore, the parties hereto have executed this grant the day and year specified below. SIGNATURES/DATES Legal Applicant/Date Program Director/Date ODCP Administrator/Date Completed forms should be routed directly to the Finance Dept. FINANCE DEPT. ONLY Finance Committee approval required? YES 11NO �, / If so, date approved: / (b I l 2-0 City of Waterloo Line -Item Budget Amendment Request Form The Finance Committee of the City Council and/or Finance Dept. is hereby requested to authorize the following line -item budget amendment for FYE 6/30/2020 submitted by the Housing Authority Department: imiC.4 6,4, 0 EXPENSES/REVENUE pG6146.4 6 DEGREASE EXPENDITURES (INCREASE REVENUE) (DECREASE REVENUE) 4PfCREA=EXPENDITURES Fund Dept Activity Acct # Acct Name Proj Code Amount Fund Dept Activity Acct # Acct Name Proj Code Amount 283 13 5450 1520 Computer Software 442.71ii 283 13 5450 1710 Contingency 442.78 283 13 5452 1520 Computer Software 1,5148 283 13 5452 1710 Contingency 1,545.a2 TOTAL $1,992.06 TOTAL $1,992.06 This amendment is being requested because: Balance needed to pay HAPPY Software contract renewal in the total amount of $22,640.39. 65% of the total will come from Activity 5452 (Section 8), and 35% from Activity 5450 (Ridgeway Towers). Prior Committee Actions (Dates): 11) 1a6 ,d, LrJ2n- /-z3-2020 (Signature Dept. Head or Designee) Date (Signature Finance Dept. Review) Date Date Posted (Finance Dept.) K:\users\shared goodieslforms\Budget Amendment Request Form.xls (Apr 2003) Project Name City Contract No. Project Manager Project Budget Total PROJECT BUDGET WORKSHEET - ALL PROJECTS PAGE ONE Park Avenue Bicycle Signals Mohammad Elahi $ 171,250.00 1. How will this project be funded? A. Federal Grant Yes X No CFDA # n Grant Name .TrajDsportation Alternative Program (TAP) B. State Grant Grant Name C. City Match ( Yes No pk55t0 ilfiriu S(4,— Source of Funding GO BOND D. Other Entities Yes Name No To be assigned by the Finance Dept. Project No. /' Subproject No. 14, 20.205 % Paid by federal grant 80.00% Grant Agreement Number TAP-U-8155(767)--81-07 % Paid by state grant Grant Agreement Number % Paid by City 50.00% % Paid by other entity 2. Attach copies of any grant agreements that will fund the project (REQUIRED) 3. Does the project include the purchase of right of way or other real property? If yes, will real property purchases be reimbursable under the grant? If yes, have you attached authorization to purchase real property to this document? 4. Will this project include any non -participating expenses, such as: A. Stormwater permit fees B. Publication, or printing costs C. Others, list 5. Does this project cover any regular full-time salaries or benefits? If yes, employee/position to be covered. 6. Include a brief description of the project in the space below: (REQUIRED) Improves Bicycling on Park Ave, from Franklin St South 0.75 Miles to US 218 SB, by adding Bicycle Traffic Signals. Done None X❑ ❑ Yes No ❑ ❑X ❑ ❑ ❑ ❑X ❑ ❑ 7 El ❑ ❑X Page 2 must be attached and signed. K:\shared goodies\forms\Project Budget Worksheet P1.xls\Page 1 All Projects (Mar 2010) CONSTRUCTION PROJECT BUDGET WORKSHEET PAGE TWO Project Name (from page one) Park Avenue Bicycle Signals Department No. project will be budgeted under 17 Activity No. project will be budgeted under REVENUES: 3000 Cash on Hand 3112 Local Option Sales Tax 3350 Federal Grant �137-O .90 —�4'SD 0a 1-7--172-59796. 3357 Shared Program - County 3358 Shared Program - City 3360 Shared Program - State 3361 State Grant 3365 State RISE Grant 3368 EPA Grant 3377 EDA Grant 3720 Donations - Restricted 3750 Sale of Bonds 3so .3(7.2S J 33 93 r�GDiskrH.. (Zxu D ikxw- f37 dio' / 3 ?ea City Clerk Use Only Finance Committee Approval Date To be assigned by the Finance Dept., Project No. Subproject No (Each column should only include amounts by fund) Fund: 290 Fund: f Fund: Fund: Total EXPENDITURES: TOTALS $ 137,000.00 $ 34,250.00 $ $ $ 171,250.00 2103 Engineering & Consulting $ 32,000.00 $ 8,000.00 $ 40,000.00 2125 Traffic Control Equipment $ 105,000.00 26,250.00 131,250.00 2140 Land Acquisition - 2144 Land Improvements 2146 Demolitions 2151 Building Construction 2156 Bikeway Construction 2162 Storm Sewers 2163 Sanitary Sewers 2164 Sidewalks 2165 Streets & Roadways 2199 Non -participating Misc end (Signature Dept. TOTALS $ 137,000.00 $ 34,250.00 $ $ - $ 171,250.00 1/6 -)I? 747 .fA, 04-5-24h) Date (Signature Finance Dept. Review) Date K:\shared goodies\forms\Project Budget Worksheet.xls\Page 2 (Constr Proj) (Mar 2010)