HomeMy WebLinkAboutApproved Documents - 02/06/2017FINANCE DEPT. STAFF ONLY
LINE ITEM USED 010-11-1100-1346
TRAVEL REQUEST
CITY OF WATERLOO
FY _2017_ BUDGETED
EXPENDED YTD
THIS REQUEST
LEFT AFTER THIS
REQUEST
DATE
Original - Clerk/Finance Copy - Department
NAME(S) AND POSITION(S):
Sergeant McGeough & Richter
DATE
January 13, 2017
NAME OF CLASS / MEETING:
BCA Bureau of Criminal Apprehension: Ethics and Integrity
Class
DESTINATION -.Des-Meines 4owa � p I
DEPARTURE POINT
IF NOT WATERLOO:
DEPARTURE DATE:
Feb. 21, 2017
Return Date:
Feb. 23`d, 2017
DATE(S) OF MEETING:
Feb. 22-23rd, 2017
PURPOSE OF TRAVEL:
Lt. McClelland is requesting authorization to send Sergeants McGeough and Richter to BCA: Ethics and Integrity Class in
St. Paul, Minnesota on Feb. 21-23, 2017. This course will provide supervisors and managers in law enforcement with
understanding of the value ethical leaders impart at all levels of an organization and the impact it has on the public trust. A
city vehicle will be needed for the training.
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
x COST $
YES NO
METHOD OF TRAVEL:
CITY VEHICLE
AIRFARE DEPARTING FROM:
PRIVATE VEHICLE
ESTIMATE OF COST:
$360.00 LODGING .00 Rental car
$198.00 MEALS .00 Parking
$500.00 REGISTRATION .00 AIRFARE
$/00.00 MILEAGE/FUEL .00 Baggage fee
TOTAL FOR ALL: $ 1158.00
BUDGET LINE ITEM:
x GRANT REIMBURSABLE
YES NO
x REQUIRED CERTIFICATION
YES NO
TOTAL: $ 579.00 PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WATERLOO
_
DEPARTN1E-N'�
I APPROVE THIS TRAVEL REQUEST
D MAYOR
DATE DATE
FINANCE DEPT. STAFF ONLY
LINE ITEM USED 010-11-1100-1346
TRAVEL REQUEST
CITY OF WATERLOO
FY _2017 BUDGETED 0-6 060 3'
EXPENDED YTD ;'l
0
THIS REQUEST .3‘,6
LEFT AFTER THIS
REQUEST /g, ( i `F
DATE �,7,,..) /-/7-(7
Original - Clerk/Finance Copy - Department
NAME(S) AND POSITION(S):
Inv. Pohl
DATE
January 11, 2017
NAME OF CLASS / MEETING:
Field Search v5.0 Computer Investigations class
DESTINATION Des Moines, Iowa
DEPARTURE POINT
IF NOT WATERLOO:
DEPARTURE DATE:
Feb. 23rd, 2017
Return Date:
Feb. 23rd, 2017
DATE(S) OF MEETING:
Feb. 23'd, 2017
PURPOSE OF TRAVEL:
Sgt. Devine is requesting authorization to send Inv. Pohl to Field Search v5.0 Computer Investigations Class in Des
Moines, Iowa on February 23rd, 2017. Inv. Pohl will be trained in the Field v5.0 Search Software that will search URL
records, Images, Videos, files in recycle and a keyword search tool. Inv. Pohl is currently assigned to the Investigations
Division and primary works on forensic investigations involving computers and phones. A city vehicle will be needed for
the training.
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
x COST $
YES NO
METHOD OF TRAVEL:
CITY VEHICLE
AIRFARE DEPARTING FROM:
PRIVATE VEHICLE
ESTIMATE OF COST:
$.00 LODGING .00 Rental car
$15.00 MEALS .00 Parking
$325.00 REGISTRATION .00 AIRFARE
$25.00 MILEAGE/FUEL .00 Baggage fee
TOTAL FOR ALL: $ 365.00
BUDGET LINE ITEM:
x GRANT REIMBURSABLE
YES NO
x REQUIRED CERTIFICATION
YES NO
TOTAL: $ 365.00 PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WATERLOO
DATE
I APPROVE THIS TRAVEL REQUEST
t
MAYOR
t V
/;),37, 7
DATE
City Clerk Use Only
Finance Committee
Approval Date I/A /)1
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 Bldg Maint
$ 1,780.00 plus est. shipping costs of $
Department to expend
to pay for or purchase
This purchase or expenditure is being made because:
Purchase of 20 LED Kits to finish conversion of lighting to Led fixtures at Library
(eligible for MidAmerican Rebate)
Vendor selected for this purchase: Van Meter
n Bids or written quotes were taken on this purchase, as follows:
n Bids or quotes were not taken on this purchase because:
Van Meter is current installer of previous LED lighting at the Library
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
Federal/other grants
n
Sewer
Other (specify)
This expenditure is to be coded to the following budget line -item:
416-22-3100-2152
(Fund - Department - Activity - Account Number)
in which the budgeted amount is
and the current available balance is
Respectfully submitted,
a-44t .o._i i134 7
Sanitation
$ aOot
(Project Code)
i7-/7
(Si nature Dept. Head or Designee) Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\Pre-Auth - Library - LED Lighting.xls (Mar 2010)
City Clerk Use Only
Finance Committee
Approval Date ‘/2-7)Ill
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 Bldg Maint Department to expend
$ 1,206.35 plus est. shipping costs of $ to pay for or purchase
This purchase or expenditure is being made because:
Semi Annual Service - Fire Suppression System and Fire Extinguisher inspections
for 5 Sullivan Brothers Convention Center
Vendor selected for this purchase: Proshield Fire & Security
❑ Bids or written quotes were taken on this purchase, as follows:
❑ Bids or quotes were not taken on this purchase because:
Proshield has previously provided this service
Prior Committee Actions (Dates):
Please check the following box(es) as appropriate to describe the funding for this expense:
General Fund n Road Use Tax ❑ Sewer
Bonds
nFederal/other grants n Other (specify)
Sanitation
This expenditure is to be coded to the following budget line -item:
2oaanna1-52- 010- 2-6?86,a /3'7(
(Fund - Department - Activity - Account Number) (Project Code)
in which the budgeted amount is
and the current available balance is $ 6 ICJ
Respectfully submitted, �7
( gnature Dept. Head or Designee) Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\Pre-Auth - 5 Sull Bros - Proshield.xls (Mar 2010)
City Clerk Use Only
Finance Committee
Approval Date \/L3 '(-1
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 Central Garage Department to expend
$ 2,071.55 plus est. shipping costs of $ 0.00 to pay for or purchase
Electronics Install - Fire 330
This purchase or expenditure is being made because:
Electronics Install - Fire 330
Vendor selected for this purchase: Racom Corp
Bids or written quotes were taken on this purchase, as follows:
n Bids or quotes were not taken on this purchase because:
OEM Only - Local Provider
Prior Committee Actions (Dates):
Please check the following box(es) as appropriate to describe the funding for this expense:
El
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:
415-12-1400-2117
(Fund - Department - Activity - Account Number)
in which the budgeted amount is
and the current available balance is
(Project Code)
$ 70,000.00
$ 3,022.20 ✓
Respectfully su tted,
/ - i g / 7 Tii-.d e ',t'.0 (� ).9,r. 2m >., - /r /8 (7
K:\shared goodies\forms\Central Garage - Fire - Electronics Install - 330 - Jan 2017.xls (Mar 2010)
City Clerk Use Only
Finance Committee /
Approval Date 1 / 2 3 / i
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 Central Garage Department to expend
$ 3,950.00 plus est. shipping costs of $ 0.00 to pay for or purchase
Front Axle repair parts - backhoe 194G01
This purchase or expenditure is being made because:
Excessive play in front end of backhoe
Vendor selected for this purchase: Murphy Tractor Co
n Bids or written quotes were taken on this purchase, as follows:
�X Bids or quotes were not taken on this purchase because:
OEM parts availability only
Prior Committee Actions (Dates):
Please check the following box(es) as appropriate to describe the funding for this expense:
15 I General Fund nX Road Use Tax n Sewer n Sanitation
n Bonds Federal/other grants n Other (specify)
This expenditure is to be coded to the following budget line -item:
010-18-7955-1571
(Fund - Department - Activity - Account Number) (Project Code)
in which the budgeted amount is
and the current available balance is
$ 240,000.00
$ 2,031�
Respectfully su .tted,
414 IIC� O w
K:\shared goodies\forms\Central Garage - Street Dept Backhoe Front End - Jan 17.xls (Mar 2010)
City Clerk Use Only
Finance Committee
1
Approval Date I 9-3 /11
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 WFR Department to expend
$ 1,230.00 plus est. shipping costs of $ 50.00 to pay for or purchase
Purchase two (2) Survitec Ice Suits
This purchase or expenditure is being made because:
WFR needed to replace outdated and damaged ice rescue suits.
Vendor selected for this purchase: Atlas
❑ Bids or written quotes were taken on this purchase, as follows:
See attached.
❑ 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 ❑ Sewer n Sanitation
Federal/other grants ❑ Other (specify)
This expenditure is to be coded to the following budget line -item:
010-12-1412-1573 12GRTPLAY
(Fund - Department - Activity - Account Number) (Project Code)
in which the budgeted amount is
and the current available balance is
$ 1,431.00 ""
$ 1,280.00'/
(Signature Dept. Head or Designee) Date (Signature Finance Dept. Review) Date
Sent over 011717.
City Clerk Use Only
Finance Committee
Approval Date '• 3 /1 1
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
$ 1,142.62 plus est. shipping costs of $ 0.00 to pay for or purchase
Digital Forensic Card Reader equipment
This purchase or expenditure is being made because:
this is half the cost of the purchase of Digital Forensic Card reader to assist
an investigator to extract videos from surviellence systems
Vendor selected for this purchase: Black Hawk County Attorney
❑ Bids or written quotes were taken on this purchase, as follows:
❑x
Bids or quotes were not taken on this purchase because:
Digital Intelligence provided training to a WPD Investigator and is the sole provider
of the equipment needed to utilize the training, This purchase was split with the
County Attorney who paid for the entire purchase and this is reimbursement
Prior Committee Actions (Dates):
Please check the following box(es) as appropriate to describe the funding for this expense:
❑ General Fund
ri Bonds
El
Road Use Tax ri Sewer ❑ Sanitation
Federal/other grants ❑ Other (specify) WPD Forfeiture Funds
This expenditure is to be coded to the following budget line -item:
010-11-1150-1512 11 TRIW PD
(Fund - Department - Activity - Account Number) (Project Code)
in which the budgeted amount is
and the current available balance is
espectfully sub
/I 7/7 77,tekttic-, 4 Le_.-42i/GeA__ /
ignature t. ead •r De gnee) Date
De (Signature Finance Dept. Review) Date
( 9 p
$ rl/,UcO
$ -/0,7O s'a
K:\shared goodies\forms\Expenditure Pre -Authorization (Mar 2010)
City Clerk Use Only
Finance Committee
Approval Date ( 3 / 11
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 Sanitation Department to expend
$ 5,145.25 plus est_ shipping costs of $ 0.00 to pay for or purchase
Re -Line container box - truck 710
This purchase or expenditure is being made because:
Interior of box worn beyond limits - nonrepairable
Vendor selected for this purchase: Wayne Engineering
pi Bids or written quotes were taken on this purchase, as follows:
❑ Bids or quotes were not taken on this purchase because:
OEM Only
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 I I Sanitation
Federal/other grants n Other (specify)
This expenditure is to be coded to the following budget line -item:
010-18-7955-1569
(Fund - Department - Activity - Account Number)
in which the budgeted amount is
and the current available balance is
Respectfully submitted,
(Project Code)
$ 265,000.00 V
$
/-/7-/ 7
✓� I�1 c�L C /j -12Gu4
K.\shared goodies\forms\Sanitation - Replace Liner - 710 - Jan 2017.xls (Mar 2010)
7-17-77
City Clerk Use Only
Finance Committee
Approval Date `' 2-3/0
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 Sanitation Department to expend
$ 6,842.69 plus est. shipping costs of $ 150.00 to pay for or purchase
Transmission Oil Cooler and Shield Assembly - Truck # 301
This purchase or expenditure is being made because:
Cooler and shield non -repairable as result of accident
Vendor selected for this purchase: Cedar Rapids Truck Center
n Bids or written quotes were taken on this purchase, as follows:
n Bids or quotes were not taken on this purchase because:
OEM Only
Prior Committee Actions (Dates):
Please check the following box(es) as appropriate to describe the funding for this expense:
nGeneral Fund n Road Use Tax n Sewer ❑X Sanitation
I I Bonds pi Federal/other grants I I Other (specify)
This expenditure is to be coded to the following budget line -item:
010-18-7955-1569
(Fund - Department - Activity - Account Number)
(Project Code)
in which the budgeted amount is $ 265,000.00 ✓
and the current available balance is
Respectful submitted,
$ `i 3 65 3 93 ✓
`711 cl' 7,Y �7
K:\shared goodies\forms\Sanitation - Trans Oil Cooler and Shield - 301 - Jan 2017.xls (Mar 2010)
City Clerk Use Only
Finance Committee Approval Date 1/ ).3 Al
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 Department to expend
$ 5.600.00 plus ext. shipping cost of $ 0.00 to pay for or purchase
Fence repair from Sept 2016 Flood damage at Waste Management Services facility
This purchase or expenditure is being made because:
Sept 2016 Flood event damaged fencing around Waste Management Services facility.
Vendor selected for this purchase:
D & N Fence Co., Inc
nBids or written quotes were taken on this purchase, as follows
Three fencing companies were contacted but only one submitted a quote. D & N Fence Co., Inc.
submitted quote and recommend for repairs.
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: Road Use Tax: Sewer: nSanitation:
Bonds:
❑Federallother grants:
0Other(specify):
This expenditure is to be coded to the following budget line -item:
570-14-5A-1373 f77F/ %ems
(Project Code)
(Fund - Department - Activity - Account Number)
in which budgeted amount is
and the current available balance is
Respectfully submitted,
12-01
(Signature Dept. Head Or Designee Date
$ 10,00a90 566)6
$
7 Fk.f l' .t- (J.%&, / /4 / 7
(Signature Finance Dept. Review) Date
City Clerk Use Only
Finance Committee
Approval Date `i,q3/(1
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 Traffic Operations Department to expend
$ 1,740.00 plus est. shipping costs of $ to pay for or purchase
100 - 24" X 24" High Intensity No Parking signs.
This purchase or expenditure is being made because:
Annual upgrade of signs.
Vendor selected for this purchase: Newman Signs
n Bids or written quotes were taken on this purchase, as follows:
Newman Signs, Inc
Hall Signs
3M
Jamestown, ND $1,740.00
Bloomington, IN 1,755.56
St. Paul, MN 2,156.00
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:
El
General Fund
Bonds
❑
Road Use Tax n Sewer
Federal/other grants n Other (specify)
This expenditure is to be coded to the following budget line -item:
415-17-7120-2125
(Fund - Department - Activity - Account Number)
in which the budgeted amount is
and the current available balance is
Respectfully submitted,
(Signature Dept. He d or Designee)
Sanitation
(Project Code)
$ 10,000.00 ✓
Vi%D (Signature Finance Dept. Review)
/-4"-/-7
Date
K:\shared goodies Worms \2017-January-Expenditure Pre-Authorization-415-17-7120-2125-100 - No Parking Signs$1,740.00-Newman.xls (Mar
2010)
Completed forms should be routed directly to the Finance Dept.
FINANCE DEPT. ONLY
Finance C mmittee approval required?
YES I/ NO
If so, dete approved: / 3 Ai
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 17 submitted by the POLICE 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 11 1160 3603
TRI Co. Forf.
11TRI.TRIF
60,000.00
010 11 1160 1512
Tri Co. For
11TRI TRIF
60,000.00
010 11 1160 1512
Tri Co. Forf.
11TRI.TRIF
19,000.00
010 11 1160 3603
Tri Co. Forf.
11TRI.TRIF
19,000.00
010 11 1150 3603
WPD Forf.
11TRI.WPDf
19,000.00
011 11 1150 1512
WPD For.
11TRI.WPDf
19,000.00
TOTAL
$98,000.00
TOTAL
$98,000.00
This amendment is being requested because:
This is to conform with the City's budget line item control policy. Using current year revenues to increase the FY17 expense line to
cover distribution to outside agencies & cover WPD's share of the distribution.
Prior Committee Actions (Dates):
0A-P1'
(Signature Dept. H or Iesignee)
I ,31,E
Date
(Signature Finance Dept. Review)
Date
Date Posted (Finance Dept.)
K:\users\shared goodies \forms \csbudgetamer dregform (Apr 2003)
TRAVEL REQUEST
CITY OF WATERLOO
FINANCE DEPT. STAFF ONLY
LINE ITEM USED .,gp 5;2,0 / 340
FY .2,,I7 BUDGETED 50004 5-0
EXPENDED YTD
THIS REQUEST /36�9 jU
LEFT AFTER THIS w
REQUEST ;.2(ae,tI- ( /o
DATE /7
Original - Clerk/Finance Co. - be••rtment
NAME(S) AND POSITION(S):
Todd Gaede - Sewer Maint
Justin Gaede — Sewer Maint
Forrest Graves — Sewer Maint
Dana Clement — Sewer Maint
DATE:
February 1, 2017
NAME OF CLASS / MEETING:
Iowa Water Environment Association Collection Systems
Conference
DESTINATION:
DEPARTURE POINT
IF NOT WATERLOO: Marshalltown, Iowa
DEPARTURE DATE:
March 1-3, 2017
RETURN DATE:
March 1-3, 2017
DATE(S) OF MEETING:
March 1-3, 2017
PURPOSE OF TRAVEL/TRAINING:
Education, CEUs
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
xx COST $
YES NO
METHOD OF TRAVEL:
xx
CITY VEHICLE PRIVATE VEHICLE
AIRFARE DEPARTING FROM:
ESTIMATE OF COST:
LODGING TAXI
MEALS PARKING
130.00 REGISTRATION AIRFARE
MILEAGE/FUEL MISCITOLLS
TOTAL FOR ALL: $ 520.00
520-14-5200-1346 $130.00
BUDGET LINE ITEM: 521-14-5310-1346 $390.00
GRANT REIMBURSABLE
YES NO
YES NO
TOTAL: $ ?0- 00 PER PERSON
REQUIRED CERTIFICATION
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WATERLOO
DEPARTME HEAD
I APPROVE THIS TRAVEL REQUEST
MAYOR
Eikr,fiared Goodies\Forms\Travel Request Form January 2010 DATE
TRAVEL REQUEST
CITY OF WATERLOO
FINANCE DEPT. STAFF ONLY
LINE ITEM USED q,20 i°i 52,00 /3'/Lr
FY 2 17 BUDGETED 5v0 U
EXPENDED YTD 1e/6)5 �1
THIS REQUEST 6410
LEFT AFTER THIS
REQUEST /lvfc
DATE d ?mil'7Z
Original - Clerk/Finance Co. - De•.rtment
NAME(S) AND POSITION(S):
Steve Isenhower, ICT Acting Foreman
John Hyman, ICT ".Judk
DATE: January 30, 2017
NAME OF CLASS / MEETING:
Introduction to ControlLogix
DESTINA/TION: Van Meter. Waterloo, IA
IF NOT WATERLOO:
DEPARTURE DATE:
February 23, 2017
RETURN DATE:
February 23, 2017
DATE(S) OF MEETING:
February 23, 2017
PURPOSE OF TRAVEL/TRAINING:
Training for RSLogix 5000
Please cancel travel request approved 1/3/17.
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
xx COST $
YES NO
METHOD OF TRAVEL:
xx CITY VEHICLE
AIRFARE DEPARTING FROM:
PRIVATE VEHICLE
ESTIMATE OF COST:
LODGING
MEALS
420.00 REGISTRATION
MILEAGE/FUEL
TOTAL FOR ALL: $ 840.00
TAXI
BUDGET LINE ITEM: 520-14-5200-1346
PARKING YES NO
AIRFARE
MISCITOLLS YES NO
GRANT REIMBURSABLE
REQUIRED CERTIFICATION
TOTAL: $ 420.00
PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WAT - " LOO
DATE
K:\Shared Goodies\Forms\Travel Request Form January 2010
1 APPROVE THIS TRAVEL REQUEST
MAYOR
A /1 1
DATE
FINANCE DEPT. STAFF ONLY
LINE ITEM USED j,�) /c/ S-AUU /. 'k
TRAVEL REQUEST
CITY OF WATERLOO
FY �s '/ % BUDGETED
EXPENDED YTD
THIS REQUEST
LEFT AFTER THIS
REQUEST
DATE
Original - Clerk/Finance
NAME(S) AND POSITION(S):
Craig Billerbeck - Lab Tech
DATE:
Jan 30, 2017
NAME OF CLASS / MEETING:
Activated Sludge Overview
DEPARTURE DATE:
March 7, 2017
PURPOSE OF TRAVEL/TRAINING:
Education, CEU's
DESTINATION: DEPARTURE POINT
IF NOT WATERLOO: Kirkwood Community College
Cedar Rapids, IA
RETURN DATE:
March 7, 2017
DATE(S) OF MEETING:
March 7, 2017
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
xx COST $
YES NO
METHOD OF TRAVEL:
x CITY VEHICLE
AIRFARE
DEPARTING FROM:
PRIVATE VEHICLE
ESTIMATE OF COST:
LODGING
MEALS
125.00 REGISTRATION
MILEAGE/FUEL
TOTAL FOR ALL: $ 125.00
TAXI
PARKING
AIRFARE
MISC/TOLLS
BUDGET LINE ITEM: 520-14-5200-1346
x GRANT REIMBURSABLE
YES NO
x
YES NO
REQUIRED CERTIFICATION
TOTAL: $ 125.00 PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WA RLOO
DEPARTMENT AD
I APPROVE THIS TRAVEL REQUEST
MAYOR
'71% t,I 7
DATE DATE
K:\Shared Goodies\Forms\Travel Request Form January 2010
Kirkwood Community College Continuing Education
Phone -In Registration
PO Box 2068
Cedar Rapids, IA 52406-2068
Sponsorship Billing Authorization Form - Non -Credit Programs
Please complete and fax or mail to Phone -In Registration at (319)398-7185 prior to the start of your class.
Date:
January 30,2017
We authorize Kirkwood Community College Continuing Education to bill our company for the below listed student
and class(es). We will assume responsibility for tuition.
Student name: Craig Billerbeck
PI
Student address: Street: 1656 Plymouth Avenue
City: Waterloo
state: IA Zip: 50702 Phone: 319-269-6112
Student Gender: male
Student Email address: cabillerbeck44@yahoo.com
Student SSN or Kirkwood ID #: 478-72-7459
Date of Birth: 12-21-64
Course #
Class Title
Class Dates
Class Tuition
81982
Activated Sludge Overview
March 7, 2017
$125.00
ise send the bill to the following name and address:
Company name: City of Waterloo Waste Management Services Department
Attention: Evelyn Russell
Address: 3505 Easton Avenue
Waterloo, IA 50703
Email Address: evelyn.russell@waterloo-ia.org
Phone: 319-291-4553
If you would like to pay by company credit card and not be billed please provide: ❑ Mastercard ❑ Visa ❑ Discover
CC#:
Expiration Date: /
Card Holder Name:
Card Billing Address:
If this bill remains unpaid at the end of the class, the charges will revert back to the student's account and he/she will
be held accountable. The student will not receive CEU's or transcripts and will not be allowed to register until the
account is paid in full.
Please note: Under the Federal Right to Privacy Act, Kirkwood Community College cannot disclose any student
information without the written consent (on a separate form) of the student.
7ct
Student Signature (required)
Steven Hoambrecker
Authorized Company Signer's printed name Authorized signature (required)
TRAVEL REQUEST
CITY OF WATERLOO
FINANCE DEPT.
LINE ITEM USED
FY ) ui / BUDGETED
EXPENDED YTD
THIS REQUEST
LEFT AFTER THIS
REQUEST
DATE
Original - Clerk/Finance
STAFF ONLY
k,(0 07 7836 I3q;p
34ov
/5 —3 3=
7t)
Co. - De.•rtment
NAME(S) AND POSITION(S):
Eric Thorson, City Engineer
DATE:
January 25, 2017
NAME OF CLASS / MEETING:
2017 American Public Works Assoc. Spring Conference
DEPARTURE DATE:
March 29, 2017
DESTINATION: West Des Moines, IA
DEPARTURE POINT
IF NOT WATERLOO:
DATE(S) OF MEETING:
March 29-31 2017
RETURN DATE:
March 31, 2017
PURPOSE OF TRAVEL/TRAINING:
To attend the APWA Spring Conference Education Sessions and Trade Show
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
X COST $
YES NO
METHOD OF TRAVEL:
X CITY VEHICLE
AIRFARE
DEPARTING FROM:
PRIVATE VEHICLE
ESTIMATE OF COST:
$240.00 LODGING
50.00 MEALS
185.00 REGISTRATION
MILEAGE/FUEL
TOTAL FOR ALL: $ 475.00
TAXI
PARKING
AIRFARE
MISC/TOLLS
BUDGET LINE ITEM: 266-07-7830-1346
X GRANT REIMBURSABLE
YES NO
X
YES NO
REQUIRED CERTIFICATION
TOTAL: $ 475.00
PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WATERLOO
DePAis'r
fi /.rn
RTME EAD
January 25, 2017
I APPROVE THIS TRAVEL REQUEST
MAYOR
DATE DATE
ice:AShared Goodies\Forms\Travel Request Form January 2010
TRAVEL REQUEST
CITY OF WATERLOO
fim
FY Ul 1 BUDGETED
EXPENDED YTD
THIS REQUEST
LEFT AFTER THIS
REQUEST
DATE
Orr.mai - Clerk/Finance Cosy - Deportment
FINANCE DEPT. STAFF ONN.Y
LINE ITEM USED ;2P 4' 3� S8.5-0 /3440
'700 v
3883 0--
0;72 q/
27?w ;-/-l1
NAME(S) AND POSITION(S):
Matt Chesmore
DATE:
1/30/2017
NAME OF CLASS 1 MEETING:
Lead Inspector ?risk Assessor Recertification Training
DESTINATION:
Des Moines, Iowa
DEPARTURE POINT
IF NOT WATERLOO:
DEPARTURE DATE:
2/1/2017
RETURN DATE:
2/3/2017
DATE(S) OF MEETING:
Feb 2-3 2017
PURPOSE OF TRAVELJTRAINING
AMENDED TRAVEL REQUEST
Recertification of Matt's lead Inspector/Risk Assessor Certification -Previously approved on 1/3/2017 by council
Class begins at 8:OOam instead of previously stated 10:OOam
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
x COST $
YES NO
METHOD OF TRAVEL:
X CITY VEHICLE
AIRFARE
PRIVATE VEHICLE
DEPARTING FROM: Carnegie Annex
ESTIMATE OF COST:
140.00
+140.00 LODGING TAXI
35.00+35.00 MEALS PARKING
450.00 REGISTRATION AIRFARE
25.00 MILEAGEIFUEL MISCROLLS
TOTAL FOR ALL: $ 825.00
BUDGET LINE ITEM: 224-32-5850.1346
YES NO
YES NO
TOTAL: $
GRANT REIMBURSABLE
BG14H.0001
REQUIRED CERTIFICATION
PER PERSON
I BELIEVE THIS TRIP SE VEVA
AND IS NECESSARY A ' BEN
CITY OF R • 0
DEPARTMENT HEAD
IC PURPOSE
TO THE
pp T
K: S ed Goodies\Forms\Travel Request Form January 2010
1 APPROVE THIS TRAVEL REQUEST
MAYOR
DATE
FINANCE DEPT. STAFF ONLY
LINE ITEM USED
TRAVEL REQUEST
CITY OF WATERLOO
FY BUDGETED
EXPENDED YTD
THIS REQUEST
LEFT AFTER THIS
REQUEST
DATE
Original - Clerk/Finance Co. - De.artment
NAME(S) AND POSITION(S):
Matthew Chesmore
DATE:
December 20, 2016
NAME OF CLASS / MEETING:
Lead Inspector/Risk Assessor Recertification Training
DEPARTURE DATE:
February 2, 2017
DESTINATION: Des Moines, IA
DEPARTURE POINT
IF NOT WATERLOO:
DATE(S) OF MEETING:
February 2-3, 2017
RETURN DATE:
February 3, 2017
PURPOSE OF TRAVEL/TRAINING:
Recertification of Matt's Lead Inspector/Risk Assessor Certification. Every 3 years a 16 hour recertification class has to
be taken with corresponding testing. This is to enable Matt to produce Lead Inspection/Risk Assessment Reports and to
supervise CDBG/HOME Housing Rehabilitation Projects.
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
X COST $
YES NO
METHOD OF TRAVEL:
X CITY VEHICLE
AIRFARE DEPARTING FROM: Carnegie Annex
PRIVATE VEHICLE
ESTIMATE OF COST:
140.00 LODGING
35.00 MEALS
450.00 REGISTRATION
25.00 MILEAGE/FUEL
TOTAL FOR ALL: $ 650.00
TAXI
PARKING
AIRFARE
MISC/TOLLS
BUDGET LINE ITEM: Z17/-3Z-585G- 134/G7
GRANT REIMBURSABLE
YES NO l� COO
G J��'
X REQUIRED CERTIFICATION
YES NO
TOTAL: $ PER PERSON
I BELIEVE THIS TRIP SERVES'�i PU -PURPOSE
AND IS NECESSARY AND BENEFJ IAL TO THE
CITY OF WATERLO
dr
DEPARTMENT HEAD
.21,%3
I APPROVE THIS TRAVEL REQUEST
MAYOR
DATE DATE
K:\Shared Goodies\Forms\Travel Request Form January 2010
TRAVEL REQUEST
CITY OF WATERLOO
FINANCE bEPT. STAFF
LINE ITEM USED :.1/0 OS
FY4 /I BUDGETED
EXPENDED YTO
THIS REQUEST
LEFT AFTER THIS
REQUEST
DATE
Ori.inal - Clerk/Finance
ONLY
6/00 /3ci
lee (2c(41—
/30`�
Co • - De •• rtment
NAME(S) AND POSITION(S):
Adrienne Miller, Economic Development Specialist
DATE:
January 26, 2017
NAME OF CLASS / MEETING:
Heartland 2017
DESTINATION: Blue Springs, MO
DEPARTURE POINT
IF NOT WATERLOO:
DEPARTURE DATE:
April 23, 2017
RETURN DATE:
April 27, 2017
DATE(S) OF MEETING:
April 23-27, 2017
PURPOSE OF TRAVEL/TRAINING:
To attend the Heartland Economic Development Course
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
X COST $
YES NO
METHOD OF TRAVEL:
X CITY VEHICLE
ESTIMATE OF COST:
480
100
885
100
AIRFARE
LODGING
MEALS
REGISTRATION
MILEAGE/FUEL
DEPARTING FROM:
TOTAL FOR ALL: $ 1,565
TAXI
PARKING
AIRFARE
MISC/TOLLS
PRIVATE VEHICLE
4e Am04,l16m .! d
BUDGET LINE ITEM: 010 08 5700 1346
X GRANT REIMBURSABLE
YES NO
X , REQUIRED CERTIFICATION
YES NO
TOTAL: $ PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND B,ENEFICIAL
CITY OF WATER
DEPARTMENT HEAD
I APPROVE THIS TRAVEL REQUEST
MAYOR
/-Z it (�—
DATE DATE
K:\Shared Goodies\Forms\Travel Request Form January 2010
/
TRAVEL REQUEST
CITY OF WATERLOO
AMENDED
FINANCE DEPT. STAFF ONLY
LINE ITEM USED 010 12 1400 1346
FY 2Ol7 BUDGETED 10 o ()‘--
EXPENDED YTD 2.2"// (o t�
THIS REQUEST o7.?,Z 9-3
LEFT AFTER THIS
REQUEST i.{0 (a 0 8)---
DATE j ' /7
Original - Clerk/Finance Copy - be.artment
NAME(S) AND POSITION(S):
Pat Treloar, Fire Chief
DATE:
1-31-17
NAME OF CLASS / MEETING:
Event Media Relations
DEPARTURE DATE:
1/24/17
DESTINATION: Des Moines
DEPARTURE POINT
IF NOT WATERLOO:
DATE(S) OF MEETING:
1/24&25/17
RETURN DATE:
1/25/17
PURPOSE OF TRAVEL/TRAINING:
1 % day training covers how to effectively communicate public information during a disaster.
Reason for this amended travel request is that hotel rates had increased in the Des Moines area due to zero occupancy.
Original travel request was approved for $170.00. Amended total is $222.93.
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
X COST $
YES NO
METHOD OF TRAVEL:
X CITY VEHICLE
AIRFARE DEPARTING FROM:
PRIVATE VEHICLE
ESTIMATE OF COST:
201.60 LODGING TAXI
21.33 MEALS PARKING
REGISTRATION AIRFARE
MILEAGE/FUEL MISC/TOLLS
TOTAL FOR ALL: $ 222.93
BUDGET LINE ITEM: 010-12-1400-1346
GRANT REIMBURSABLE
YES NO
YES NO
TOTAL: $ PER PERSON
REQUIRED CERTIFICATION
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY A ENEFICIAL TO THE
CITY OF O
I APPROVE THIS TRAVEL REQUEST
DEPARTMENT HEAD MAYOR
DATE DATE
K:\Shared Goodies\Forms\Travel Request Form January 2010
TRAVEL REQUEST
CITY OF WATERLOO
FINANCE DEPT.
LINE ITEM USED
FY _2017_ BUDGETED
EXPENDED YTD
THIS REQUEST
LEFT AFTER THIS
REQUEST
DATE
Original - Clerk/Finance
STAFF ONLY
010-11-1100-1346
727,4)
Copy - De. • rtment
NAME(S) AND POSITION(S):
Sgt. Hoelscher Sgt. Rasmussen P.O. Gann P.O. Erie
DATE
January 25th, 2017
NAME OF CLASS / MEETING:
Finding the Leader in You:By Calibre Press
DEPARTURE DATE:
February 16th, 2017
DESTINATION Waterloo, Iowa
DEPARTURE POINT
IF NOT WATERLOO:
Return Date:
February 17th, 2017
DATE(S) OF MEETING:
February 16-17, 2017
PURPOSE OF TRAVEL:
Lt. Cirksena is requesting authorization to send Sgt. Hoelscher, Sgt. Rasmussen, P.O. Erie and P.O. Gann to Finding the
Leader in you: by Calibre Press, on February 16th-17th, 2017 in Waterloo, Iowa at Hawkeye Community College. The
course will include the following topics: Common denominators of successful Organizations and Leaders, Missions and
Goals, Human animal and emotional intelligence, consequences of poor leadership, developing trust, ethical leadership,
effective organizational climate and appreciation and discipline. A city vehicle will be needed for this training.
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
x COST $
YES NO
METHOD OF TRAVEL:
x CITY VEHICLE
AIRFARE DEPARTING FROM:
PRIVATE VEHICLE
ESTIMATE OF COST:
$.00 LODGING
$.00 MEALS
$1196.00 REGISTRATION
$.00 MILEAGE/FUEL
.00
.00
.00
.00
TOTAL FOR ALL: $ 1196.00
Rental car
Parking
AIRFARE
Baggage fee
BUDGET LINE ITEM:
YES
YES
x GRANT REIMBURSABLE
NO
x REQUIRED CERTIFICATION
NO
TOTAL: $ 299.00 PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WATERLOO
DEPARTMENT HEAD
I APPROVE THIS TRAVEL REQUEST
MAYOR
216/(7
DATE DATE
TRAVEL REQUEST
CITY OF WATERLOO
FINANCE DEPT.
LINE ITEM USED
FY _2017 BUDGETED
EXPENDED YTD
THIS REQUEST
LEFT AFTER THIS
REQUEST
DATE
Original - Clerk/Finance
STAFF ONLY
010-11-1100-1346
dSU
/`l5`g
3
/7,815 S
�lil H' ,2-7-/ 7
Co.y - be•artment
NAME(S) AND POSITION(S):
P.O. Alex Bovy
DATE
January 26`h, 2017
NAME OF CLASS / MEETING:
MCTC Midwest Counter Drug Training Center HWY Drug
Investigations for Patrol
DESTINATION Johnston, Iowa
DEPARTURE POINT
IF NOT WATERLOO:
DEPARTURE DATE:
March 27`h, 2017
Return Date:
March 29h, 2017
DATE(S) OF MEETING:
March 27-29, 2017
PURPOSE OF TRAVEL:
Sgt. Camarata is requesting to authorization to send P.O. Alex Bovy to MCTC Highway Drug Investigations for Patrol in
Johnston, Iowa on March 27th thru 29, 2017. The primary purpose of the class is to detect, interdict and disrupt the
continual flow of illicit narcotics on the nations highways. There is no registration cost for this course and the lodging is
free. A city vehicle will be needed for this travel.
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
x COST $
YES NO
METHOD OF TRAVEL:
x CITY VEHICLE
AIRFARE DEPARTING FROM:
PRIVATE VEHICLE
ESTIMATE OF COST:
$.00 LODGING
$105.00 MEALS
$00 REGISTRATION
$40.00 MILEAGE/FUEL
.00
.00
.00
.00
TOTAL FOR ALL: $ 145.00
Rental car
Parking
AIRFARE
Baggage fee
BUDGET LINE ITEM:
x GRANT REIMBURSABLE
YES NO
x REQUIRED CERTIFICATION
YES NO
TOTAL: $ 145.00 PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WATERLOO
DEPARTMENT HEAD
DATE
I APPROVE THIS TRAVEL REQUEST
MAYOR
DATE
TRAVEL REQUEST
CITY OF WATERLOO
FINANCE DEPT.
LINE ITEM USED
FY _2017_ BUDGETED
EXPENDED YTD
THIS REQUEST
LEFT AFTER THIS
REQUEST
DATE
Original - Clerk/Finance
STAFF ONLY
010-11-1100-1346
1,.7q of
3,�
/5,, ,
2--a
Co - De•artment
NAME(S) AND POSITION(S):
Officer Erie and Inv. Gergen
DATE:
January 26, 2017
NAME OF CLASS / MEETING:
(ILEETA) Training Conference
International Law Enforcement Educators and Trainers
Association.
DESTINATION: St. Louis, MO.
DEPARTURE POINT
IF NOT WATERLOO:
DEPARTURE DATE:
March 19th, 2017
Return Date:
March 24th, 2017
DATE(S) OF MEETING:
March 20th-24th, 2017
PURPOSE OF TRAVEL:
Lt. Cirksena is requesting to send Officer Erie and Inv. Gergen to the International Law Enforcement Educators Trainers
Association held St. Louis, MO., March 19th to March 24th. This conference is for law enforcement trainers and educators
only. It offers the latest in training and current trends in law enforcement taught by some of the most well-known
educators/trainers in the country, as well as attorneys who specialize in use of force cases and a myriad of other topics.
These officers gain valuable knowledge at this conference and in turn pass this on to WPD officers throughout the year
during in-service training. Gergen and Erie are department use of force/control tactics instructors. A city vehicle will be
needed for travel.
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
x COST $ 0.00
YES NO
METHOD OF TRAVEL:
XX CITY VEHICLE
AIRFARE DEPARTING FROM:
PRIVATE VEHICLE
ESTIMATE OF COST:
$ 875.00 LODGING
$496.00 MEALS
$774.00 REGISTRATION
$/00.00 MILEAGE/FUEL
TOTAL FOR ALL: $ 2245.00
TAXI
PARKING
AIRFARE
MISCITOLLS
BUDGET LINE ITEM: 010-11-1100-1346
x GRANT REIMBURSABLE
YES NO
x REQUIRED CERTIFICATION
YES NO
TOTAL: $ 1122.50 PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WATERLOO
I APPROVE THIS TRAVEL REQUEST
S • L
DEPARTMENT HEAD MAYOR
\- -z��T
DATE DATE
FINANCE DEPT. STAFF ONLY
$225.00
$. 00
TRAVEL REQUEST
CITY OF WATERLOO
NAME(S) AND POSITION(S):
Inv. Koontz
LINE ITEM USED
FY _2017_ BUDGETED
EXPENDED YTD
THIS REQUEST
LEFT AFTER THIS
REQUEST
DATE -77/W
Original - Clerk/Finance Co
010-11-1100-1346
,3vo
/75/3 3"C
- De • • rtment
NAME OF CLASS / MEETING:
Social Media and Open Source Investigation
DEPARTURE DATE:
March 6th, 2017
DATE
January 25th, 2017
DESTINATION Cedar Rapids, Iowa
DEPARTURE POINT
IF NOT WATERLOO:
Return Date:
March 8th, 2017
DATE(S) OF MEETING:
March 6th-8th, 2017
PURPOSE OF TRAVEL:
Sgt. Rasmussen id requesting authorization to send Inv. Koontz to Social Media and Open source Investigation course in
Cedar Rapids, Iowa on March 6th -8`h 2017. The course will focus on open source searching techniques, free resources,
legal issues and best practices for online investigations. It will also cover internet basics such as the history of the internet,
IP addresses, browsers and search engines. Inv. Koontz is currently assigned to the Investigations Division and this
course will assist him with his current assignment. A City Vehicle will be needed for this training.
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
METHOD OF TRAVEL:
x CITY VEHICLE
AIRFARE
x COST $
YES NO
DEPARTING FROM:
PRIVATE VEHICLE
ESTIMATE OF COST:
$.00
LODGING .00
Rental car
$75.00 MEALS .00 Parking
AIRFARE
Baggage fee
REGISTRATION .00
MILEAGE/FUEL .00
TOTAL FOR ALL: $ 300.00
BUDGET LINE ITEM:
x GRANT REIMBURSABLE
YES NO
REQUIRED CERTIFICATION
YES NO
TOTAL: $ 300.00 PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WATERLOO
DEPARTMENT HEAD
DATE
I APPROVE THIS TRAVEL REQUEST
MAYOR
DATE
K:\Shared Goodies\Forms\Travel Request Form January 2010
TRAVEL REQUEST
CITY OF WATERLOO
NAME(S) AND POSITION(S):
Wayne Castle
Associate Engineer
FINANCE DEPT. STAFF ONLY
LINE ITEM USED _ .Z/ 01 7E30 /3 ckG,
FY �D/%BUDGETED
EXPENDED YTD
THIS REQUEST
LEFT AFTER THIS
REQUEST
DATE
Original - Clerk/Finance
2%74✓ a-/—/7
Co. - De.artment
NAME OF CLASS / MEETING:
80th Annual SLSI Land Surveyors Conference
SB6iGrY of 60.40 /4)G-id/es aF 2-0w.1
DEPARTURE DATE:
March 2, 2017
DATE:
February 1, 2017
DESTINATION: Ames, IA
DEPARTURE POINT
IF NOT WATERLOO:
RETURN DATE:
March 3, 2017
PURPOSE OF TRAVEL/TRAINING:
80th Annual SLSI Land Surveyors Conference
DATE(S) OF MEETING:
March 2 — 3, 2017
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
X COST $
YES NO
METHOD OF TRAVEL:
X CITY VEHICLE
AIRFARE
DEPARTING FROM:
PRIVATE VEHICLE
ESTIMATE OF COST:
100.00 LODGING
MEALS
275.00 REGISTRATION
MILEAGE/FUEL
TOTAL FOR ALL: $ 375.00
TAXI
PARKING
AIRFARE
MISC/TOLLS
BUDGET LINE ITEM: 521-07-7830-1346
X GRANT REIMBURSABLE
YES NO
X
YES NO
REQUIRED CERTIFICATION
TOTAL: $ 375.00
PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WATERLOO
Yye !�t-4Lrn/
DEPAMENT HEAD
February 1, 2017
I APPROVE THIS TRAVEL REQUEST
MAYOR
DAT E DATE
TRAVEL REQUEST
CITY OF WATERLOO
FINANCE DEPT. STAFF ONLY
LINE ITEM USED ,J/v (!Y 37(20 /3S
FY, I7BUDGETED
EXPENDED YTD
THIS REQUEST
LEFT AFTER THIS
REQUEST
DATE
Ori.inal - Clerk/Finance
Co. - be.•rtment
NAME(S) AND POSITION(S):
Noel Anderson, CP&D Director
DATE:
January 23, 2017
NAME OF CLASS / MEETING:
2017 Coalition
DESTINATION: Washington, DC
DEPARTURE POINT
IF NOT WATERLOO:
DEPARTURE DATE:
June 12, 2017
RETURN DATE:
June 14, 2017
DATE(S) OF MEETING:
June 13, 2017
PURPOSE OF TRAVEL/TRAINING:
Travel with the Cedar Valley Coalition Group to meet with Congressional Delegation members
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
X COST $
YES NO
METHOD OF TRAVEL:
X
CITY VEHICLE
AIRFARE
PRIVATE VEHICLE
DEPARTING FROM: Waterloo Iowa
ESTIMATE OF COST:
815 LODGING 100
165
MEALS
REGISTRATION 650
MILEAGE/FUEL 100
TOTAL FOR ALL: $ 1,830
TAXI
PARKING
AIRFARE
MISC/TOLLS
BUDGET LINE ITEM: 010 08 5700 1345
X GRANT REIMBURSABLE
YES NO
X REQUIRED CERTIFICATION
YES NO
TOTAL: $
PER PERSON
I BELIEVE THIS TRIP SERVES A PU,
AND IS NECESSARY AI�}D BENEF
CITY OF WATERLO
PURPOSE
THE
DEPARTMENT HEAD
I APPROVE THIS TRAVEL REQUEST
MAYOR
DATE DATE
K:\Shared Goodies\Forms\Travel Request Form January 2010
TRAVEL REQUEST
CITY OF WATERLOO
FINANCE DEPT. STAFF ONLY
LINE ITEM USED 9l/d .2t Sup /3L/(.a
FY �0// BUDGETED
EXPENDED YTD
THIS REQUEST
LEFT AFTER THIS
REQUEST
DATE
Original - Clerk/Finance
iv,c,pv
3, /3 Cv z=-
/3S
?11� 1-/- i7
Co.-De••rtment
NAME(S) AND POSITIONS):
Greg Ahlhelm, Interim Building Official/Plans Examiner
DATE:
1/24/2017
NAME OF CLASS / MEETING:
IAPMO — HVAC Continuing Education
J 4rL 4 „t J1/46ei4,✓IOft ariohcs
DESTINATION Waterloo, Iowa
DEPARTURE POINT
IF NOT WATERLOO
DEPARTURE DATE:
3/31/2017
RETURN DATE:
3/31/2017
DATE(S) OF MEETING:
3/31/2017
PURPOSE OF TRAVEL/TRAINING
Continuing Education
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
x COST $
YES NO
METHOD OF TRAVEL:
X CITY VEHICLE
AIRFARE DEPARTING FROM:
PRIVATE VEHICLE
ESTIMATE OF COST:
LODGING
MEALS
135.00 REGISTRATION
MILEAGE/FUEL
TOTAL FOR ALL: $ 135.00
TAXI
PARKING
AIRFARE
MISC/TOLLS
BUDGET LINE ITEM: 010-22-5100-1346
X GRANT REIMBURSABLE
YES NO
X
YES NO
REQUIRED CERTIFICATION
TOTAL: $ 135.00
PER PERSON
I BELIEVE THIS TRIP SERV A P LIC PURPOSE
AND IS NECESSARY AND, ENEFICIHE
CITY OF WATERLO
DEPARTMENT HEAD
I APPROVE THIS TRAVEL REQUEST
DATE DATE
K:\Shared Goodies\Forms\Travel Request Form January 2010
TRAVEL REQUEST
CITY OF WATERLOO
FINANCE DEPT.
LINE ITEM USED
FY 2-011 BUDGETED
EXPENDED YTD
THIS REQUEST
LEFT AFTER THIS
REQUEST
DATE
Original - Clerk/Finance
STAFF ONLY
/v ;.? SFao 13414
14 (J7)73
/3 6
27/AJ 2-( . Q/%
Co pv - Department
NAME(S) AND POSITION(S):
Brian J. Baker, Chief HVAC Inspector
DATE:
1/24/2017
NAME OF CLASS / MEETING:
IAPMO — Plumbing Continuing Education
L.crLrs144 / VFIc2sfrb-dita41-
DEPARTURE DATE:
4/1/2017
PURPOSE OF TRAVEL/TRAINING
Continuing Education
DESTINATION Waterloo, Iowa
DEPARTURE POINT
IF NOT WATERLOO
RETURN DATE:
4/1/2017
DATE(S) OF MEETING:
4/1/2017
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
COST $
YES NO
METHOD OF TRAVEL:
X CITY VEHICLE
AIRFARE DEPARTING FROM:
PRIVATE VEHICLE
ESTIMATE OF COST:
LODGING
MEALS
135.00 REGISTRATION
MILEAGE/FUEL
TOTAL FOR ALL: $ 135.00
TAXI
PARKING
AIRFARE
MISC/TOLLS
BUDGET LINE ITEM: 010-22-5100-1346
X GRANT REIMBURSABLE
YES NO
X
YES NO
REQUIRED CERTIFICATION
TOTAL: $ 135.00
PER PERSON
I BELIEVE THIS TRIP SERVES A PI
AND IS NECESSARY AND BENEFICI
CITY OF WATERLOO
LIC PURPOSE
TO THE.
DATE
K:\Shared Goodies\Forms\Travel Request Form January 2010
I APPROVE THIS TRAVEL REQUEST
MAYOR
DATE
Sent over 01/31/17
FINANCE DEPT. STAFF ONLY
TRAVEL REQUEST
CITY OF WATERLOO
NAME(S) AND POSITION(S):
Chris Ferguson, Fire Marshal
NAME OF CLASS / MEETING:
K-9 Recertification
DEPARTURE DATE:
6/05/17
LINE ITEM USED
FY 20/ 7 BUDGETED
EXPENDED YTD
THIS REQUEST
LEFT AFTER THIS
REQUEST
DATE:
d/vlt/V/2 /625
%I ' t4L.. I432
7)7
2-I-7v,7
01/31/17
RETURN DATE:
6/09/17
DESTINATION: Grand Rapids, MI
DEPARTURE POINT
IF NOT WATERLOO:
DATE(S) OF MEETING:
6/06/17 - 6/08/17, 2017
PURPOSE OF TRAVEL:
Annual required K-9 recertification through Maine Specialty Dogs.
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
YES NO
COST $
METHOD OF TRAVEL:
CITY VEHICLE
AIRFARE DEPARTING FROM:
PRIVATE VEHICLE
ESTIMATE OF COST:
500.00 LODGING TAXI
50.00 MEALS PARKING
85.00 REGISTRATION AIRFARE
150.00 MILEAGE/FUEL MISC/TOLLS
TOTAL FOR ALL: $ 785.00
010-12-1412-1528
BUDGET LINE ITEM: 12GRT F30
x GRANT REIMBURSABLE
YES NO
x
YES NO
REQUIRED CERTIFICATION
TOTAL: $ 785.00 PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
CIT TE O
I APPROVE THIS TRAVEL REQUEST
DEPARTMENT HEAD fl
MAYOR
- l�-
)--/L711
DATE DATE
FINANCE DEPT. STAFF ONLY
TRAVEL REQUEST
CITY OF WATERLOO
NAMES) AND POSITION(S):
Julie Sr',er"E'kecutive Director
Wanda Hill -Dorris, Housing Coordinator
Janet Wessels, Housing Coordinator
LINE ITEM USED . /3 5413-
FY BUDGETED
EXPENDED YTD
THIS REQUEST
LEFT AFTER THIS
REQUEST
DATE
Ori.'nal - Clerk/Finance
2S 5
—7/do
76 3
�r 7-1 7
Co • - De•. rtment
NAME OF CLASS / MEETING:
Iowa NAHRO (National Association of Housing and Rehabilitation
Officials) 2017 Annual Conference/Training
DEPARTURE DATE:
April 19, 2017
DATE:
February 6, 2017
DESTINATION: West Des Moines, IA
DEPARTURE POINT
IF NOT WATERLOO:
PURPOSE OF TRAVEL/TRAINING:
Conference/Training
RETURN DATE:
April21, 2017
DATE(S) OF MEETING:
April 19, 20 and 21, 2017
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
METHOD OF TRAVEL:
X CITY VEHICLE
AIRFARE
X COST$
YES NO
PRIVATE VEHICLE
DEPARTING FROM: Waterloo, Iowa
ESTIMATE OF COST:
880.00 LODGING
270.00 MEALS
1,050.00 REGISTRATION
60.00 MILEAGE/FUEL
TOTAL FOR ALL: $ 2,260.00
TAXI
PARKING
AIRFARE
MSC/TOLLS
283-13-5452-1346 and
BUDGET LINE ITEM: 283-13-5450-1346
X GRANT REIMBURSABLE
YES NO
X REQUIRED CERTIFICATION
YES NO
TOTAL: $ 753.33
PER PERSON
I BELIEVE THIS TRIP SERVEc/-64IBLIC PURPOSE
AND IS NECESSARY AND BENEFIAL TO THE
CITY OF WATER'
DEPARTMENT HEAD
I APPROVE THIS TRAVEL REQUEST
/11
pp, are Uoodies\Forms\'1
avel Request Form January 2010 DATE
City Clerk Use Only
Finance Committee Y/ /
Approval Date C 1 1
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 Building Maint Department to expend
$ 3,870.00 plus est. shipping costs of $ to pay for or purchase
This purchase or expenditure is being made because:
Door repair at the Veteran's Memorial Hall
Vendor selected for this purchase: Allen Glass Co.
QX Bids or written quotes were taken on this purchase, as follows:
Allen Glass Co. - $ 3,870.00
Lindgren Glass - $ 5,740.00
pi 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:
nGeneral Fund n Road Use Tax E Sewer Sanitation
nBonds I 7 Federal/other grants ❑ Other (specify)
This expenditure is to be coded to the following budget line -item:
010-22-8850-1571 22FAC5SUL
(Fund - Department - Activity - Account Number) (Project Code)
in which the budgeted amount is
and the current availablee is
$ 3,67o'
/. 29.) j 6),f 124 P- /'17
(Signature Dept. Head or Designee) Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\Expenditure Pre-Authorization.xls (Mar 2010)
City of Waterloo
Expenditure Pre -Authorization Request Form
City Clerk Use Only
Finance Committee
Approval Date �(4'A -I
The Finance Committee of the City Council is hereby requested to authorize the following
purchase or expenditure submitted by the
Building Maint Department to expend
$ 2,608.70 plus est. shipping costs of $ to pay for or purchase
This purchase or expenditure is being made because:
Replace VFD (variable frequency drive) for one air handler at the Five Sullivan
Brothers Convention Center
Vendor selected for this purchase: Hupp Engineered Products
pi Bids or written quotes were taken on this purchase, as follows:
Hupp Engineered Products - $ 2,608.70
K & W Electric - $ 5,590.97
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
Bonds
Road Use Tax
Federal/other grants ❑
Sewer
Other (specify)
Sanitation
This expenditure is to be coded to the following budget line -item:
010-22-6860-1373 22FAC5SUL
(Fund - Department - Activity - Account Number) (Project Code)
in which the budgeted amount is
and the current available balanc: is
$ 700D
(Signature Dept. Head or Dignee) Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\Expenditure Pre-Authorization.xls (Mar 2010)
City of Waterloo
Expenditure Pre -Authorization Request Form
City Clerk Use Only
Finance Committee
Approval Date
The Finance Committee of the City Council is hereby requested to authorize the following
purchase or expenditure submitted by the Engineering Department to expend
$ 4,197.60 plus est. shipping costs of $ 0.00 to pay for or purchase
Per VGM Development Agreement removal of San Marnan Pavement striping
This purchase or expenditure is being made because:
Required by VGM Development Agreement
Vendor selected for this purchase: Iowa Plains Signing, Inc.
n Bids or written quotes were taken on this purchase, as follows:
Iowa Plains Signing - $4,197.80
❑ Bids or quotes were not taken on this purchase because:
Prior Committee Actions (Dates):
rinn,utf6O
10/5/2017
Please check the following box(es) as appropriate to describe the funding for this expense:
General Fund
Bonds
1-1
Road Use Tax n Sewer n Sanitation
Federal/other grants n Other (specify) San Marnan TIF
This expenditure is to be coded to the following budget line -item:
426-08-6205-2148
(Fund - Department - Activity - Account Number)
in which the budgeted amount is
and the current available balance is
Respectfulllysubmitted,
__���
(Signature Dept. Head or Designee)
(Project Code)
$ 50,000.00'-./
$ 5,000.00
z l0 I/7 7���i,, o,� (4 ), ,/lA
Date (Signature Finance Dept. Review)
-/-/7
Date
K:\shared goodies\forms\Expenditure Pre-Authorization.xls (Mar 2010)
FILE
it i of Waterloo
City Clerk Use Only
Finance Committee
tiSr t
Approval Date it u f f
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
$ 3,952.50 plus est. shipping costs of $ 0.00 to pay for or purchase
Per VGM Development Agreement removal of San Marnan Pavement striping
This purchase or expenditure is being made because:
Required by VGM Development Agreement.
Vendor selected for this purchase: Iowa Plains Signing, Inc.
❑ Bids or written quotes were taken on this purchase, as follows:
Iowa Plains Signing, Inc. - $3,952.50
❑ Bids or quotes were not taken on this purchase because:
Prior Committee Actions (Dates): NA
Please check the following box(es) as appropriate to describe the funding for this expense:
El
General Fund
Bonds
Road Use Tax ❑ Sewer
Federal/other grants I I Other (specify)
This expenditure is to be coded to the following budget line -item:
426-08-6205-2148
(Fund - Department - Activity - Account Number)
in which the budgeted amount is
and the current available balance is
Respectfully submitted,
Sanitation
San Marnan TIF
(Project Code)
$ 5f2.00/c •
(Signature ept. Head or Designee) Date (Sign`ature Finance Dept. Review) Date
K:\shared goodies \forms\Expenditure Pre-Authorization.xls (Mar 2010)
City Clerk Use Only
Finance Committee /
' Approval Date L 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 Engineering Department to expend
$ 4,185.48 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, 2017. 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:
0
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 ❑ Road Use Tax n Sewer
Bonds
El
Sanitation
❑ Federal/other grants ❑ Other (specify) Local Option Sales Tax
This expenditure is to be coded to the following budget line -item:
205-07-7830-1520
(Fund - Department - Activity - Account Number)
in which the budgeted amount is
and the current available balance is
Respectfully submitted,
�Q )�
(Signature Dept. Head or Designee) Date (Signature Finance Dept. Review) Date
(Project Code)
$ 7,000.00 /
$ 7,000.00 ✓
K:\shared goodies\forms\Autocad 2018 Pre-Authorization.xlsx (Mar 2010)
City Clerk Use Only
Finance Committee 2/
Approval Date ( 7
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 WFR Department to expend
$ 1,300.00 plus est. shipping costs of $ n/a to pay for or purchase
(3) three recruit hiring physicals.
This purchase or expenditure is being made because:
Psychological evaluations are required for new hires.
Vendor selected for this purchase: Center for Behavioral Health, PC
Bids or written quotes were taken on this purchase, as follows:
[ Bids or quotes were not taken on this purchase because:
We have a contract with Dr. Roland for psychological evaluations.
Pr;or Committee Actions (Dates):
Please check the following box(es) as appropriate to describe the funding for this expense:
PH
General Fund
Bonds
n
Road Use Tax Sewer n Sanitation
Federal/other grants n Other (specify)
This expenditure is to be coded to the following budget line -item:
01 'J-12-1400-1314
(Fund - Department - Activity - Account Number)
(Project Code)
in which the budgeted amount is $ 14,500.00 V
and the current available balance is
$ 7,038.00 ✓
(Si fnatur ept. Head or Designee) Date (Signature Finance Dept. Review) Date
Sent over 013016.
City Clerk Use Only
Finance Committee Approval Date 971,61
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
$ 10,052.55 plus est. shipping costs of $ n/a to pay for or purchase
56 lineal feet of concrete block interior walls and other masonry work
This purchase or expenditure is being made because:
to make repairs to Riverfront Sports Park concession stand caused by flood of 2016
at Exchange Park
Vendor selected for this purchase: B and B Builders and Supply
❑x
Bids or written quotes were taken on this purchase, as follows:
B and B Builders and Supply, Waterloo Iowa $10,052.55
Carl Schuler Masonry, Waerloo Iowa $17,700
Bowers Masonry, Waterloo Iowa No Bid
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:
n
General Fund
Bonds
Road Use Tax
Federal/other grants
Sewer
Other (specify)
This expenditure is to be coded to the following budget line -item:
415-37-4202-2178
(Fund - Department - Activity - Account Number)
in which the budgeted amount is
and the current available balance is
submitted,
�/�J.r,�u�
(Signature eptd or Designee) Date (Signature Finance Dept. Review) Date
Sanitation
(Project Code)
$ 90,000.00 :/
$ 30,416.92 /
K:\shared goodies \forms\Pre-Authorization Concession Stand RSP (2).xls (Mar 2010)
City of Waterloo
Expenditure 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
$ 1,944.00 plus est. shipping costs of $ to pay for or purchase
Baseballs for the Optimist Baseball program.
This purchase or expenditure is being made because:
Games balls are needed for Optimist Baseball games for players in grades 2-8.
❑x
Bids or written quotes were taken on this purchase, as follows:
AD Starr (Pittsburgh, PA) $1,944.00
BSN (Cedar Falls, IA) $2,247.50
Craft Cochran (Waterloo, IA) Did not submit bid
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
n Bonds
Road Use Tax n Sewer n Sanitation
Federal/other grants ❑ Other (specify)
This expenditure is to be coded to the following budget line -item:
010-37-4200-1566 Optimist Expense
(Fund - Department - Activity - Account Number)
in which the budgeted amount is
and the current available balance is
Respectfully submitted,
y (Signature Dept. He esignee) Dat (Signature Finance Dept. Review) Date
(Project Code)
�d
$ LI40,o� ��p -La
$ t-13, (L.; a) ✓
users\shared goodies\forms\Expenditure Pre-Authorization-2013 Baseballs(Oct 2004)
City Clerk Use Only
Finance Committee 21
Approval Date /t 1
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
$ 1,417.50 plus est. shipping costs of $ na to pay for or purchase
Baseball and Softball socks.
This purchase or expenditure is being made because:
Participants in our baseball and softball programs receive socks as part of their
registration fee.
Vendor selected for this purchase: Advantage Screenprint (Waterloo, IA)
❑X
Bids or written quotes were taken on this purchase, as follows:
Advnatage Screenprint (Waterloo, IA) $1,417,50
BSN (Cedar Falls, IA) $1,521.00
AD Starr (Pittsburgh, PA) $1,566.00
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:
❑ General Fund ❑ Road Use Tax ❑ Sewer ❑ Sanitation
❑ Bonds ❑ Federal/other grants ❑ Other (specify)
This expenditure is to be coded to the following budget line -item:
010-37-4200-1566 Optimist Equipment
(Fund - Department - Activity - Account Number)
in which the budgeted amount is
and the current available balance is
Respectfully bmitted
/ - 5 -( 7 u F; -c- kd x-<-e ,r 1 2'i'1�
(Signature Dept. or Designee) Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\Expenditure Pre-Authorization-2015 socks (Mar 2010)
(Project Code)
$ `k , o00.. p -c,)
City Clerk Use Only
Finance Committee /
Approval Date (O r (1
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
$ 3,755.00 plus est. shipping costs cif $ na to pay for or purchase
Baseball/softball pants.
This purchase or expenditure is being made because:
Participants in our baseball and softball programs receive pants as part of the registration
fee.
Vendor selected for this purchase: Creative Impact (Evansdale, IA)
❑x
El
Bids or written quotes were taken on this purchase, as follows:
Creative Impact (Evansdale, IA) $3,755.00
Advantage Screenprint (Waterloo, IA) $3,830.00
AD Starr (Pittsburgh, PA) $3,830.00
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 ❑ Sewer
❑
Bonds
❑ Federal/other grants ❑ Other (specify)
This expenditure is to be coded to the following budget line -item:
010-37-4200-1566 Optimist Equipment
(Fund - Department - Activity - Account Number)
in which the budgeted amount is
and the current available balance is
Respectfully submitted,—"ZZ n p
(Signature Dept. Had esignee) Date (Signature Finance Dept. Review) Date
Sanitation
(Project Code)
$ ` 5.d1 t{a.6038•�
K:\shared goodies Worms \Expenditure Pre-Authorization-2015 pants (Mar 2010)
City of Waterloo
Expenditure Pre -Authorization Request Form
Approval Date
City Clerk Use Only
Finance Committee /
bl
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
$ 12,556.25 plus est. shipping costs of $ na to pay for or purchase
Major League Baseball jerseys for participants in Optimist Baseball and Softball offered
for grades 2-8.
This purchase or expenditure is being made because:
Participants in our baseball and softball programs receive jerseys as part of their
registration fee.
Vendor selected for this purchase: Advantage Screenprint (Waterloo, IA)
Bids or written quotes were taken on this purchase, as follows:
Advantage Screenprint (Waterloo, IA) $12,556.25
Creative Impact (Evansdale, IA) $12,761.25
Craft Cochran (Cedar Falls, IA) did not submit bid
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:
Q General Fund n Road Use Tax ❑ Sewer Sanitation
• Bonds n Federal/other grants n Other (specify)
This expenditure is to be coded to the following budget line -item:
010-37-4200-1566 Optimist Equipment
(Fund - Department - Activity - Account Number)
in which the budgeted amount is
and the current available balance is
Res Ily submitted,
/ —e5- -( 7/7 Le JJx. !/ikG mvi .1-/-t?
(Signature Dept ead or Designee) Date (Sigature Finance Dept. Review) Date
(Project Code)
$ r'f t ,3 S"S3'%o✓
K:\shared goodies\forms\Expenditure Pre-Authorization-2015 jerseys (Mar 2010)
City of Waterloo
Expenditure Pre -Authorization Request Form
City Clerk Use Only
Finance Committee
Approval Date
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
$ 9,157.50 plus est. shipping costs of $ na to pay for or purchase
Major League replica hats and visors.
This purchase or expenditure is being made because:
Participants in our baseball, softball, tee ball and coach pitch programs receive a hat as
part of their registration fee.
Vendor selected for this purchase: AD Starr Pittsburgh, PA
E Bids or written quotes were taken on this purchase, as follows:
AD Starr (Pittsburgh, PA) $9,157.50
BSN (Cedar Falls, IA) $9,480.00
• 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:
• General Fund Road Use Tax ❑ Sewer n Sanitation
• Bonds El Federal/other grants n Other (specify)
This expenditure is to be coded to the following budget line -item:
010-37-4200-1566 Optimist Equipment
(Fund - Department - Activity - Account Number)
in which the budgeted amount is
and the current available balance is
Respectfully submitted,
(Project Code)
$
LI(\(
I\N��(a�.-`.n V:l
$ t{5, \ 3..44 2k 3.27 &.
� / 7
(Signature Dew= ad or Designee) Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\Expenditure Pre-Authorization-2015 hats (Mar 2010)
City of Waterloo
Expenditure Pre -Authorization Request Form
City Clerk Use Only
Finance Committee
Approval Date L /( 1
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
$ 23,410.20 plus est. shipping costs of $ N/A to pay for or purchase
60 trees to be supplied and planted by contractor
This purchase or expenditure is being made because:
Replace ash trees removed at Iry Warren Golf Course due to the Emerald Ash Borer
infestation in the community.
Vendor selected for this purchase: Matthias Landscaping
❑ Bids or written quotes were taken on this purchase, as follows:
Matthias Landscaping - $23,410.20
Jordan's Nursery - $27,045
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
Bonds
Road Use Tax Sewer
Federal/other grants ❑ Other (specify)
This expenditure is to be coded to the following budget line -item:
416-37-4100-2166
(Fund - Department - Activity - Account Number)
in which the budgeted amount is
and the current available balance is
Resp�submitted;
Sanitation
(Project Code)
$ 300,000.00
$ 1-54,447.00 /5..
esignee) Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\diture Pre -Authorization (Mar 2010)
City of Waterloos l (1
Expenditure 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
$ 12,400.00 plus est. shipping costs of $ to pay for or puchase
trees purchased for the Plant Some Shade project. This is a project with the Iowa DNR
and MidAmerican Energy.
This purchase or expenditure is being made because:
The tree distribution project that offers trees to MidAmerican Energy customers at $30
per tree. Iowa DNR will reimburse the City for the remaining expense of the trees.
Bid decision was made by Iowa DNR.
❑ Bids or written quotes were taken on this purchase, as follows:
Trees will be purchased from vendors as selected by Iowa DNR.
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
Sewer
Sanitation
Federal/other grants FIX Other (specify) DNR - MidAm customers
This expenditure is to be coded to the following budget line -item:
010-37-4105-1536 37RST-PS16
(Fund - Department - Activity - Account Number) (Project Code)
in which the budgeted amount is
and the current available balance is
Respectfully submitted,
$ 12,400.00
$ 12,400.00 V
;,24(l7 ?'Ii r 6.r lIA-, l o f-/
(Signature Dept. d or Designee) Dale (Signature Finance Dept. Review) Date
users\shared goodies\forms\Pre Auth PS16 spring 2017.xls(Oct 2004)
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
$ 24,794.75 plus est. shipping costs of $ N/A to pay for or purchase
59 trees to be supplied and planted by contractor
City Clerk Use Only
Finance Committee
Approval Date 2 /‘'/( 7
This purchase or expenditure is being made because:
Replace ash trees removed at Bontrager and C.A.Morris Parks due to the Emerald Ash
Borer infestation in the community
Vendor selected for this purchase: Matthias Landscaping Waterloo IA
I ^ I Bids or written quotes were taken on this purchase, as follows:
Matthias Landscaping, Waterloo IA - $ 24,794.75
Jordan's Nursery, Cedar Falls IA - $30,750
l l 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 ❑ Sewer
Bonds ❑ Federal/other grants ❑ Other (specify)
This expenditure is to be coded to the following budget line -item:
010-37-4100 1536 $4086.75 010-37-4105 1536 $15,508
(Fund - Department - Activity - Account Number)
4l(o•31-4100-71166 *5,.00
in which the budgeted amount is
and the current available balance is
Respectfully submitted,
(Signature Dept
Sanitation
to be determined
(Project Code)
$ 5,000 15,508✓ 300,000 /
$ 5,000'715,508 /16215 78 /
3 l 7 7/-iy.CLLLt'lA_- -7-17'7
Designee) Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\Park Tree Planting.xls (Mar 2010)
(Signature Dept.
City of Waterloo
Expenditure Pre -Authorization Request Form
City Clerk Use Only
Finance Committee
Approval Date 9 /b/1 7
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
$ 8,781.60 plus est. shipping costs of $ 0.00 to pay for or purchase
Payment to Waterloo Black Hawks LLC. for 10% of the city's gross concession revenues
from (15) regular season Black Hawk games during the 2016-2017 season at Young Arena.
This purchase or expenditure is being made because:
the Black Hawks receive %10 of all gross food revenues at Young Arena from regular &
post season home games & $1,000 for every post season game held at Young Arena.
Vendor selected for this purchase:
Bids or written quotes were taken on this purchase, as follows:
n Bids or quotes were not taken on this purchase because:
this is a contractual obligation between the Waterloo Black Hawks and City of
Waterloo.
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 Sanitation
Federal/other grants n Other (specify)
This expenditure is to be coded to the following budget line -item:
010-37-4500-1390
(Fund - Department - Activity - Account Number)
in which the budgeted amount is
and the current available balance is
III submitted,
teee �7 a,LJIL // A&i.//1
Designee) Date Signature Finance Dept. Review) Date
(Project Code)
$ 35, 800.00 ✓
$ 25,305.00
r (0 5
K:\shared goodieslforms\2017 WBH Profit Payment 15games.xls (Mar 2010)
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 Planning Department to expend
$ 7,500.00 plus est. shipping costs of $ 0.00 to pay for or purchase
Asbestos removal for Single Speed Project - 325 Commercial Street
This purchase or expenditure is being made because:
Agreement between Single Speed & city to remove all asbestos prior to sale
Vendor selected for this purchase: Service Roofing
IT Bids or written quotes were taken on this purchase, as follows:
Q Bids or quotes were not taken on this purchase because:
Single Speed hired Service Roofing to redo the entire roof; made sense to remove
asbestos at same time
Prior Committee Actions (Dates):
Please check the following box(es) as appropriate to describe the funding for this expense:
n General Fund n Road Use Tax n Sewer Sanitation
nBonds n Federal/other grants I I Other (specify)
This expenditure is to be coded to the following budget line -item:
414 08 5150 1396
(Fund - Department - Activity - Account Number)
in which the budgeted amount is
and the current availa6le balance is
Respectf
(Project Code)
$ 100,000.00 V
$ 4-08; 090 0@-
3-(-2ui
(Signaturevept. Head or Designee) Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\Expenditure Pre-Authorization.xls (Mar 2010)
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 Planning
$ 3,840.00 plus est. shipping costs of $ 0.00
Department to expend
to pay for or purchase
Asbestos survey services for 1100 Grant Ave, 919-925 Commercial and 120 Center St.
This purchase or expenditure is being made because:
In preparation for demolition of properties
Vendor selected for this purchase: Impact 7G
❑X
Bids or written quotes were taken on this purchase, as follows:
Impact 7G - $3,840
Hawkeye Env - $ *' Li (jU
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:
nGeneral Fund n Road Use Tax Sewer Sanitation
n Bonds Federal/other grants n Other (specify)
This expenditure is to be coded to the following budget line -item:
414 08 5150 1396
(Fund - Department - Activity - Account Number)
in which the budgeted amount is
and the current available b e is
(Project Code)
$ 100,000.00
$ 100,000.00
;a-/-l7
(Signature Dept. Hea r Designee) Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\Expenditure Pre-Authorization.xls (Mar 2010)
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 P&Z,Eng & CD Department to expend
$ 3,091.92 plus est. shipping costs of $ 0.00 to pay for or purchase
ArcGIS Software Maintenance & ArcPad Maintenance Agreement
This purchase or expenditure is being made because:
The maintenance agreement is a yearly ageement that provides technical support
for the software, as well as no -cost upgrades that become available
Vendor selected for this purchase: ESRI
n Bids or written quotes were taken on this purchase, as follows:
n Bids or quotes were not taken on this purchase because:
This is a maintenance agreement to current software
Prior Committee Actions (Dates):
Please check the following box(es) as appropriate to describe the funding for this expense:
n General Fund n Road Use Tax n Sewer n Sanitation
❑ Bonds n Federal/other grants n Other (specify) LOST,storm water,CDBG
This expenditure is to be coded to the following budget line -item:
010 08 570 1520 ($622.23); 224 32 5850 1520 ($311.11)
(Fund - Department - Activity - Account Number)
I520- 14G.3(0
fix( "R n ('
in which the budgeted amount is
and the current available bade is
X ir1.L t ✓h s(dON1'rfie
Respe trfy&mi
F
BG21A ADMN
(Project Code)
)5 -t
$ 320200 loopy 65b'
? 201 gj170001 q SO ✓
f✓u, 3tt r i 12Ree ') 2.22-
�,�.� i /L �/ �•0I.)� � �!� 0/r� Ii(.r9,n.ii
(Signature Dept. Head or Designee) Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\ESRI MtAgmt 1.31.17.xls (Mar 2010)
City Clerk Use Only
Finance Committee
Approval Date '(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 Police Department to expend
$ 2,650.00 plus est. shipping costs of $ 25.00 to pay for or purchase
Purchase (2) two Taser X26P with extended warranty and holsters
This purchase or expenditure is being made because:
replace broken worn out Taser's so we have an extra Tasers when one breaks
Vendor selected for this purchase: Taser International
❑ Bids or written quotes were taken on this purchase, as follows:
I I Bids or quotes were not taken on this purchase because:
Taser International is a proprietary company to this software and is the only provider
for this annual license renewal.
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 n Sanitation
Federal/other grants ❑ Other (specify)
This expenditure is to be coded to the following budget line -item:
416-11-1100-2128
(Fund - Department - Activity - Account Number)
in which the budgeted amount is
and the current available balance is
Respectfully suitted,
(Signature De p . H Head or De
(Project Code)
$ .13.Oo0
$ l� 3��s� ✓
13C(1-) 9%.rz,.>/i,citc- (A) i',t ,fAA ,2-1-17
Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\Expenditure Pre'Authorization (Mar 2010)
City Clerk Use Only
Finance Committee 4
Approval Date di 1
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
$ 5,600.00 plus est. shipping costs of $ 100.00 to pay for or purchase
purchase a new pole camera system
This purchase or expenditure is being made because:
purchase an additional pole camera surviellence system
Vendor selected for this purchase: RC System
n Bids or written quotes were taken on this purchase, as follows:
Q Bids or quotes were not taken on this purchase because:
This equipment is in addtion to an existing system used by the Waterloo
Police Department
Prior Committee Actions (Dates):
Please check the following box(es) as appropriate to describe the funding for this expense:
❑ General Fund
n Bonds
Road Use Tax n Sewer ❑ Sanitation
Federal/other grants n Other (specify) WPD Forfeiture Funds
This expenditure is to be coded to the following budget line -item:
010-11-1150-1512 11TRIWPDF
(Fund - Department Activity - Account Number) (Project Code)
in which the budgeted amount is
and the current available balance is
spectfully ubrrjitted,
,►•
��� I�3° /y% %lc (��cs2c2 /�7
( ignature D pt. Head or esignee) Date (Signature Finance Dept. Review) Date
$ 510d
K:\shared goodies\forms\Expenditure Pre -Authorization (Mar 2010)
City Clerk Use Only
Finance Committee
Approval Date /
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 Department to expend
$ 9,700.00 plus ext. shipping cost of $ 0.00 to pay for or purchase
Annual support, operation and maintenance of streamgaging station 05464000 on the Cedar River at
Waterloo
This purchase or expenditure is being made because:
For continuing support, operation and maintenance of streamgaging station 05464000
on the Cedar River at Waterloo.
Vendor selected for this purchase:
U.S. Geological Survey
[]Bids or written quotes were taken on this purchase, as follows
X
Bids or quotes were not taken on this purchase because:
U.S. Geological Survey is rep. for annual service of streamgaging station.
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:
[]Bonds:
Sanitation:
❑Federal/other grants: nOther(specify):
This expenditure is to be coded to the following budget line -item:
520-14-5200-1319
(Fund - Department - Activity - Account Number) (Project Code)
in which budgeted amount is $ 103,545.00
and the current available balance is $ 54,4)5445 f? &id
Respectfully submitted, "\/;N-.L12-Ae)tN--- 1(21 f (2.0 {1 iv(c,e/%dZ6�— G)„.riA-r2c4 < i7
(Signature Dept. Head Or Designee) I Date (Signature Finance Dept. Review) Date
City Clerk Use Only
\Finance Committee
\Approval Date
City of Waterloo Request Form
Expenditure Authorization Reqned to authorize the following
The Finance Committee of the City Council is here by Se�Qr Department to expend
repurchase or expenditure submitted by the to pay for or purchase
$ 4,478.00 plus ext. shipping cost of $ 400.00
Re.lacement •um • Keen model KG3 with 40 ft. sower cable for David lift station
This purchase or expenditure is being made because:
On of the current um s is worn- ut.
Vendor selected for this purchase:
Quality Pump & Control
❑Bids or written quotes were taken on this purchase, as follows
®Bids or quotes were not taken on this purchase because:
Quality Pump & Control is rep. for replacement pump.
Prior Committee Actions (Dates):
Please check the following box(es) as appropriate to describe the funding for this expense:
General Fund: Road Use Tax: ['Sewer: ❑Sanitation:
Bonds: Federal/other grants:
❑Other(specify):
This expenditure is to be coded to the following budget line -item:
520-14-5200-1571
(Fund - Department - Activity - Account Number)
in which budgeted amount is
and the current available balance is
Respectfully submitted,
(,(302_,5\-7
(Signature Dept. Head Or Designee) 1 Date
(Project Code)
$ 350,000.00 ✓
$ 140.952.37 V
(Signature Finance Dept. Review) Date
City Clerk Use Only
Finance Committee
Approval Date "IL(
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 Traffic Operations Department to expend
$ 10,000.00 plus est. shipping costs of $ to pay for or purchase
to provide and install new fiber from new signal cabinet at Franklin St. and 1st St. to
E. 6th St. and Mulberry Street.
This purchase or expenditure is being made because:
Provide fiber connection to traffic signals and city hall and fire station.
Vendor selected for this purchase: KW Electric, Inc.
n Bids or written quotes were taken on this purchase, as follows:
KW Electric, Inc. Cedar Falls, Iowa $10,000.00
CEC (Communications Engr. Co.) Hiawatha, Iowa $55,613.00
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:
❑X
General Fund ❑ Road Use Tax ❑ Sewer
Bonds
❑ Federal/other grants n Other (specify)
This expenditure is to be coded to the following budget line -item:
416-17-7161-2125
Sanitation
(Fund - Department - Activity - Account Number) (Project Code)
in which the budgeted amount is
and the current available balance is
Respectfully submitted,
$ 40,000.00
$ 40,000.00
1,rA4z7
(Signature Dept. Head or Designee) late (Signature Finance Dept. Review) Date
K:\shared goodies\forms\2017-January-Expenditure Pre-Authorization-416-17-7161-2125-$10,000 - KW Electric -fiber connection -Franklin -1st
to 6th St.xls (Mar 2010)
PROJECT BUDGET WORKSHEET- NON -CONSTRUCTION
PAGE TWO
City Clerk Use Only
Finance Committee
Approval Date "6 I! 1
Project Name (from page one) IA DNR - MidAmerican Energy Plant Some Shade #16
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
3712 Sale of Trees
EXPENDITURES:
37 Leisure Service
010 37 4105
To be assigned by the Finance Dept.
Project No,
Subproject No.
37a5i
(Each column should only include amounts by fund)
Fund:
010 Fund: Fund: Fund:
8,000.00
Total
8000.00
5,400.00 5,400.00
TOTALS $ 13,400.00 $ - $ $ - $ 13,400.00
1111 Salaries - Regular
1112 Salaries - Part Time
1315 Education & Training
1345 Travel - Official City
1346 Travel - Prof Training
1390 Contractual Services
1536 Trees
1,000.00 $ 1,000.00
12,400.00 12,400.00
1541 Cleaning Supplies -
TOTALS $ 13,400.00 $ - $ - $ $ 13,400.00
(Signature Dep . ead)
l 2v- /? . t- /��.0 .� 02-7-f7
Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\PSS Project Budget Workshee.xls\Page 2 (Donat or NON-constr) (Mar 2010)
PROJECT BUDGET WORKSHEET - ALL PROJECTS
PAGE ONE
Project Name IA DNR - MidAmerican Energy Plant Some Shade #16
City Contract No.
Project Manager
Project Budget Total $
Todd Derifield
1. How will this project be funded?
A. Federal Grant Yes No X CFDA #
Grant Name
B. State Grant Yes
Grant Name
C. City Match
D. Other Entities Yes X No
Name
No
Source of Funding
To be assigned by the Finance Dept.
Project No.
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?
If yes, employee/position to be covered.
6. Include a brief description of the project in the space below: (REQUIRED)
Done None
Yes No
L
X
This project is with the Iowa DNR and Mid -American Energy. Trees are offered for sale at $30.00 to customers of
Mid -American Energy. IA DNR reimburses the City for the expense of the trees, plus an administrative fee. This will be the
16th time the City has participated in the Plant Some Shade project.
Distribution date is May 4, 2017.
Page 2 must be attached and signed.
K:\shared goodies\forms\PSS Project Budget Workshee.xls\Page 1 All Projects (Mar 2010)
PROJECT BUDGET WORKSHEET- NON -CONSTRUCTION
PAGE TWO
City Clerk Use Only
Finance Committee /
Approval Date 2 / 1 7
Project Name (from page one) Morris Park Bontraeger Park Tree Replacement (MBTR17)
Department No. project will be budgeted under 37
Activity No. project will be budgeted under 4105
To be assigned by the Finance Dept.
Project No.
Subproject No.
312si
(Each column should only include amounts by fund)
Fund: Fund: Fund:
010 010 _416 Fund:
Total
REVENUES: 010-37-4100 010-37-4105 416-37-4100
37RST-
3000 Cash on Hand Qp ,r/'•t� 4,086.75 $ 4,086.75
3350 Federal Grant
3352 Federal HUD Grant
3354 Shared Program - Local
3357 Shared Program - County
3358 Shared Program - City
3,360 Shared Program - State
3361 State Grant
3720 Donations - Restricted 15,508.00 - 15,508.00
3750 Sale of Bonds 5,200.00 5,200.00
3111 Hotel Motel Discretionary
EXPENDITURES:
TOTALS $ 4,086.75 $ 15,508.00 $ 5,200.00 $ $ 24,794.75
1111 Salaries - Regular
1112 Salaries - Part Time
1315 Education & Training
1345 Travel - Official City
1346 Travel - Prof Training
1390 Contractual Services
1536 Trees
2166 Trees
(Signature Dept.
4,086.75
15, 508.00 19, 594.75
5,200.00 5,200.00
TOTALS $ 4,086.75 $ 15,508.00 $ 5,200.00 $ $ 24,794.75
c ''7 711.c64. /lam
Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\Project Morris Bontraeger.xls\Page 2 (Donat or NON-constr) (Mar 2010)
PROJECT BUDGET WORKSHEET - ALL PROJECTS
PAGE ONE
Project Name Morris Park Bontraeger Park Tree Replacement
City Contract No.
Project Manager
Todd Derifeld
Project Budget Total $ 24,794.75
1. How will this project be funded?
A. Federal Grant Yes
Grant Name
No
CFDA #
B. State Grant Yes
Grant Name
No
C. City Match Source of Funding
D. Other Entities Yes
Name
No
MidAmerican Grant and Comm Foundation Grant
To be assigned by the Finance Dept.
Project Na.
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?
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
❑ 0
❑ ❑
❑ ❑
❑ ❑X
❑ ❑X
❑ ❑X
❑ ❑X
This project is to replace trees in Morris Park and Bontraeger Park. Many ash trees were removed due to infestation of
the EAB.
FUNDING - we will be using $15,508.00 grant received from Community Foundation of Northeast Iowa.
Leisure Ash Replacement bond money and operating budget.
Page 2 must be attached and signed.
K:\shared goodies\forms\Project Morris Bontraeger.xls\Page 1 All Projects (Mar 2010)
PROJECT BUDGET WORKSHEET - ALL PROJECTS
PAGE ONE
Project Name ACM Inspection - 120 Center St
City Contract No. 17-7540-28
Project Manager Noel Anderson
Project Budget Total $ 1,280.00
1. How will this project be funded?
A. Federal Grant Yes No CFDA #
Grant Name
X
B. State Grant Yes X No
Grant Name IDNR ACM Inspection - 120 Center St
C. City Match Source of Funding
D. Other Entities Yes No
Name
/2
To be assigned by the Finance Dept.
Project No.
Subproject No. j,.?✓,`�r= ate
% Paid by federal grant
Grant Agreement Number
% Paid by state grant 100.00%
Grant Agreement Number 17-7540-28
% 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)
Proper assessment, testing, & documentation of asbestos containing material (ACMs) within structures at project site
Done None
0 ❑
Yes No
❑ 0
❑ ❑
❑ 0
CI 0
❑ ❑
❑ 0
Page 2 must be attached and signed.
K:\shared goodies\forms\Project Budget Worksheet.xls\Page 1 All Projects (Mar 2010)
PROJECT BUDGET WORKSHEET- NON -CONSTRUCTION
PAGE TWO
Project Name (from page one) ACM Inspection - 120 Center St.
Department No. project will be budgeted under 08
Activity No. project will be budgeted under 6100
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
EXPENDITURES:
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: Fund: Fund:
1,280.00
Total
1,280.00
TOTALS $ 1,280.00 $ $ - $ $ 1,280.00
1111 Salaries - Regular
1112 Salaries - Part Time
1315 Education & Training
1345 Travel - Official City
1346 Travel - Prof Training
1390 Contractual Services
2103 Eng & Consulting
(Signature Dept. Head)
1,280.00
1,280.00
1,280.00 $ $ $ $ 1,280.00
/- /-9-
Date
(Signature Finance Dept. Review)
Date
K:\shared goodies\forms\Project Budget Worksheet.xls\Page 2 (Donat or NON-constr) (Mar 2010)