Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Council Packet - 11/7/2016
TRAVEL REQUEST CITY OF WATERLOO FINANCE DEPT. STAFF ONLY LINE ITEM USED / ( Sc) /3 4 FY c i ?BUDGETED d UvO EXPENDED YTD /.2 THIS REQUEST ,39 LEFT AFTER THIS US REQUEST 5S DATE 2; v' l0''3E' -/Ca Original - Clerk/Finance Copy - Department NAME(S) AND POSITION(S): Jacob Frederick (Fitness Specialist) DATE: Recertifying Group Exercise not attending a conference. NAME OF CLASS / MEETING: ACE Group Exercise Certification 600- DEPARTURE DATE: RETUR DATE: DESTINATION: Test will be taken at UNI DEPARTURE POINT IF NOT WATERLOO: DATE(S) OF MEETING: Test date will be set after receiving study materials. PURPOSE OF TRAVEL/TRAINING: To recertify in group exercise programming so 1 can continue to be able. WILL TRAVEL REQUIRE ADDITIONAL PERSOF' 1 X COST $ YES NO METHOD OF TRAVEL: CITY VEHICLE PRIVATE VEHICLE AIRFARE DE,'ARTING FROM: ESTIMATE OF COST: LODGING TAXI MEALS 'sr,RKING 239.00 REGISTRATION AIRFARE MILEAGE/FUEL :'',ISC/TOLLS TOTAL FOR ALL: $ 239.00 BUDGET LINE ITEM: d 0-3 7-4I' GRANT REIMBURSABLE /3c/' YES NO YES NO TOTAL: $ PER PERSON REQUIRED CERTIFICATION I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE AND IS NECESSARY AND BENEFICIAL TO THE CITY OF WATERLOO DEPARTMENT HEAD i DATE K:\Shared Goodies\Forms\Travel Request 17o1 n January 2010 I APPROVE THIS TRAVEL REQUEST MAYOR DATE Group Fitness Instructor Certification With a group fitness certification, you hav;. the ability to get the most people moving, every day, and to make a tremendous impact on the health <:nd well-being of our communities. Truly, the need for talented and enthusiastic group fitness it s tructors with robust credentials has never been greater. The ACE Group Fitness Instructor program has no equal For 30 years, ACE has continually elevated Troup fitness standards with our NCCA-accredited Group Fitness Instructor Certification —well estr.-:.fished as the gold standard in the industry. Candidates who earn our certification are prepared to de:. er exceptional experiences in whatever modality ignites their passion, whether it's dance -based, indoor cycling, strength training, or anything in between. The all -new ACE Group Fitness Instructor r'..udy experience was created in collaboration with leading instructors in the group fitness space whcs hands-on expertise crosses multiple modalities. Building on input from these industry experts, we've ccveloped a practical, applied study experience that serves as a comprehensive resource for both new < nc1 veteran instructors. Whether you're a full-time instructor loo:.:)g to expand your expertise, or you're devoted to teaching a single class, our study program gives you .' e tools you need to deliver safe and memorable movement experiences in any modality. You deserve more than a 1-Day worksho. Our study program features an interactiv ;, digital learning experience that takes you step-by-step through the fundamentals of exercise prc ; amming, class design, music selection, teaching strategies, engagement and motivation techniques d much more, so you can create world -class experiences in every class. And don't worry, we'll be with you every :: ep of the way. The ACE Resource Center offers real-time study help from ACE Professionals. So M. _:1 in doubt, reach out —ACE Professionals are here to help by phone or email. . Gmail - American Council on Exercise Store Receipt Page 1 of 3 mail Jacob Frederick jacobefred@gmail.com> American Council on Exercise Store Receipt support@acefitness.org <support@acefitness.org> To: jacobefred@gmail.com { Pricing will be valid for 60 days from of quote. Payment must be received in full prior to exam and live workshop deadlines. Mail Quote and Payment to: American Council on Exercise 4851 Paramount Dr. San Diego, CA 92123 Order Information Wed, Oct 19, 2016 at 8:28 AM Order Number: QTE1069817 E-mail: jacobefred@gmail.com Date of purchase: 10/19/2016 6:28 AM Card Name: Card Number: PO Number: Shipment Details Group Fitness Instructor Pro Essentials Additional Certification Program - Hard Copy Only Quantity:1 @ $239.20 $239.20 https://mail.google.com/mail/u/0/?ui=2&ilc=f0c5b0ac59&view=pt&search=inbox&msg=157dd2... 10/19/2016 TRAVEL REQUEST CITY OF WATERLOO FINANCE DEPT. STAFF ONLY LINE ITEM USED 010-11-1100-1346 FY _2017_ BUDGETED 47.006 EXPENDED YTD 2 3/(p €1. THIS REQUEST //d LEFT AFTER THIS REQUEST . ( (.4 3 /y DATE y, !o- 3 o Original- Clerk/Finance Copy - De•artment NAME(S) AND POSITION(S): Sergeant Brian Hoelscher DATE: October 24, 2016 NAME OF CLASS / MEETING: Rifle Instructor Recertification DESTINATION: Johnston, Iowa DEPARTURE POINT IF NOT WATERLOO: DEPARTURE DATE: November 17th, 2016 Return Date: November 17th, 2016 DATE(S) OF MEETING: November 17th, 2016 PURPOSE OF TRAVEL: Lt. Cirksena is requesting permission to send the Sergeant Hoelscher to ILEA for rifle instructor recertification. It is an 8 hour course and is required to keep certification through the state of Iowa. Hoelscher is a firearms instructor. Cost is $175.00. A city vehicle will be used and fueled up at the pumps prior to departure. He will also be allotted $15.00 for lunch. WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL: x COST $ YES NO METHOD OF TRAVEL: XX CITY VEHICLE AIRFARE DEPARTING FROM: PRIVATE VEHICLE ESTIMATE OF COST: $0.00 LODGING TAXI $15.00 MEALS PARKING $175.00 REGISTRATION AIRFARE $0.00 MILEAGE/FUEL MISC/TOLLS TOTAL FOR ALL: $ 190.00 BUDGET LINE ITEM: x GRANT REIMBURSABLE YES NO REQUIRED CERTIFICATION YES NO TOTAL: $ 190.00 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 DEPARTMENT HEAD MAYOR DATE DATE TRAVEL REQUEST CITY OF WATERLOO FINANCE DEPT. LINE ITEM USED FY _2017_ BUDGETED EXPENDED YTD THIS REQUEST LEFT AFTER THIS REQUEST STAFF ONLY 010-11-1100-1345'6 05 DATE f✓A-_, 4.: 36' / (c Original - Clerk/Finance Copy - Department NAME(S) AND POSITION(S): Investigator Chris Gergen DATE October 24th, 2016 NAME OF CLASS / MEETING: Reid Technique of Investigative Interviewing and Advanced Interrogation DESTINATION Des Moines, Iowa DEPARTURE POINT IF NOT WATERLOO: DEPARTURE DATE: December 6th, 2016 Return Date: December 8th, 2016 DATE(S) OF MEETING: December 6th thru 8th, 2016 PURPOSE OF TRAVEL: Lt. Fangman is requesting authorization to send Inv. Chris Gergen to the Reid Technique of Investigative Interviewing and advanced Interrogation in Des Moines, Iowa on December 6th thru the 8th, 2016. The class will help develop interrogation strategies and interrogation themes to assist Investigator Gergen with his current assignment as an Investigator for the Waterloo Police Department. 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: $300.00 LODGING $105.00 MEALS $500.00 REGISTRATION $50.00 MILEAGE/FUEL .00 .00 .00 .00 TOTAL FOR ALL: $ 955.00 Rental car Parking AIRFARE Baggage fee BUDGET LINE ITEM: x GRANT REIMBURSABLE YES NO x REQUIRED CERTIFICATION YES NO TOTAL: $ 955.00 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 DEPARTMENT HEAD MAYOR ll DATE DATE TRAVEL REQUEST CITY OF WATERLOO FINANCE DEPT. LINE ITEM USED FY=/ 7 BUDGETED EXPENDED YTD THIS REQUEST LEFT AFTER THIS REQUEST STAFF ONLY 3:2 6:-.5 /346, DATE 377, 4) -/& Original - Clerk/Finance Copy - Department NAME(S) AND POSITION(S): Nancy Gulick, Community Development Coordinator DATE: October 20, 2016 NAME OF CLASS / MEETING: National Community Development Association Winter Legislative, Policy and Professional Development meeting DESTINATION: Washington D.C. DEPARTURE POINT IF NOT WATERLOO: DEPARTURE DATE: 2-14-2017 RETURN DATE: 2-17-2017 DATE(S) OF MEETING: 2-15 to 2-17-2017 PURPOSE OF TRAVEL/TRAINING: Attend meetings and meet with State of Iowa Senators and Representatives. I am also a member of the Technology Sub- committee. WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL: X COST$ YES NO METHOD OF TRAVEL: CITY VEHICLE American Airlines AIRFARE PRIVATE VEHICLE DEPARTING FROM: Waterloo (airfare on Expedia on 10-19-2016 is $422) ESTIMATE OF COST: $750 LODGING $9 MEALS $550 REGISTRATION MILEAGE/FUEL $100 $30 $600 $60 TOTAL FOR ALL: $ 2,310 TAXI PARKING AIRFARE MISC/TOLLS 224-32-5850-1346 BUDGET LINE ITEM: BG2IA.ADMN X GRANT REIMBURSABLE YES NO X REQUIRED CERTIFICATION YES NO TOTAL: $ 2,310 PER PERSON I BELIEVE THIS TRIP SERVE.... PU PURPOSE AND IS NECESSARY AND' EB N MCIAL T THE CITY OF WATERLOO DEPARTMENT HEAD October 20, 2016 I APPROVE THIS TRAVEL REQUEST MAYOR DATE J:\NANCY-G\travel\Travel Request Form Washington DC Oct 2016.doc DATE 5= Community Development Assn Winter Legislative, Policy and Professional Development Meeting Washington, DC — Holiday Inn Capitol Hill February 15-17, 2017 Agenda About NCDA's Winter Conference The 2017 NCDA Winter Conference focuses on three primary areas: legislative, policy, and professional development. The conference agenda content is focused on local government employees who oversee or directly administer the CDBG, HOME, and HUD's homeless assistance programs. The conference offers unparalleled professional development in eight program focus areas: community development, housing, planning, financial, technology/systems development, compliance, homelessness, and management. The conference will provide a wide range of information, networking opportunities for learning and sharing of best practices. Why You Should Attend. Why You Should Bring Other Staff. •Professional development •Learn the latest trends, best practices, and program regulations •Network with peers •Hear directly from HUD and Congressional staff NOTE: Congressional visits are encouraged, site visits are optional. NCDA members are strongly encouraged to schedule afternoon visits on Friday, February 17. Wednesday, February 15, 2017 Registration & Continental Breakfast Registration - 8:00 am — 5:00 pm; Breakfast - 8:00 am — 9:00 am PLENARY SESSION 9:00 am —10:00 am Conference Welcome and Legislative Update NCDA President Bonnie Moore (Shreveport, LA) and Executive Director, Vicki Watson, will welcome conference participants. Congressional staff will provide an update on the FY18 funding outlook for CDBG, HOME, and HUD's homeless assistance programs. 1 SUBCOMMITTEE MEETINGS (First Group). 10:00am-11:00am NCDA's six subcommittees are charged with tasks from developing policy to recruiting and retaining members to guiding the association's educational efforts. All meetings are open to all conference participants. We welcome and encourage your participation. If you are interested in becoming a voting member of a subcommittee, contact the co-chairs or the Executive Director. Community Development Program and Policy Subcommittee The subcommittee will hear important CDBG program updates from HUD staff and will approve its 2017 policy priorities. Membership Subcommittee The subcommittee will receive a membership update from staff. The subcommittee will also discuss and approve a 2017 membership recruitment and retention plan for the Association. Technology Subcommittee The subcommittee will discuss ideas for using technology to promote wider marketing of the association to attract new members. The subcommittee will also discuss the development of a system to track members' National CD Week activities. The subcommittee will approve its 2017 priorities. 11:00 am —11:10 am Break SUBCOMMITTEE MEETINGS (Second Group) 11:10 am —12:10 noon Planning and Professional Development Subcommittee The subcommittee will select topics for the 2017 annual conference agenda, review bids for the 2018 and 2019 annual conferences, and approve the 2017 subcommittee priorities. Housing Program and Policy Subcommittee The subcommittee will hear important HOME policy updates from HUD staff and will approve its 2017 priorities. Economic Development Program and Policy Subcommittee The subcommittee will discuss the development of an Economic Development course for NCDA's training arsenal. The subcommittee will approve its 2017 priorities. 12:10 noon —1:30 pm Lunch on your own TRAINING 1:30 pm — 5:30 pm 2 Planning Track: Affirmatively Furthering Fair Housing - Developing the Local Government Assessment Tool This training will provide important information on the Local Government Assessment Tool which replaces the Analysis of Impediments to Fair Housing. Participants will learn about the required components of the Assessment Tool, how the Tool fits into the Consolidated Plan process, and what you need to do to prepare for the Assessment Tool. Community Development Track: Basic CDBG This training will give a snapshot or a primer overview of the CDBG program focusing on the following areas: history of the program, national objectives, eligible activities, sub -recipients, timeliness, monitoring, and record keeping requirements. Housing Track: Basic HOME This training will give a snapshot or a primer overview of the HOME program focusing on the following areas: history of the program, eligible activities, CHDOs, monitoring, and record keeping requirements. Thursday, February 16, 2017 Registration & Continental Breakfast Registration - 8:00 am — 5:00 pm; Breakfast - 8:00 am — 9:00 am PLENARY SESSION 9:00 am — 10:30 am HUD Policy Update Conference participants will hear directly from HUD staff on important CDBG, HOME, Continuum of Care, and ESG policy updates and initiatives. 10:30 am — 10:45 am Break CONCURRENT SESSIONS 10:45 am —12 noon Technology/Systems/Financial Track: IDIS The session will provide information on IDIS system changes, new edits, and reporting. Planning Track: Consolidated Plan Best Practices Tips and best practices from the field on the development and implementation of the Consolidated Plan including, generating citizen participation, consulting and collaborating with local program partners, developing local performance standards and tracking goals. Housing/Community Development Track: Administration of Housing Rehabilitation Programs This session will provide information on recruiting and retaining contractors, streamlining application and inspection processes, and compliance. 3 Management Track: Leadership Roundtable This session will provide ideas for working with community leaders and city officials to form collaborative partnerships. 12:00 noon —1:30 pm Lunch on your own Board of Directors Luncheon Meeting 12 noon —1:30 pm TRAINING 1:30 pm — 5:30 pm Financial Track: Financial Management This training will focus on the financial management of the CDBG and HOME programs. Topics to be covered include the following: internal controls, determining allowable costs, budget control, cash management, financial reporting, pre -agreement costs, and annual audit requirements. Technology/Systems Track: Environmental Review (HEROs) This training will provide a primer on HUD's online system for developing, documenting, and managing environmental reviews. Housing Track: Advanced HOME Training This training will provide a more advanced look at certain areas of the HOME program including HOME program agreements, underwriting, subsidy layering, monitoring, and the Uniform Physical Condition Standards. Community Development Track: Economic Development This training will provide information on using CDBG for economic development including microenterprise and small business development and large-scale commercial and industrial development, using the Section 108 component of the CDBG program. Regional Caucus Meetings 5:30 pm — 6:30 pm • Region I • Region IV • Region VI Conference Reception 7:00pm-10:00pm Registration Continental Breakfast 8:00 am — 5:00 pm Friday, February 17, 2017 4 CONCURRENT SESSIONS 9:00 am —10:00 am Technology/Systems/Financial Track: Grant Based Accounting Participants will hear firsthand from other community development professionals on how to transition smoothly from the FIFO method in IDIS to HUD's grant -based accounting system, including funding activities, drawing down funds, revising vouchers, and meeting program commitment and expenditure deadlines. Community Development Track: CDBG-DR HUD's CDBG-DR program provides needed funds to areas hit by natural disasters. This session will cover the regulatory processes associated with CDBG-DR funding, including the development of an implementation plan, meeting the LMI set -aside, and requesting waivers. Housing Track: Preserving Affordable Housing This session will examine the policies and actions of several local communities to preserve affordable housing. Management Track: Working with the Media This session will provide information on how to work with your local media to promote CDBG and other programs, including techniques for gaining media coverage and information on building a media contact list. ROUNDTABLE DISCUSSIONS 10:00am-11:00am Conference participants will have the opportunity to attend roundtable discussions on the following topics. These informal discussions provide the opportunity for participants to gain insight on the subject matter and query other participants on the topic. • Compliance Track: Section 3 Compliance • Housing Tract: HOPWA • Financial Tract: Procurement • Community Development Tract: Citizen Advisory Committees • Homelessness Track: Continuum of Care Rating and Ranking Criteria • Planning/Technology/Systems Development Track: CAPER Development • Compliance: Quality Documentation and Agreements • Professional Development Track: So You Want to Be An NCDA Trainer 11:00 am —11:10 am Break 5 PLENARY SESSION 11:10am-12:30pm Community Development Best Practices Winners of the 2017 Audrey Nelson Community Development Achievement Award will present their projects which exemplify outstanding achievement in service to neighborhoods and their lower -income residents through their innovative and exemplary use of CDBG and HOME funds. PLENARY SESSION Audrey Nelson Community Development Achievement Awards Luncheon 12:30 pm — 2:00 pm Emcee: Vicki Watson, NCDA Executive Director Update on the 2017 Annual Conference — George Mensah, Community and Economic Development Director, City of Miami, FL AFTERNOON CONGRESSIONAL VISITS 2:00 pm — 5:00 pm This is an optional activity, Conference participants are encouraged to meet with their Congressional offices to voice support for increased funding for CDBG, HOME, and HUD's homeless assistance programs and to provide information on how the programs are being used in their districts. NCDA's Congressional Talking Points will be available in the conference packets to help in this endeavor. Please schedule these meetings ahead of time with your Congressional offices. 6 Sent over 102416 TRAVEL REQUEST CITY OF WATERLOO NAME(S) AND POSITION(S): Jason Hernandez, Medical Officer NAME OF CLASS / MEETING: IEMSA Conference DEPARTURE DATE: November 10,2016 DATE: 102416 FINANCE DEPT. STAFF ONLY LINE ITEM USED 0/0 /,2 /y/v /3q4, FYd20i7BUDGETED ();00eI EXPENDED YTD 100 THIS REQUEST LEFT AFTER THIS REQUEST AT G 7 L Rio 3,, -/ d, DESTINATION: Des Moines, IA DEPARTURE POINT IF NOT WATERLOO: PURPOSE OF TRAVEL: RETURN DATE: November 12, 2016 DATE(S) OF MEETING: November 10-12, 2016 Attending 27th IEMSA Conference. Attending Critical Care Paramedic (CCP) Refresher Course. WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL: METHOD OF TRAVEL: x COST$ YES NO CITY VEHICLE AIRFARE x PRIVATE VEHICLE DEPARTING FROM: ESTIMATE OF COST: $300.00 LODGING $20.00 MEALS $340.00 REGISTRATION MILEAGE/FUEL $30.00 TOTAL FOR ALL: $ 690.00 TAXI PARKING AIRFARE Membership BUDGET LINE ITEM: 010-12-1410-1346 x GRANT REIMBURSABLE YES NO x YES NO REQUIRED CERTIFICATION TOTAL: $ 690.00 PER PERSON I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE AND I AR 1 BE ICIAL-T THE CI OF WATER '00 1O aL-1b DATE I APPROVE THIS TRAVEL REQUEST MAYOR DATE 2016 : 27T" ANNUAL IEMSA CONFERENCE REGISTRATION REGISTER BEFORE UCTOBER 3151TO AVOID A S50 LATE REGISTRATION FEE! FIRST NAME ADDRESS _ 30-0 LAST NAME: 444 ,507 Q 3 CIfY/SfATE/ZIP LAST 4-DIGI OiSSa 9, _ (0O DATE OF BIRTH: PHONE--•----•�--- EMAIL CERTIFICATION LEVEL IEMSA INDIVIDUAL MEMBERSHIP: SAVE UP TO $90 [SIGN-UP ('RENEW NOW a PAY MEMPE R PPIEES TODAYI] $ ,30 O NEW ® RENEW $3o/YR THURSDAY : PRE -CONFERENCE WORKSHOP REGISTRATION S J! O FULL DAY : CRITICAL CARE PARAMEDIC MCP) REFRESHER $120 MEMBER /$150 NON-MEMBER S t/2 DAY: AM FIRE/RESCUE HANDS-ON TRAINING $60 MEMBER' / NON-MEMBER S 1/2DAY :PM STEMI/12 LEAD SCENARIO BASED/HANDS ON TRAINING $60 MEMBER' / $90 NON-MEMBER S 1/2 DAY: PM S.A.V.E.: SAFELY ADDRESSING VIOLENT ENCOUNTERS $60 MEMBER' / $90 NON-MEMBER IEMSA AFFILIATE MEMBERS MAY PICK (tl AM & Cl/ PM WORKSHOP FROM THESE (41 WORKSHOPS INDICATE 'FREE' OR ONLINE APPLY PROMO CODE AFF-LEADER. S 112 DAY: AM SERVICE DIRECTOR WORKSHOP $60 MEMBER' / $90 NON-MEMBER S 1/2 DAY: AM MEDICAL DIRECTOR WORKSHOP $60 MEMBER' / $90 NON-MEMBER S 1/2 DAY: PM LEADERSHIP/MANAGEMENT WORKSHOP $60 MEMBER' / $90 NON-MEMBER S 1/2 DAY: PM DRUGS Ft QI/CQI WORKSHOP $60 MEMBER' / $90 NON-MEMBER 2-DAY : FRIDAY & SATURDAY CONFERENCE REGISTRATION S 2Z 5220 MEMBER / 5290 NON-MEMBER S c U:lY L0'1GH PASS : $30 1-DAY: FRIDaTY REGISTRATION $165 MEMBER / 5240 NON-MEMBER S 1-DAY LU!ICH. PASS : $1s 1-DAY: SATURDAY REGISTRATION S $165 MEMBER / $240 NON-MEMBER S 1-DAY LUNCH PASS $ts LATE FEES: $ -I- $5O LATE REGISTRATION FEE REGISTRATIONS REC'D AFTER 12 AM/OCTOBER 31" s,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,h,,,.,,,,,,,.,.,n,,,,,,,, ,,,,,. 7,.,,n...,.n...n,..n..,.� , TOTAL REGISTRATION FEES f1 0 0 cc U' Z w 11.1 0 0 U -J Z z —......_..._.__.�___.._...___..--..___._...._..____.._—_..,_ CERT/LICENSE = 1- n w m 0Ca-02--7z. REGISTER BEFORE OCTOBER 31ST aAVOID A S50 LATE FEE ALL REGISTRANTS WILL RECEIVE AN IEMSA BACKPACK! D 3-WAYS TO REGISTER: El ONLINE BY CREDIT CARD: Go to www.tenw.net/ conference —click on 'Register Now',complete the online form, make payment securely by credit card. © COMPLETE THIS REGISTRATION FORM & MAIL WITH PAYMENT to confine your registration. Make checks payable to IEMSA and mail to: 5550 Wild Rose Lane, Ste. 400, West Des Moines, IA 50266. ID COMP1fTF THIS FORA ACID FAX This method is only for credit card payment registrations. Fax to 877-478-0925. R+ ru uj POLICY: Refunds, less a $50 processing fee, will be made for cancellations made prior to October 1581. No refunds made after Oct 31st. REGISTRATION DEADLINE. Register prior to October 31st to ensure entrance to the conference. Registrations received after this date & on -site registrations may be limited. IEMSA will not invoice services for payment. PO's not accented form of Payment. 1 NCELLATION POLICY: The Conference committee reserves the right to cancel any session or special event thar does not meet minimum requirements, or to change a spea. as necessary. CHOOSE YOUR BREAK-OUT SESSIONS ON THE BACK OF THIS FORM. REGISTRATION FORM > CONTINUED ON PAGE 42 }41 IOWA EMERGENCY MEDICAL SERVICES ASSOCIATION JULY/SEPTEMBER'2016 • ISSUE 3 IOWA EVENTS CENTER DES MOINES, IA • NOVEMBER 10-12, 2016 [FULL BROCHURE INSIDE] FOR POSITIVE CHANGE IN IOWA EMS NEW AT THE CONFERENCE! • ABE SERIES : NEW ORLEANS EMS LIFE BEHIND THE CAMERAS • S.A.V.E : SAFELY ADDRESSING VIOLENT ENCOUNTERS • LABOR B SEX TRAFFICKING IN IOWA FINANCE DEPT. STAFF ONLY TRAVEL REQUEST CITY OF WATERLOO LINE ITEM USED FY :Z' ( BUDGETED EXPENDED YTD THIS REQUEST LEFT AFTER THIS REQUEST DATE Original - Clerk/Finance [rrc) is to J LU /246' 3270 Co. - De.artment NAME(S) AND POSITION(S): David R. Zellhoefer, City Attorney Date: November 17, 18, 2016 NAME OF CLASS / MEETING: IMAA Annual Seminar Lc., 1-2-it" 4Gf- DESTINATION: Johnston, Iowa (Hilton Garden Inn) DEPARTURE POINT IF NOT WATERLOO: DEPARTURE DATE: November 17, 2016 RETURN DATE: November 18, 2016 DATE(S) OF MEETING: November 17, 18, 2016 PURPOSE OF TRAVEL/TRAINING: Annual Seminar for Municipal Attorney Association WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL: X COST $ 0 YES NO METHOD OF TRAVEL: CITY VEHICLE AIRFARE X PRIVATE VEHICLE DEPARTING FROM: ESTIMATE OF COST: LODGING MEALS 115.00 REGISTRATION MILEAGE/FUEL TOTAL FOR ALL: $ 115.00 TAXI PARKING AIRFARE MISC/TOLLS BUDGET LINE ITEM: 010-06-8600-1346 X GRANT REIMBURSABLE YES NO X REQUIRED CERTIFICATION YES NO TOTAL: $ 115.00 PER PERSON I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE AND IS NECESSARY AND BENEFICIAL TO THE CITY OF WATERLOO 7.) DEPAR EAD I APPROVE THIS TRAVEL REQUEST MAYOR DATE DATE K:\Shared Goodies\Forms\Travel Request Form January 2010 TRAVEL REQUEST CITY OF WATERLOO FINANCE DEPT. LINE ITEM USED FY:20/ 7 BUDGETED EXPENDED YTD THIS REQUEST LEFT AFTER THIS REQUEST DATE Original - Clerk/Finance STAFF ONLY 71Z2 ,/...3. esto0 3r7) /0-/' 17;2 Copy - Department NAME(S) AND POSITION(S): Mohammad Elahi, Traffic Engineer DATE: November 1, 2016 NAME OF CLASS / MEETING: MoboTrex, Inc. 2016 Davenport User's Group DESTINATION: Davenport, Iowa DEPARTURE POINT IF NOT WATERLOO: DEPARTURE DATE: December 6, 2016 RETURN DATE: December 8, 2016 DATE(S) OF MEETING: December 7 & 8, 2016 PURPOSE OF TRAVEL/TRAINING: Opportunity to network, meet leading traffic industry manufacturers one on one and experience classroom sessions on innovative technology. WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL: X COST $ YES NO METHOD OF TRAVEL: XX CITY VEHICLE AIRFARE DEPARTING FROM: PRIVATE VEHICLE ESTIMATE OF COST: $200.00 LODGING $60.00 MEALS $40.00 REGISTRATION $25.00 MILEAGE/FUEL TOTAL FOR ALL: $ 325.00 TAXI PARKING AIRFARE MISC/TOLLS BUDGET LINE ITEM: 266-17-7120-1533 YES YES X NO X NO GRANT REIMBURSABLE REQUIRED CERTIFICATION TOTAL: $ 325.00 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 FINANCE DEPT. STAFF ONLY LINE ITEM USED / C j 5/0 G P261 FYr,'t I BUDGETED 0c EXPENDED YTD 6,/2 ?= THIS REQUEST / `7 %S LEFT AFTER THIS REQUEST 24FGC DATE 7% /C'6/,/0 Original - Clerk/Finance Copy - Department NAME(S) AND POSITION(S): Quentin Hart, Mayor DATE: October 31, 2016 NAME OF CLASS / MEETING: Nat'l League of Cities City Summit DESTINATION: Pittsburgh, PA DEPARTURE POINT IF NOT WATERLOO: DEPARTURE DATE: 11/16/16 RETURN DATE: 11/20/16 DATE(S) OF MEETING: 11/16-11/19/20 PURPOSE OF TRAVEL/TRAINING: Attend the National League of Cities City Summit WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL: x COST $ YES NO METHOD OF TRAVEL: CITY VEHICLE PRIVATE VEHICLE x AIRFARE DEPARTING FROM: Waterloo, Iowa ESTIMATE OF COST: (7% sales tax plus 7% occupancy tax for lodging). Q will pay for meals) 940.00 LODGING 75.00 TAXI MEALS PARKING 460.00 REGISTRATION 500.00 AIRFARE MILEAGE/FUEL MISC/TOLLS TOTAL FOR ALL: $ 1,975.00 BUDGET LINE ITEM: 010-01-8100-1345 GRANT REIMBURSABLE YES NO YES NO TOTAL: $ 1,975.00 PER PERSON REQUIRED CERTIFICATION I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE AND IS NECESSARY AND BENEFICIAL TO THE CITY OF WATERLOO I APPROVE THIS TRAVEL REQUEST DEPARTMENT HEAD MAYOR DATE DATE lb 3�/� K:\Shared Goodies\Forms\Travel Request Form January 2010 City Clerk Use Only Finance Committee Approval Date ` ` (' 1' L. 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 $ 1,770.00 plus est. shipping costs of $ to pay for or purchase This purchase or expenditure is being made because: Window cleaning of 2 skywalks; interior/exterior of North and South windows overlooking Exhib Hall; East windows interior/exterior @5 Sull Bros Convention Center Vendor selected for this purchase: Miller Window Service n Bids or written quotes were taken on this purchase, as follows: ❑X Bids or quotes were not taken on this purchase because: No bids taken -Miller Window Service providing same service and price since 2013 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 n Other (specify) This expenditure is to be coded to the following budget line -item: 010-22-6860-1371 (Fund - Department - Activity - Account Number) in which the budgeted amount is and the current available balance is Respectfully submitted, a-(-1 (Si nature Dept. Head or Designee) (Project Code) $ Ala u60`' $ Date (Signature Finance Dept. Review) Date K:\shared goodies\forms\Expenditure Pre-Authorization.xls (Mar 2010) City Clerk Use Only Finance Committee Approval Date t 7/t L 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 $ 2,046.20 plus est. shipping costs of $ to pay for or purchase Gas pump repair at fuel site. This purchase or expenditure is being made because: Repaired leaks on Pumps 7 & 8. Only vendor that in familiar with city fuel site - installs and repairs pumps & equipment Vendor selected for this purchase: Dick's Petroleum Company n Bids or written quotes were taken on this purchase, as follows: Dick's Petroleum Company Tripoli, Iowa $2,046.20 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 Sewer n Sanitation Federal/other grants ❑ Other (specify) This expenditure is to be coded to the following budget line -item: 010-18-7950-1371 (Fund - Department - Activity - Account Number) in which the budgeted amount is and the current available balance is Respectfully submitted, Y GYr[ Yr1 JIRO—) Jo ikc, 1. /A-r:r zn /1 (Signature Dept. He d or Designee) Date (SignatuYe Finance Dept. Review) Date (Project Code) $ /15-4,k K:\shared goodies \forms\2016-October-Expenditure Pre-Authorization-#7 & 8 pump repairs - Dick's Petroleum-010-18-7950-1371 $2,046.20.xls (Mar 2010) City Clerk Use Only Finance Committee l Approval Date 11 R. 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 $ 1,993.38 plus est. shipping costs of $ to pay for or purchase Valve for Steer Control for Waste Management Endloader #144A03 This purchase or expenditure is being made because: Steer Control valve is leaking and must be replaced. Only vendor that can supply this John Deere item locally. Vendor selected for this purchase: ❑ Bids or written quotes were taken on this purchase, as follows: Murphy Tractor & Supply Waterloo, IA $1,993.38 ❑ 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 n Road Use Tax ❑ Bonds Federal/other grants Sewer ri Sanitation Other (specify) This expend] ure is to be coded to the following budget line -item: 010-18-795i 1569 (Fund - Department - Activity - Account Number) in which the budgeted amount is and the current available balance is Respectfully submitted, ,, /c V / ' 22//Aike.,A, (J.I� ,A /o -3v I6 ( nature Dept. Head .r Designee) irate Signature Finance Dept. Review) Date (Project Code) $ ;i(oS,oav v% r $ /5-5'351 �� ✓ K:\shared goodies\forms\2016-October-Expenditure Pre -Authorization -Murphy Tractor & Supply -Steer Control Valve-WM endloader - $1,993.38-010-18-7955-1569.xls (Mar 2010) City Clerk Use Only Finance Committee Approval Date \t1 1 /I L 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 $ 3,211.00 plus est. shipping costs of $ to pay for or purchase 4 - 10 ton Air Lift Jacks This purchase or expenditure is being made because: To replace malfunctioning jacks beyond repair. Vendor selected for this purchase: NAPA Auto Parts �X Bids or written quotes were taken on this purchase, as follows: NAPA Auto Parts Waterloo, IA (802.75 ea) $3,211.00 Sadler Power Train Truck Paris Waterloo, IA (1,041.91 ea) $4,167.64 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 n Road Use Tax n Sewer ❑ Sanitation nBonds I I Federal/other grants n Other (specify) This expenditure is to be coded to the following budget line -item: 414'18-7950-2110 (Fund - Department - Activity - Account Number) in which the budgeted amount is and the current available balance is Respectfully submitted, /0/ 61/47 1-do ign ture Dept. Hea or Designee) Date (Signature Finance Dept. Review) Date (Project Code) $ 460O0.00 - S /i-3 $ 4270-t1.25 5 3„ 03 'i• K:\shared goodies\forms\2016-October-Expenditure Pre-Authorization-NAPA Auto Parts -air jacks-$3,211.00-411-18-7950-2110.xls (Mar 2010) City Clerk Use Only Finance Committee Approval Date City of Waterloo Expenditure Pre -Authorization Request Form owin The Finance Committee of the City Council is hereby nested to authorize theent to peg nd purchase or expenditure submitted by the E $ 1,350.00 plus est. shipping costs of $ 0.00 to pay for or purchase Construction Surve work for the VGM North .arkin• lot utilit relocations. This purchase or expenditure is being made because: Required b VGM Development A reement Vendor selected for this purchase: VJ Fr,nineering ri Bids or written quotes were taken on this purchase, as follows. VJ Engineerin $1,350.00 D 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. General Fund Road Use Tax Sewer El Sanitation Bonds Federal/other grants 0 Other (specify) San Marnan TIF This expenditure is to be coded to the following budget line -item: 426-08-6205-2-1&3 4 9 (Fund - Department - Activity - Account Number) in which the budgeted amount is and the current available balance is Respectfully submitted, ( lgnature ept. Head or Designee) K:\shared goodies Worms \Expenditure Pre-Authorization.xls (Mar 2010) (Project Code) $ l,3vU $ (, 3 6b uy mA,A.da. /,J„c. bt 113-dlo Date (Signature Finance Dept. Review) Date VJ Engineering 1501 Technology Pkwy, Suite 100 Cedar Falls, Iowa 50613 ph: (319) 266-5829 fax: (319) 266-5160 engineering - surveying October 25, 2016 Dennis Gentz, P.E. Assistant City Engineer City of Waterloo, Iowa Dear Dennis, We appreciate the opportunity to provide this construction services proposal for construction survey work for the proposed VGM north parking lot utility relocations. VJ Engineering offers the following information and associated services we will provide, upon our receipt of a signed Agreement: Construction Staking Services 1) Provide staking (offset hubs) for the relocation of fire hydrant. 2) Provide staking (offset hubs) for the 230' of 18" storm sewer. 3) Provide staking (offset hubs) for storm manhole G. VJ Engineering offers the above construction staking services on a time and materials basis with an estimated fee of $1,350 If this proposal is acceptable, please contact us and we will prepare a contract. If you have any questions feel free to contact our office. Respectfully, Wendell Lupkes, L.S. VJ Engineering Printed Name and Title VJ Engineering Project #: 16-8098 Agreement for Provision of Limited Professional Services Date: 12/7/2016 Project Name: VGM North Parkincl Lot Utility Relocations - Staking CLIENT INFORMATION Company Name: City of Waterloo (if individual, skip this line and put client name in "Contact") Phone: 319-291-4312 Contact: Dennis Gentz Phone: Address: 715 Mulberry Street Fax: 319-291-4262 City: Waterloo State: IA Zip: 50703 Email Address: dennis.gentzgwaterloo-ia.org Claim/PO # PROJECT INFORMATION Site Address: W. San Maman Drive City: Waterloo State: IA Zip: SCOPE OF WORK (Define effort: survey/design/inspect etc...) Provide construction staking services for the relocated fire hydrant, 18" storm sewer, and storm manhole G as detailed in attached proposal dated October 25, 2016. DELIVERABLES (Tangible product: report/drawings etc...) Stakes set in field Target Deadline: ATTACHMENTS (Provided by the client, VJ or other) Terms & Conditions- 2016 and proposal dated October 25, 2016 FEE STRUCTURE Time and Materials: ►1Yes / No Lump Sum Contract $ TERMS: Pay Upon Receipt Plus Reimbursables? ❑ Yes / ❑ No Reviewed by See Terms & Conditions far rates. Estimated Fee $1,350.00 Subject to minimum charge: ❑Yes / No v-( Invoice(s) due net 15 day n Retainer Required? $ Minimum Charge $250 ❑ $500 ❑ Signature authorized VJ Representative Signature authorized client Representative Wendell Lupkes, L.S. 12/7/2016 , )C 7 iii>7ry iinEi(-' iEFiq J2/ [J)) (date) Printed name and title (date) PROJECT MANAGER/ENGINEER Wendell Lupkes ❑ 2570 Holiday Road Suite 10, Coralville, Iowa 52241 Ph: 319-338-4939 Fax 319-338-9457 ►:1 1501 Technology Parkway Suite 100, Cedar Falls, Iowa 50613 Ph: 319-266-5829 Fax 319-266-5160 Terms And Conditions VAN WINKLE JACOB ENGINEERING, INC. D/B/A VJ ENGINEERING (hereinafter referred to as "THE FIRM") shall perform the services outlined in this agreement for the stated fee arrangement. Access to Site: The Firm shall have site access to perform all services necessary in completing a project. The Firm agrees to take the necessary precautions to minimize damages caused by such activities. Unless otherwise agreed or caused by The Firm's negligence, all cost of restoration shall be borne by Client and are not included in the fee. Warranties: The Firm shall provide professional services in accordance with accepted standards and shall maintain professional standards for all work performed in conjunction with the Project. Other than the above, the Firm makes no warranty, express, or implied, as to its professional services rendered under this Agreement. Opinions of Probable Cost: If, as part of this Agreement, The Firm is providing opinions of probable construction cost, the Client understands that The Firm has no control over costs or the price of labor, equipment or materials, or over the Contractor's method of pricing, and that The Firm's opinions of probable construction costs are to be made on the basis of The Firm's qualifications and experience. The Finn makes no warranty, expressed or implied, as to the accuracy of such opinions compared to bid or actual costs. Billings/Payments: Invoices for the Firm's services shall be submitted, at the Firm's option, The Firm may submit invoices either upon completion of the services or throughout the life of the project. Invoices shall be paid within 15 days of the invoice date. If the invoice is not paid within 30 days, The Firm may terminate all services free of liability. The Firm does not waive any claim or right against Client by terminating services for nonpayment. Only The Firm's General Manager has authority to enter into alternative payment agreements. No Secondary payment agreement shall be binding upon The Firm unless agreed to in writing by the General Manager. Late Payments: Invoices that are not paid within 45 days of the invoice date may be assessed a Late Fee. The Client shall pay all cost including court costs and reasonable attorney fees associated with collecting any unpaid balance. Indemnification: The Client shall indemnify and hold The Firm harmless from and against any and all claims, losses and expenses (including reasonable attorney's fees) arising out of or resulting from the performance of the services, provided that any such claim, damage, loss or expense is caused in whole or in part by the negligent act, omission, and/or strict liability of the Client, anyone directly or indirectly employed by the Client (except the Firm),or anyone for whose acts of them may be liable. Termination of Services: This agreement may be terminated by the Client or the Firm should the other fail to perform its obligations hereunder. In the event of termination, the Client shall pay the Firm for all services rendered to the date of termination, all reimbursable expenses, and reimbursable termination expenses. Ownership of Documents: All documents produced by the Firm under this agreement shall remain the property of the Firm and may not be used by the Client for any other endeavor without the express written consent of the Firm. Applicable Laws: This agreement shall be governed by the laws of the State of Iowa. Page 1 I/1/2016 Fees The anticipated fee for time & materials, if stated, shall be understood to be an estimate. All expenses relating to the project agreed upon here may be invoiced back to the customer. These expenses may include but are not limited to; over -time hours at 1.5 times the listed rates, mileage, legal fees, software fees, plotting and copying fees, permitting fees, and travel expense. During the course of the project if the time expended is more than this fee, the Client will be contacted with an explanation of the fee and/or a change order form to sign. Where the fee arrangement is to be on an hourly basis, the rates shall be those that prevail at the time services are rendered. Minimum fee for Professional Licensed Engineer is $250 for in-house consultation and $500 for a site visit. Rates for 2016 are as follows: Description Bridge Inspection Rate $95.00 CAD Drafting $80.00 Clerical $50.00 Construction Observation $85.00 Design- Land Developer $100.00 Design- Mechanical $95.00 Design- Structural $105.00 Engineer- Building Envelope (subject to minimum fee above) $115.00 Engineer- Civil (subject to minimum fee noted above) $120.00 Engineer- Mechanical (subject to minimum fee noted above) $130.00 Engineer- Roof (subject to minimum fee noted above) $115.00 Engineer- Structural (subject to minimum fee noted above) $130.00 Engineering- Senior Technician $90.00 Engineering- Technician $75.00 Environmental Consultant $115.00 Expert Witness $200.00 Geologist $85.00 Land Survey- Licensed Land Surveyor $120.00 Land Survey- Drafting $100.00 Land Survey- Intern $90.00 Land Survey- 2 Man Crew or 1 Man and GPS/Robotic Instrument $135.00 Land Survey- 3 man crew S155.00 Mileage- per mile $1.00 Plotting Services- per sheet $5.00 Project Manager/ Engineer $110.00 Reimbursable Expenses 115% Review- Code Review $100.00 Review- Structural Review $130.00 Spec Writer $85.00 Page 2 1/1/2016 VJ Engineering 1501 Technology Pkwy, Suite 100 Cedar Falls, Iowa 50613 ph: (319) 266-5829 fax: (319) 266-5160 engineering - surveying October 25, 2016 Dennis Gentz, P.E. Assistant City Engineer City of Waterloo, Iowa Dear Dennis, We appreciate the opportunity to provide this construction services proposal for construction survey work for the proposed VGM north parking lot utility relocations. VJ Engineering offers the following information and associated services we will provide, upon our receipt of a signed Agreement: Construction Staking Services 1) Provide staking (offset hubs) for the relocation of fire hydrant. 2) Provide staking (offset hubs) for the 230' of 18" storm sewer. 3) Provide staking (offset hubs) for storm manhole G. VJ Engineering offers the above construction staking services on a time and materials basis with an estimated fee of $1,350 Hillis proposal is acceptable, please contact us and we will prepare a contract. If you have any questions feel free to contact our office. Respectfully, 4.Gw.,.e-d off/ _" Wendell Lupkes, L.S. VJ Engineering 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 Fire Department Department to expend $ 8,879.68 plus est. shipping costs of $ 25.00 to pay for or purchase Display Screen for Control Panel in Fire Engine #303 This purchase or expenditure is being made because: This is a retrofit for the current screen that cannot be repaired as it is LCD which is no longer made. Only vendor that can retrofit current screen. Vendor selected for this purchase: Global Emergency Products ❑ Bids or written quotes were taken on this purchase, as follows: Global Emergency Products Aurora, Illinois $8,879.68 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: ❑XEl 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: 010-18-1405-1571 (Fund - Department - Activity - Account Number) in which the budgeted amount is and the current available balance is (Project Code) $ b'b�ODa, $ fo1,28?'� Respectfully submitted, c ) (Signature Dept. He or Designee) ate (Signature Finance Dept. Review) Date K:\shared goodies\forms\2016-October-Expenditure Pre -Authorization -Global Emergency Products - Retrofit Display screen for control panel- 010-18-1405-1571-$8,879.68.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 Fire Department Department to expend $ 7,646.86 plus est. shipping costs of $ to pay for or purchase 8 tires for two fire engines This purchase or expenditure is being made because: To replace worn tires. This is a state bid. Vendor selected for this purchase: Black's Tire Company LLC n Bids or written quotes were taken on this purchase, as follows: Black's Tire Company LLC Ottumwa, Iowa $7,646.86 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 Bonds Road Use Tax ❑ Sewer ❑ Sanitation Federal/other grants ❑ Other (specify) This expenditure is to be coded to the following budget line -item: 010-18-1405-1569 (Fund - Department - Activity - Account Number) in which the budgeted amount is and the current available balance is (Project Code) $ / 00o $ /4S-09Z' Respectfully submitted, (Signature Dept. H d or Designee) ate (Sig ture Finance Dept. Review) Date K:\shared goodies \forms\2016-October-Expenditure Pre -Authorization -Black's Tire Company LLC- 8 engine fire tires-010-18-1405-1569 $7,646.86.xls (Mar 2010) City Clerk Use Only Finance Committee Approval Date /I 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 Fire Department Department to expend $ 2,702.88 plus est. shipping costs of $ to pay for or purchase 8 tires for two ambulances This purchase or expenditure is being made because: To replace worn tires. This is a state bid. Vendor selected for this purchase: Black's Tire Company LLC n Bids or written quotes were taken on this purchase, as follows: Black's Tire Company LLC Ottumwa, Iowa $2,702.88 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 n Sanitation Federal/other grants Other (specify) This expenditure is to be coded to the following budget line -item: 010-18-1411-1569 (Fund - Department - Activity - Account Number) in which the budgeted amount is and the current available balance is (Project Code) $ 77"70 Res ectfully submitte , &P cu 107t3/A.r WI .e& b-e/ / 11-� (Signature Dept. d or Designee) ate (Signature Finance Dept. Review) Date K:\shared goodies\forms\2016-October-Expenditure Pre -Authorization -Black's Tire Company LLC- 8 ambulance tires-010-18-1411-1569 $2,702.88.xls (Mar 2010) City Clerk Use Only Finance Committee Approval Date t \ l Vr L 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 $ 2,880.14 plus est. shipping costs of $ na to pay for or purchase professional signage at Byrnes Tennis Center This purchase or expenditure is being made because: we wanted people to know where court are located on the Tennis Center grounds Vendor selected for this purchase: Nagle Signs Inc. (Waterloo, IA) Bids or written quotes were taken on this purchase, as follows: n Bids or quotes were not taken on this purchase because: this is the same vender that has done previous signage throughout the Tennis Center. Utilizing this vendor will insure the signage throughout the facility matches. 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 ri Federal/other grants n Other (specify) Hotel/Motel Grant This expenditure is to be coded to the following budget line -item: 010-37-4105-2176 37-HMT.TENNIS16 (Fund - Department - Activity - Account Number) (Project Code) in which the budgeted amount is and the current available balance is Respectfully submitted, (Signature Dept. He Designee) Date (Signature Finance Dept. Review) $ 7,155.00 "/ $ 7,155.00 ✓ Date K:\shared goodies\forms\Tennis Center Signage 2016 (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 Leisure Services Department to expend $ 2,350.00 plus est. shipping costs of $ na to pay for or purchase finish drywall, texture, prime & paint new strength room at the Cedar Valley SportsPlex This purchase or expenditure is being made because: the strength room needs to be finished before we can start having classes in it. Vendor selected for this purchase: Michael Painting (Waterloo, IA) ❑X Bids or written quotes were taken on this purchase, as follows: Michael Painting (Waterloo, IA) $ 2,350.00 Verbraken's New Look Paining & Wall Covering (Waterloo, IA) $3,875.00 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 n Road Use Tax n Sewer Sanitation • Bonds n Federal/other grants ❑ Other (specify) This expenditure is to be coded to the following budget line -item: 010-37-4180-1390 Other Contractual Services (Fund - Department - Activity - Account Number) in which the budgeted amount is and the current available balance is (Project Code) $ 12,000.00 $ 7,768.68 Respectfully submitted, 411C ti.r04u/1, j7 / llv (Signature Dep or Designee) Date (Signature Finance Dept. Review) Date K:\shared goodies\forms\Finish Dry wall for Shell Space 2016 (Mar 2010) City of Waterloo Expenditure Pre -Authorization Request Form City Clerk Use Only Finance Committee Approval Date tf7A L 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 $ 1,876.25 plus est. shipping costs of $ na to pay for or purchase a wall mounted weight strength device for the new strength room at the SportsPlex. This purchase or expenditure is being made because: with this it will give us the ability to do strength training and suspension training along with group exercise classes. Vendor selected for this purchase: Rogue Fitness (Columbus, OH) $1,876.25 ❑X Bids or written quotes were taken on this purchase, as follows: Rogue Fitness(Columbus, OH) $1,876.25 Again Faster Equipment (Orange Park, FL) $3,200.00 Fringe Sport (Austin, TX) $2,099.00 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 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: 010-37-4180-1567 Recreational Equipment & Supplies (Fund - Department - Activity - Account Number) (Project Code) in which the budgeted amount is $ 21,848.00 and the current available balance is $ 44439 9-7 5353 Respectfully submitted, (Signature Dept. or Designee) Date (Sig K:\shared goodies\forms\Wall Mounted Rig Shell Space 2016 (Mar 2010) ature Finance Dept. Review) 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 Leisure Services Department to expend $ 6,986.00 plus est. shipping costs of $ na to pay for or purchase interlocking rubber flooring for the new strength room at the SportsPlex City Clerk Use Only Finance Committee Approval Date 11 This purchase or expenditure is being made because: with the classes that will be held in the room, rubbing flooring is needed. Vendor selected for this purchase: n Bids or written quotes were taken on this purchase, as follows: Push Pedal Pull (Cedar Rapids, IA) $6,986.00 Anderson Ladd (Des Moines, IA) $8,472.46 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 ❑ Road Use Tax n Sewer ❑ Sanitation Bonds n Federal/other grants n Other (specify) This expenditure is to be coded to the following budget line -item: 010-37-4180-1567 Recreational Equipment & Supplies (Fund - Department - Activity - Account Number) in which the budgeted amount is and the current available balance is Respectfully submitted, (Signature Dept. H esignee) Date (Sign ture Finance Dept. Review) (Project Code) $ 21,848.00 $ 14,030.87 /2. 3i g ✓ Date K:\shared goodies\forms\Interlocking Rubber Flooring Shell Space 2016 (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 Leisure Services Department to expend $ 1,700.00 plus est. shipping costs of $ na to pay for or purchase mirrors for the new strenght room City Clerk Use Only Finance Committee Approval Date 4 ( 7 /I b This purchase or expenditure is being made because: mirrors are needed for classes that will be held in the room. Vendor selected for this purchase: Allen Glass Co., Inc. (Waterloo, IA) Bids or written quotes were taken on this purchase, as follows: Allen Glass Co., Inc. (Waterloo, IA) $ 1,700.00 Lindgren Glass (Waterloo, IA) NO BID ri 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 n Sewer Sanitation Bonds I I Federal/other grants ri Other (specify) This expenditure is to be coded to the following budget line -item: 010-37-4180-1 (Fund - Department - Activity - Account Number) in which the budgeted amount is and the current available balance is Respectfully submitted, (Project Code) $ 6; 50-0760' / g (di $ 4.461:50 f(ZO 3 p g?7 esignee) Date (Signature Finance Dept. Review) Date K:\shared goodies \forms\Mirros for new shell space room (Mar 2010) City of Waterloo Expenditure Pre -Authorization Request Form City Clerk Use Only Finance Committee Approval Date 1 \ ( 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 $ me 7,520 plus est. shipping costs of $ to pay for or purchase transport of infield material for baseball/softball fields, youth diamonds. AMENDED more material was needed than originally projected. This purchase or expenditure is being made because: to repair the playing surface after the flood of September 2016. Vendor selected for this purchase: Falkstone (St. Ansgar, IA) Bids or written quotes were taken on this purchase, as follows: Falkstone, St. Ansgar IA $27.25 per ton Bryan Rock Products, Shakopee MN $36.75 per ton n Bids or quotes were not taken on this purchase because: Prior Committee Actions (Dates): 10/10/16 approved at $6,520.00 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 n Other (specify) FEMA This expenditure is to be coded to the following budget line -item: 290-37-4100-1390 01 FL16-37RSP (Fund - Department - Activity - Account Number) (Project Code) in which the budgeted amount is and the current available balance is fully submitted ead or Designee) Date (Signs ure Finance Dept. Review) Date K:\shared goodiesCorms\Falkstone preauth (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 Leisure Services Department to expend to pay for �otrr purchase 8' perimeter fence and privacy screen at Leisure Services shoIkItIVp[�to Include 800' tension wire not included in the specs. City Clerk Use Only Finance Committee Approval Date "II /Oa $ me 21,500 plus est. shipping costs of $ This purchase or expenditure is being made because: to secure property for the storage of equipment and supplies Vendor selected for this purchase: D&N Fence Co Inc Cedar Rapids IA n Bids or written quotes were taken on this purchase, as follows: D&N Fence Co Inc, Cedar Rapids $18,970.00 + $2,495.00 = $21,465.00 Miller Fence Co, Waterloo $22,532.28 nBids or quotes were not taken on this purchase because: Prior Committee Actions (Dates): 9/19/16 approved at me $20,000 Please check the following box(es) as appropriate to describe the funding for this expense: nGeneral Fund n Road Use Tax n Sewer n Sanitation nBonds n Federal/other grants n Other (specify) This expenditure is to be coded to the following budget line -item: 416-37-4410-2176 $20,000 414-37-4105-2168 $2,495 (Fund - Department - Activity - Account Number) (Project Code) in which the budgeted amount is $ 20,000 100,000 and the current available balance is $ 20,000 9,843.41 V Respectfully submitted, (Signature Dep ad or Designee) Date (Signature Finance Dept. Review) Date K:\shared good ies\forms\D&N xis (Mar 2010) The purc $ 2 four City of Waterloo Expenditure Pre -Authorization Request Form Finance Committee of the City Council is hereby requested to authorize the following hase or expenditure submitted by the Leisure Services Department to expend 517.89 plus est. shipping costs of $ na to pay for or purchase (4) water pumps for the pool boiler system at the SportsPlex City Clerk Use Only Finance Committee Approval Date (1 /I Ce This purchase or expenditure is being made because: the four (4) orginal pumps had siezed up. Vend x or selected for this purchase: Wayne Dennis Supply Co. (Waterloo,IA) $2,517.89 Bids or written quotes were taken on this purchase, as follows: Bids or quotes were not taken on this purchase because: this is the only vendor who could get the equipment here in a timely manner. Prior Committee Actions (Dates): Please G B eneral Fund onds check the following box(es) as appropriate to describe the funding for this expense: n 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: 010-37-4180-1371 Building & Grounds Maintenance (Fund - Department - Activity - Account Number) (Project Code) in which the budgeted amount is and th e current available balance is Respectfull submitted, (-y/� (Signature Dep ead or Designee) Date �,�,�an /A)., . Review) e /� Date (Sign ture Finance Dept. Review) Date $ 127506799. x7o9 ` $ 3,677.91 K:\shared goodies\forms\2016 Pool Boiler Pumps Pre-Auth.xls (Mar 2010) City Clerk Use Only Finance Committee Approval Date � fi J! 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 Leisure Services Department to expend $ 2,785.01 plus est. shipping costs of $ na to pay for or purchase professional services to reconstruct baseball/softball fences at Riverfront Sports Park This purchase or expenditure is being made because: TO REPAIR BASEBALL/SOFTBALL FENCES AFTER FLOOD OF 2016. Vendor selected for this purchase: D&N Fence Co., Inc. (Cedar Rapids, IA) ❑X Bids or written quotes were taken on this purchase, as follows: D&N Fence Co., Inc. (Cedar Rapids, IA) $ 2,785.009 Miller Fence & Flag Co., Inc. (Waterloo, IA) $ 2,864.009 ❑ 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 ❑ Other (specify) FEMA This expenditure is to be coded to the following budget line -item: 290-37-4100-1371 0/0 37 'f){0 /37/ 01FL16-37RSP (Fund - Department - Activity - Account Number) (Project Code) in which the budgeted amount is and the current available balance is 0 vco ��� $ ..off 31O0 $ ,2314)Kji-- 460o' /� 2V G / )1/1(teitA,ILL- to . )- f or Designee) Date (Signature Finance Dept. Review) Date K:\shared goodies\forms\BaseballSoftball Fences after Flood 2016 (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 Leisure Services Department to expend $ 2,178.00 plus est. shipping costs of $ to pay for or purchase Two (2) light posts with mini acorn globes. AMENDED was already approved at $1678.00 lights we need to match existing lights are $500.00 more City Clerk Use Only Finance Committee Approval Date "Wit. This purchase or expenditure is being made because: to replace two posts that were broken in Leavitt Park. Vendor selected for this purchase: Chick -A -Pen Hill Des Moines IA Bids or written quotes were taken on this purchase, as follows: n Bids or quotes were not taken on this purchase because: This vendor sells the lamps that match the other lamps in Leavitt Park. Prior Committee Actions (Dates): 8/1/16 approved at $1,678.00 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: 010-37-4100 1371 (Fund - Department - Activity - Account Number) in which the budgeted amount is and the current available balance is Respectfully submitted, (Signature Dept. He�of esignee) Date (Signaure Finance Dept. Review) Date K:\shared goodies\forms\Expenditure Pre-Authorization.xls (Mar 2010) (Project Code) $ 22,050.00 $ 14,380.00 `� 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 $ 2,227.00 plus est. shipping costs of $ 0.00 to pay for or purchase Annual Maintenance license renewal for (34) cradlepoints City Clerk Use Only Finance Committee 1 Approval Date t�'7 / i xeldsiJodg ay; wa;si(s aaiioq food ay; ao; sdwnd Ja;eM (j7) ino; aseyoand ao Jo; ked o; eu $ ;o sisoo 6u0diys'isa snld 68•L49'Z $ puedxe o;;uewlJedea seoinaag aans!ei ay; Aq pa;;iwgns aan;ipuadxe Jo aseyoand 6wMopo; ay; ezuoy;ne o; pa;senbei Ageiaq si ipuno3 Apo ay; as;;iwwoO aoueuid ayl wioA lsenbab uoi}sziiowv-aid ein}ipuedx3 ooiia}eM }o AI!3 °I )/i_) aled lenaddy / eau!wwoo aoueu!d ,quo asn )1Jei3 Al!O 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 $ 2,950.55 plus est. shipping costs of $ to pay for or purchase 10 (Input/Output) Box - Generation II for Garbage Truck - #202 City Clerk Use Only Finance Committee Approval Date 't �7 //1, This purchase or expenditure is being made because: Replace 10 Box that has communication for garbage truck to operate. $200.00 credit will be issued for malfunctioning box. Only 1 vendor provides this equipment. Vendor selected for this purchase: n Bids or written quotes were taken on this purchase, as follows: Wayne's Engineering LLC Cedar Falls, Iowa $2,950.55 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 n Sewer n Sanitation n Bonds n Federal/other grants 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) $ 06 I ature Dept. _d or Designee) Da (Signature Finance Dept. Review) Date K:\shared goodies \forms\2016-October-Expenditure Pre-Authorization-Wayne's Engr. - 10 Box-$2,950.55-151102- truck-010-18-7955- 1569.xls (Mar 2010) City Clerk Use Only Finance Committee Approval Date It /7 1 b 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 $ 2,591.95 plus ext. shipping cost of $ 75.00 to pay for or purchase Replacement Hazardous submersible sewage pump for Digester complex This purchase or expenditure is being made because: Hazardous submersible pump worn-out needs replacement. Vendor selected for this purchase: Ferguson Enterprises, Inc. Bids or written quotes were taken on this purchase, as follows ITIBids or quotes were not taken on this purchase because: Ferguson Enterprises, Inc. is rep. for replacement submersible pump. Prior Committee Actions (Dates): Please check the following box(es) as appropriate to describe the funding for this expense: General Fund: nRoad Use Tax: Sewer: ❑Sanitation: [Bonds: ❑Federal/other grants: 0Other(specify): This expenditure is to be coded to the following budget line -item: 520-14-5200-1571 (Fund - Department - Activity - Account Number) (Project Code) in which budgeted amount is $ 350,000.00 V and the current available balance is $ 2N .0'16-14 /9% %5 3 3� v Respectfully submitted, 72:( Oc* 11 2o ((, � �(G ��)a 141,1A (Signature Dept. Head Or Designee) Date (Sidnature Finance Dept. Review) Date ntFax 7/28/2016 11:27:14 AM PAGE 1/001 Fax Server 1 I :25:49 JUL 28 2016 Bid No • B824637 Bid Date - 07/28/ 16 Quoted By.: NLT FERGUSON #1699 920 S HACKETT RD WATERLOO, IA 50701.3566 Customer: CITY OF WATERLOO WASTER MGMT SVCS DEPT 3505 EASTON AVE WATERLOO, IA 50703 Cust POS...: Item SP-HPGX200FD De•cfption Deliver To: RICimit From: niahola• Tjabbwn Corrrnenh: FERGUSON ENTERPRISES INC #1657 Price Quotation Phone : 319 236-0222 Fax :319-235-0444 Page if 1 CUst Phone: 319 291-4553 Terms • NET 10TH PROX Ship To: CITY OF WATERI..00 WASTER MGM( SVCS DEPT 3505 EASTON AVE WATERLOO, A 50703 Job Name: HYDRO-RIHCARD Quantity HAZARDOUS SUBMERSIBLE SEWAGE 3-4 WEEK LEAD TIME Net Price UM 2591.950 EA Net Total: Tax: Freight: Total: Total 2591.95 S2591.95 $0.00 $ 75.00 $2666.95 Quoted prices are based upon receipt of the total quantity for immediate shipment (48 hours) SHIPMENTS BEYOND 48 HOURS SHALL 8E AT THE PRICE IN EFFECT AT TIME OF SHIPMENT UNLESS NOTED OTHERWISE. Seller not responsible for delays, lack of product or Increase of Pricing due to causes beyond our control, and/or based upon Local. State and Federal laws governing or put Into commerce. This quote Is offered contingent upon the buyer's acceptance of Seller's terms and conditions, which are Incorporated by reference and found either followhg thls document, or on the web at htt g n .co products that can sold Govt Buyers: All items are open market unless noted otherwise. P://wdseleyacom/terms_condtikx sSale.himl. LEAD LAW WARNING: It Is Mewl to Install products that are not lead free' In accordance with US Federal or other applicable law in potable water systems anticipated for human consum ption. Products with 'dP in the description are NOT lead free and can only be Installed In non -potable applications. Buyer Is �` f n 4 Cf •/v£� /li ES % solelyy responsible for Product selection. fib Jlli ,,,-7/° ili .,z..o City Clerk Use Only Finance Committee Approval Date 11ll to 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 $ 10.000.00 plus ext. shipping cost of $ 0.00 Sept 2016 Flood Debris Clean-up at Waste Management Services Dept. Department to expend to pay for or purchase This purchase or expenditure is being made because: Flood clean-up debris as woody debris and trash. Vendor selected for this purchase: Robert C. Hauptly nBids or written quotes were taken on this purchase, as follows Three vendors were notified and only one vendor submitted quote and that quote was from Robert C. Hauptly. General Debris Clean-up project sheet and quote 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: [lRoad Use Tax: r]Sewer: nSanitation: Bonds: nFederal/other grants: nOther(specify): This expenditure is to be coded to the following budget line -item: 520-14-5320-1570 /OAA (Fund - Department - Activity - Account Number) in which budgeted amount is (Project Code) $ 9799- � nod and the current available balance is $ q pp /v,c Respectfully submitted, & ( 20/ (o (Signature Dept. Head Or Designee) Date (Signature Finance Dept. Review) Date General Debris Clean up from 2016 Flood at WWTP General Grounds Background Following a visit with FEMA representative on 10/14/16, WMSD decided to put together a general clean -up plan for mostly woody debris left behind or deposited on plant grounds from the flood. After checking with the landfill, to minimize disposal costs, it was decided to collect such debris in 3 separate fashions, 1) woody debris < 4" 2) woody debris > 4" and 3) trash. It was also decided to utilize contract work force. On 10/18/16 a memo was prepared to sent to at least 3 vendors previously known to perform such work. Of those contacted 2 responded and took a general tour of the areas needing cleaned. Only 1 official quote was received by the 10/21/16 deadline from Robert C Hauptly. This quote seemed very reasonable and was accepted. It is anticipated the work outlined should be able to be completed for $10,000 or less. CITY OF WATERLOO IOWA WASTE MANAGEMENT SERVICES DEPARTMENT 3505 Easton Ave. • Waterloo, IA 50702 • (319) 291-4553 Date: October 18, 2016 To: Potential Debris Cleanup Vendors From: Waste Management Services Department (WMSD) Request for Debris Clean Up Services, Quote Following the recent flood event, some minor cleanup is needed. WMSD is asking for a quote from your company to perform those services. Most of the work will be removing debris collected behind fences and/or left on a road way. At least one (1) large tree needs to be removed. Please include an hourly rate for the removal of identified debris. Disposal of the collected debris will be taken to the Blackhawk County Landfill with those costs billed to the City. Vendors wishing to observe debris to be removed should contact: Bob Lentzkow at 319-291-4553 before Thursday 10/20/16 3:00 PM This "Request for Quotes" is due back by 1 PM Friday,10/21/16 to: Waste Management Services 3505 Easton Avenue General Debris Cleanup This will include all woody debris < 4 inches in diameter and miscellaneous non -woody debris. The two (2) potential wastes must be separated upon removal. a23 `` // J :a p ie � �` I �// 7 hourly rate/ hourly ,�4.11V Quote includes people and what equipment? ,e47 4,¢P &— e t-z" /)-4, 14,,<_ Large Tree Clean up There is at least 1 tree > 4 inches in diameter which needs tc9be separated from the other wastes to be taken to the landfill. This will be stipulated differently for this quote. {hourly rate ,0e r /4-4 -k 42"e11 A.-fi 15 ice Quote includes people and what equipment? brio - Company Name L'Ct(- 9-£fga-7067 CITY WEBSITE: www.cityofwaterlooiowa.com WE'RE WORKING FOR YOU! An Equal Opportunity/Affirmative Action Employer fr- 0—.44-4t 54-4j75" City Clerk Use Only Finance Committee Approval Date tt'? 11 t, 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 $ 4.000.00 plus ext. shipping cost of $ 0.00 Department to expend to pay for or purchase Replacement DX9100 controller, NCE controller, and enclosure for HVAC in laboratory This purchase or expenditure is being made because: To replace obsolete DX9100 controller and parts. Vendor selected for this purchase: Johnson Controls Bids or written quotes were taken on this purchase, as follows Bids or quotes were not taken on this purchase because: Johnson Controls is rep. for these replacement HVAC parts and labor. 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: 111Other(specify): This expenditure is to be coded to the following budget line -item: 520-14-5200-1521 (Fund - Department - Activity - Account Number) (Project Code) in which budgeted amount is $ 59,000.00 and the current available balance is $ 40439-68 34 13g Respectfully submitted, 2i 2e1(0 71.30A, t9 i 30-lw (Signature Dept. Head Or Designee) c Date (Sigriature Finance Dept. Review) Date Johnson JAI° Controls Proposal TO: CITY OF WATERLOO 3505 EASTON AVE WATERLOO IA USA 50702-2000 ATTN: STEVE ISENHOWER Date: Quote Ref: Project Name: Site: Page 1 of 2 JOHNSON CNTRL CEDAR RAPIDS QUAD CITIES CB - 0N11 1351 60TH ST NE CEDAR RAPIDS IA 52402-1248 PH: (309) 736 - 4300 FAX: () - 10/10/2016 1-IUF6K3Z Waterloo Waste 100-AHU-1 CITY OF WATERLOO 715 MULBERRY ST WATERLOO IA 50703-5714 We propose to furnish the materials and/or perform the work below for the net price of: $4,000.00 For the above price this proposal includes: Johnson Controls will provide parts and labor to replace obsolete DX9100 controller, with a new series NCE controller and enclosure. This unit will allow for network user interface, and to provide control of 100-AHU-1. Johnson Controls has not included any labor or material to provide 120 volt power to panel, mounting of panel, and any conduit that is to be ran from old panel to new panel. This proposal DOES NOT include: 1. Labor or material not specifically described above is excluded from this proposal. 2. Unless otherwise stated, any and all overtime labor is excluded from this proposal. 3. Applicable taxes or special freight charges are excluded from this proposal. Important: This proposal incorporates by reference the Terms and Conditions attached This proposal is hereby accepted and Johnson Controls is authorized to proceed with the work, subject to credit approval by Johnson Controls, Inc. Milwaukee, WI. Signature: Name: Title: Date: PO: This proposal is valid through: 11/02/2016 CITY OF WATERLOO Johnson Controls Inc. Signature: Name: Title: Date: City Clerk Use Only Finance Committee Approval Date tY1) I b 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 $ 10.117.00 plus ext. shipping cost of $ 0.00 Department to expend to pay for or purchase Special paint, Hi -temp paint, two each 9 oz. oilers, impeller keys and spacer for #2 Easton Blower This purchase or expenditure is being made because: Costs not included with first quote. First quote Teardown, Inspection. parts $14,921.00. Second quote after teardown $25,038.00 with a difference of $10,117. Vendor selected for this purchase: Gardner Denver Bids or written quotes were taken on this purchase, as follows Bids or quotes were not taken on this purchase because: Gardner Denver is rep. for repair of this blower. 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) (Project Code) in which budgeted amount is $ 350,000.00 ✓ and the current available balance is $ 199.753.33 Respectfully submitted, �`-1 ALV- Z, 241(0 1.u.A,r/.e, C, ./ ..Otir./A (Signature Dept. Head Or Designee) Date (Signature Finance Dept. Review) Date Equipment Repair Quote Aftermarket Service & Repair Group Centrifugal Products HOFFMAN by Gardner Dent Repair Proposal Dale: October 21, 2016 To: Brian Rath Company: City of Waterloo Quote: 20719185 Email: BRIAN.RATH@WATERLOO-IA.org Customer PO# WP17030 Machine Model: 2006•ADOI Repair SAPk 3101263 Serial Number: P001744X This quote is for: Upon receipt of unit, dower rotated easy. During leardown and inspection we found no damage. Unit was drained of lubrication and was very clean Internally and externally. This unit was sent in for bearing and seal change. See more on Teardown and Inspection sheet. Pictures are also attached. This quote includes the following new factory OEM parts : Description QtY Teardown & Quality Inspection 1 Assemby, mechanical test, paint, shipping preparation 1 Cleaning 1 Pans to Include: Hardware Bearing Kit Seal Kits Special Paint NOTE: This is the final repair quote after teardown and inspection. 1 2 Gardner Denver Engineered Products Division 200 Sanaa earn., cnanena• Pa 15022 Pliant: 724-239.1500 Fac:724-239•I503 Finall:9onnh. W alan1PGan7nerOmver.corn PQF 02 2000 Page 1 of 2 200e Gardner Denver, Ina. Equipment Repair Quote Afternarket Service & Repair Group Centrifugal Products HOFFMAN LAMSON by Gardner beaver Quote a 20719185 Company: City of Waterloo Factory Services Included: - Factory assembly to current specifications using OEM parts - Extensive run test in accordance with manufacturers standards - Paint will be our current standard CF Royal Blue water base paint, if anything else is required, it will be an adder. - QA inspection • Factory 1 year warranty from the date of shipment - If oil reservoirs are the Old Style oil bottles, we will automatically quote our new reservoirs with our new sight glass design. If you prefer old style oilers, it must be listed on your purchase order. This comment does not apply if you have a grease machine. The total repair cost including teardown, inspection and all items listed above is $25,038.00 USD NOTE: This quote is valid for 30 days. After 30 days, it approval to repair is not received, Gardner Denver, Inc. will notify you that the material will be scrapped unless you advise to have the material returned freight collect. tf you elect not to repair the blower, you will be invoked for the leardown and inspection fee quoted. This proposal is offered In accordance with Gardner Denver Terms & Conditions copy attached. Terms are: F.O.B. St. Peters, MO Freight is Prepaid & Add or Collect Net 30 days upon account approval or credit card Please sign as accepted or declined, below, and fax back to Bonnie Walker , tax # 724-239-1503. °Please fax a copy of your revised purchase order with the repair price listed above. Accept: PO# Decline If you have any questions or require any additional information, please feel free to contact us. Sincerely, ix.! S1 Ll Bonnie Walker Inside Sales Representative cc. Robinson & Associates / Bob Kisser Gardner Denver, Inc. Industrial Products Group 200 Sanaa 04 d . Ch . eral, PA 15022 Phalle 724,2141500 Fax: 724-2341503 0. mall: Bonnle.WalteryenantrOeMtr tam RqF 02/2005 Ppt t al O ....._. .....-- it) HOFFMAN LAMSON by Gardner Denver Teardown and Inspection This Section Contains information on the following: Teardown and Inspection Upon receipt of unit, blower rotated easy. During teardown and inspection we found, no damage. Unit was drained of lubrication and was very clean interanally and externally. This unit was sent in for bearing and seal change. If using existing reservoirs then we will need (2) 9 oz. oilers and all hardware. Will also need all new impeller keys and spacers. We recommend updating the reservoirs to include sight glasses but the reservoirs currently on the unit are in new condition. Does the customer want them replaced? We recommend updating the bearing caps to include the lip seal on the drive end but the caps currently on the unit are also in new condition. Does the customer want them replaced? Customer advised us they will replace these parts during the next bearing change. 200 Simko Blvd. Charleroi, PA 15022 Ph 724-239-1500 Fax 724-239-1503 Budget Amendment Descriptions for 11/7/2016 Finance Committee Meeting Agenda: 1. Approve the budget amendment to use funds received from Waterloo DekHockey, LLC to pay for flood lights installed at the DeckHockey rink in the amount of $1,174.13, as submitted by Leisure Services. Please use this for project budget descriptions on Finance agenda. Do not need to include this cover sheet in the Finance Committee packet. Completed forms should be routed directly to the Finance Dept. FINANCE DEPT. ONLY Finance Committee approval required? YES t/ NO If so, date approved: fit` 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 2017 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 4110 3873 reimbursement 1,174.13// 010 37 4110 1521 electrical 1,174.13 TOTAL This amendment is being requested because: $1,174.13 TOTAL $1,174.13 to budget for flood lights installed at the DekHockey rink in Expo Plaza Prior Committee Actions (Dates): (Signature Dept r Designee) Date (Signature Finance Dept. Review) Date Date Posted (Finance Dept.) K:Wsers\shared goodies\forms\Budget Amendment Request Form.xls (Apr 2003) FINANCE COMMITTEE November 7, 2016 5:10 PM Harold E. Getty Council. Chambers Members Chairperson Ron Welper Vice Chairperson Bruce Jacobs Tom Powers Roll Call: Approval of Agenda Approval of Minutes Minutes of October 24, 2016, as proposed. NEW BUSINESS TRAVEL REQUESTS 1. Pat Treloar, Chief of Fire Services Class/Meeting: Event Media Relations Destination: Des Moines, IA Dates: January 24-25, 2017 Amount not to exceed: $170.00 2. Craig Benner, Facilities Specialist Class/Meeting: 2016-2017 Aquatic CEU Workshop Destination: Cedar Falls, IA Dates: January 23, 2017 Amount not to exceed: $135.00 3. Katy Moeller, Aquatics/Member Services Specialist Class/Meeting: 2016-2017 Aquatic CEU Workshop Destination: Cedar Falls, IA Dates: January 23, 2017 Amount not to exceed: $135.00 4. Jacob Frederick (Fitness Specialist) Class/Meeting: ACE Group Exercise Certification Exam Destination: University of Northern Iowa Dates: TBD Amount not to exceed: $239.00 5. Sergeant Hoelscher Class/Meeting: Rifle Instructor Recertification Destination: Johnston, IA Dates: November 17, 2016 Amount not to exceed: $190.00 6. Investigator Gergen Class/Meeting: Reid Technique of Investigative Interviewing and Advanced Interrogation Destination: Des Moines, IA Dates: December 6-8, Amount not to exceed: $955.00 2016 7. Nancy Gulick, Community Development Coordinator Class/Meeting: National Community Development Association Winter Legislative, Policy and Professional Development Meeting Destination:Washington, D.C. Dates: February 14-17, Amount not to exceed: $2,310.00 2017 8. Jason Hernandez, Medical Officer Class/Meeting: IEMSA Conference Destination: Des Moines, IA Dates: November 10-12, Amount not to exceed: $690.00 2016 9. David Zellhoefer, City Attorney Class/Meeting: IMAAAnnual Seminar (Iowa Municipal Attorneys Association) Destination: Johnston, IA Dates: November 17-18, Amount not to exceed: $115.00 2016 10. Quentin Hart, Mayor Class/Meeting: National League of Cities Summit Destination: Pittsburgh, PA Dates: November 16-20, Amount not to exceed: $1,975.00 2016 11. Mohammad Elahi, Traffic Engineer Class/Meeting: MoboTrex, Inc. 2016 Davenport User's Group Destination: Davenport, IA Dates: December 6-8, Amount not to exceed: $325.00 2016 12. Pre -Authorizations to Expend over $1,000.00 Building Maintenance Amount and Estimated S/H: $1,770.00 Expenditure: Window cleaning of 2 skywalks; interior/exterior of north and south windows overlooking Exhibit Hall; east windows interior/exterior at 5 Sullivan Brothers Convention Center. Central Garage Amount and Estimated S/H: $2,046.20 Expenditure: Gas pump repair at fuel site. Central Garage Amount and Estimated S/H: $1,993.38 Expenditure: Valve for Steer Control for Waste Management Endloader #144A03. Central Garage Amount and Estimated S/H: $3,211.00 Expenditure: (4) 10 ton Air Lift Jacks. Engineering Amount and Estimated S/H: $1,350.00 Expenditure: Construction survey work for the VGM north parking lot utility relocations. Fire Department Amount and Estimated S/H: $8,879.68 + $25 S/H Expenditure: Display screen for control panel in Fire Engine #303. Fire Department Amount and Estimated S/H: $7,646.86 Expenditure: Eight tires for two fire engines. Fire Department Amount and Estimated S/H: $2,702.88 Expenditure: Eight tires for two ambulances. Leisure Services Amount and Estimated S/H: $2,880.14 Expenditure: Professional signage at Byrnes Tennis Center. Leisure Services Amount and Estimated S/H: $2,350.00 Expenditure: Finish drywall, texture, prime & paint new strength room at the Cedar Valley SportsPlex. Leisure Services Amount and Estimated S/H: $1,876.25 Expenditure: Wall mounted weight strength device for the new strength room at the SportsPlex. Leisure Services Amount and Estimated S/H: $6,986.00 Expenditure: Interlocking rubber flooring for the new strength room at the SportPlex. Leisure Services Amount and Estimated S/H: $1,700.00 Expenditure: Mirrors for the new strength room. Leisure Services Amount and Estimated S/H: NTE $7,520.00 Expenditure: Transport of infield material for baseball/softball fields, youth diamonds. (AMENDED - more material was needed than originally projected) Leisure Services Amount and Estimated S/H: NTE $21,500.00 Expenditure: 8' perimeter fence and privacy screen at Leisure Services Shop and Tennis Center (AMENDED - to include 800' tension wire not included in the specs) Leisure Services Amount and Estimated S/H: $2,517.89 Expenditure: Four water pumps for the pool boiler system at the SportsPlex. Leisure Services Amount and Estimated S/H: $2,785.01 Expenditure: Professional services to reconstruct baseball/softball fences at Riverfront Sport Park. Leisure Services Amount and Estimated S/H: $2,178.00 Expenditure: Two light posts with mini acorn globes (AMENDED - was already approved at $1,678.00. Lights we need to match existing lights are $500.00 more) Police Amount and Estimated S/H: $2,227.00 Expenditure: Annual Maintenance license renewal for (34) cradlepoints. Sanitation Amount and Estimated S/H: $2,950.55 Expenditure: Input/Output Box - Generation 11 for Garbage Truck #202. Sewer Department Amount and Estimated S/H: $2,591.95 + $75 S/H Expenditure: Replacement hazardous submersible sewage pump for digester complex. Sewer Department Amount and Estimated S/H: $10,000.00 Expenditure: September 2016 flood debris clean-up at Waste Management Services Department. Sewer Department Amount and Estimated S/H: $4,000.00 Expenditure: Replacement DX9100 controller, NCE controller, and enclosure for HVAC in laboratory. Sewer Department Amount and Estimated S/H: $10,117.00 Expenditure: Special paint, Hi -temp paint, (2) 9 oz. oilers, impeller keys and space for #2 Easton Blower. BUDGET LINE ITEMS TO BE AMENDED 13. Approve the budget amendment to use funds received from Waterloo DekHockey, LLC to pay for flood lights installed at the DekHockey rink in the amount of $1,174.13, as submitted by Leisure Services. • •'a r BILLS PAYMENT 14. November 7, 2016 ADJOURNMENT Kelley Felchle City Clerk Sent over 102516 TRAVEL REQUEST CITY OF WATERLOO NAME(S) AND POSITION(S): Pat Treloar, Chief of Fire Services DATE: 102516 FINANCE DEPT. STAFF ONLY LINE ITEM USED c'ir% ✓r2 7 ia'o /3 FY s- L / / BUDGETED 'No 0 EXPENDED YTD lJJ THIS REQUEST / 70 — LEFT AFTER THIS REQUEST AT 4f3o NAMEOF CLASS / MEETING: Event Media Relations DESTINATION: Des Moines, IA DEPARTURE POINT IF NOT WATERLOO: DEPARTURE DATE: 1/24/17 RETURN DATE: 1/25/17 DATE(S) OF MEETING: 1-24 &25-17 PURPOSE OF TRAVEL: This 1 Y day training covers how to effectively communicate public information during a disaster. WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL: x COST $ YES NO METHOD OF TRAVEL: x CITY VEHICLE AIRFARE x DEPARTING FROM: PRIVATE VEHICLE ESTIMATE OF COST: $150.00 LODGING $20.00 MEALS REGISTRATION MILEAGE/FUEL TOTAL FOR ALL: $ 170.00 TAXI PARKING AIRFARE MISC/TOLLS BUDGET LINE ITEM: 010-12-1400-1346 x GRANT REIMBURSABLE YES NO x REQUIRED CERTIFICATION YES NO TOTAL: $ 170.00 PER PERSON I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE AND IS NECESSARY AND BENEFICIAL TO THE CIT1LO _ A DEPARTMENT EAD ID -as- t, DATE I APPROVE THIS TRAVEL REQUEST r MAYOR DATE TRAVEL REQUEST CITY OF WATERLOO FINANCE DEPT. LINE ITEM USED FY •L:11 BUDGETED EXPENDED YTD THIS REQUEST LEFT AFTER THIS REQUEST DATE Original - Clerk/Finance STAFF ONLY 01-J Z L 5-Cv /55 — .3ios %%'/c' Co. - De•artment NAME(S) AND POSITION(S): Craig Denner Facilities Specialist DATE: 10/21/2016 NAME OF CLASS / MEETING: 2016-2017 Aquatic CEU Workshop DESTINATION: Cedar Falls DEPARTURE POINT IF NOT WATERLOO: DEPARTURE DATE: 1/23/2017 RETURN DATE: 1/23/2017 DATE(S) OF MEETING: 1/23/2017 PURPOSE OF TRAVEL/TRAINING: Earn Cont. Education for Aquatics and Certified Pool Operator WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL: X COST $ YES NO METHOD OF TRAVEL: CITY VEHICLE AIRFARE X PRIVATE VEHICLE DEPARTING FROM: Cedar Valley SportsPlex ESTIMATE OF COST: LODGING MEALS 135.00 REGISTRATION MILEAGE/FUEL TOTAL FOR ALL: $ 135.00 TAXI PARKING AIRFARE MISC/TOLLS BUDGET LINE ITEM: 010-37-4200-1.24-5 GRANT REIMBURSABLE YES NO X YES NO TOTAL: $ 135.00 REQUIRED CERTIFICATION PER PERSON I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE AND IS NECESSARY AND BENEFICIAL TO THE CITY OF WATERLOO DEPARTMENT HEA I APPROVE THIS TRAVEL REQUEST MAYOR 1'1-,/,k DATE DATE K:\Shared Goodies\Forms\Travel Request Form January 2010 PARKS AND MPCHEA'jO.L AYBO IAZ1oN 2016 — 2017 Aquatic CEU Workshop Registration Form Two simple ways to register: 1) Mail a copy of this form, with payment to: Iowa Parks and Recreation Association 1534 Penrose Street Grinnell, IA 50112-1203 Fax: 641 - 236 - 6779 2) Save time with a click! Register securely on-line Register one or more people on-line www.iapra.org Fee: $135.00 Non -Iowa Parks and Recreation Association Member $110.00 Iowa Parks and Recreation Association Member El Mail Payment Options (please check one) Check Invoice — P.O. # VISA MasterCard Credit card # Discover Exp: / Name as it appears on credit card: 3 Digit Security Code Billing address of credit card: City, State, Zip Code of credit card: Please print all information clearly. Welcome letter will be mailed directly to the participant using the following information you provide. Participant's Name: CRrtl(), DRONER Participant's Position/Title: FP lLITIes SPEC,nusT Participant's Business/Agency CEThaj VRLLE1 Spa2.-Sft, - avIERun Participant's Mailing Address: 300 '3kti:i•ERSorJ SSREET LEIstaeE SFRuic.Es Participant's City: WATERLOO State: TA Zip: 50'701 Participant's Work Phone: (`34) V'tk - d11o5 FAX: ( ) Contact Person E-mail: Cre.;Ly. atooer @ wnte.l an- i F - ores, Please © the workshop you will be attending: #2 Monday, October 24 #3 Monday, November 14 #4 Monday, December 5 #5 Monday, January 9 )( #6 Monday, January 23 #7 Monday, February 6 #8 Monday, February 27 #9 Monday, March 20 #10 Thursday, March 30 (AM) #11 Monday, April 17 #12 Monday, May 1 #13 Monday, June 19 #14 Monday, July 31 Burlington Cedar Rapids Davenport Dubuque Cedar Falls Sioux City Altoona Iowa City Waterloo Clear Lake Cedar Rapids Fort Dodge Ames Pzazz-Fun City Best Western Longbranch Best Western Steeplegate Best Western Plus 319-237-1277 319-377-6386 563-386-6900 563-557-8000 Clarion Inn University Plaza 319-277-2230 Holiday Inn -Downtown 712-277-9400 Adventureland Inn 515-265-7321 Clarion Hotel Highlander 319-35-2000 Five Sullivan Brothers Center Best Western Holiday Lodge 641-357-5253 Best Western Longbranch 319-377-6386 Starlight Village 515-573-7177 Quality Inn & Suites 515-232-9260 FINANCE DEPT. STAFF ONLY TRAVEL REQUEST CITY OF WATERLOO LINE ITEM USED FY 3,1/BUDGETED EXPENDED YTD THIS REQUEST LEFT AFTER THIS REQUEST DATE Original - Clerk/Finance u 3 i .a/ 0 /3`f6, .UO6� /3S 77 -33- Co. - De•artment NAME(S) AND POSITION(S): Katy Moeller Aquatics/Member Services Specialist DATE: 10/21/2016 NAME OF CLASS / MEETING: 2016-2017 Aquatic CEU Workshop DESTINATION: Cedar Falls DEPARTURE POINT IF NOT WATERLOO: DEPARTURE DATE: 1/23/2017 RETURN DATE: 1/23/2017 DATE(S) OF MEETING: 1/23/2017 PURPOSE OF TRAVEL/TRAINING: Earn Cont. Education for Aquatics and Certified Pool Operator WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL: X COST $ YES NO METHOD OF TRAVEL: CITY VEHICLE AIRFARE X PRIVATE VEHICLE DEPARTING FROM: Cedar Valley SportsPlex ESTIMATE OF COST: LODGING MEALS 135.00 REGISTRATION MILEAGE/FUEL TOTAL FOR ALL: $ 135.00 TAXI PARKING AIRFARE MISCITOLLS BUDGET LINE ITEM: 010-37-4180 -1345 YES NO X YES NO GRANT REIMBURSABLE REQUIRED CERTIFICATION TOTAL: $ 135.00 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 DATE DATE K:\Shared Goodies\Forms\Travel Request Form January 2010 IoWA PARKS ANDIIEC,x.",otc ASSOCIATIOU 2016 — 2017 Aquatic CEU Workshop Registration Form Two simple ways to register: 1) Mail a copy of this form, with payment to: Iowa Parks and Recreation Association 1534 Penrose Street Grinnell, IA 50112-1203 Fax: 641 — 236 — 6779 2) Save time with a click! Register securely on-line Register one or more people on-line www.iapra.org Fee: $135.00 Non -Iowa Parks and Recreation Association Member $110.00 Iowa Parks and Recreation Association Member er Mail Payment Options (please check one) Check Invoice — P.O. # VISA MasterCard Discover Credit card # Exp: Name as it appears on credit card: 3 Digit Security Code Billing address of credit card: City, State, Zip Code of credit card: Please print all information clearly. Welcome letter will be mailed directly to the participant using the following information you provide. Participant's Name: kA}Hkjt4 Moeller+ Participant's Position/Title: Participant's Business/Agency Participants Mailing Address: Participants City: WAi-er-loo pet�kaiics lMembew.CSewvicec Sre Gi (di si- Ce�aK �/atley SSPovisPtex '=Poo FeisoN +ree} State: Ibwa Zip: 5o1oi Participant's Work Phone: ( ) 2.A1-ott,s' FAX: ( ) t'1Ik Contact Person E-mail: ital-wicim,Moellekpa wai'erl no-1 a. oKlt Please Q the workshop you will be attending: _ #2 Monday, October 24 _ #3 Monday, November 14 #4 Monday, December 5 #5 Monday, January 9 )� #6 Monday, January 23 #7 Monday, February 6 #8 Monday, February 27 #9 Monday, March 20 _ #10 Thursday, March 30 (AM) _ #11 Monday, April 17 #12 Monday, May 1 _ #13 Monday, June 19 #14 Monday, July 31 Burlington Cedar Rapids Davenport Dubuque Cedar Falls Sioux City Altoona Iowa City Waterloo Clear Lake Cedar Rapids Fort Dodge Ames Pzazz-Fun City Best Western Longbranch Best Western Steeplegate Best Western Plus Clarion Inn University Plaza Holiday Inn -Downtown Adventureland Inn Clarion Hotel Highlander Five Sullivan Brothers Center Best Western Holiday Lodge 641-357-5253 Best Western Longbranch 319-377-6386 Starlight Village 515-573-7177 Quality Inn & Suites 515-232-9260 319-237-1277 319-377-6386 563-386-6900 563-557-8000 319-277-2230 712-277-9400 515-265-7321 319-35-2000