HomeMy WebLinkAboutApproved Documents - 10/1/2018 FINANCE DEPT. STAFF ONLY
LINE ITEM USED 010-11-1100-1346
TRAVEL REQUEST FY_2019_ BUDGETED i4SOVU
CITY OF WATERLOO EXPENDED YTD /G�si
THIS REQUEST (cyQo
LEFT AFTER THIS
REQUEST 35'(O y's Sv
DATE -57- —/$
Original-Clerk/Finance Co - Department
NAME(S)AND POSITION(S): DATE
P.O. Saunders 91P0198
NAME OF CLASS/MEETING: DESTINATION Johnston, Iowa
ASP Baton Instructor Re certification DEPARTURE POINT
C,Rn41*We4; /rms e 7.606Gdizx6s) IF NOT WATERLOO:
DEPARTURE DATE: Return Date. DATE(S) OF MEETING:
October 10 , 2018 October 10th, 2018 October 10th, 2018
PURPOSE OF TRAVEL:
Lt. Cirksena is requesting authorization to send P.O Saunders to ASP Baton instructor re-certification class in
Johnston, Iowa on October 10th, 2018. He must be re-certified every three years and will teach ASP Baton
tactics to WPD officers during annual training. A city vehicle will be needed for this training.
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL: x COST$
YES NO
METHOD OF TRAVEL:
x CITY VEHICLE PRIVATE VEHICLE
AIRFARE DEPARTING FROM:
ESTIMATE OF COST: BUDGET LINE ITEM:
$.00 LODGING .00 Uniforms x GRANT REIMBURSABLE
$15.00 MEALS .00 Parking YES NO
$125.00 REGISTRATION .00 AIRFARE x REQUIRED CERTIFICATION
$.00 Fuel/mileage .00 Dues YES NO
TOTAL FOR ALL: $ 140.00 TOTAL: $ 140.00 PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE I APPROVE THIS TRAVEL REQUEST
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WATERLOO
DEPARTMENT HEAD MAYOR
DATE DATE
FINANCE DEPT. STAFF ONLY
LINE ITEM USED 010-11-1100-1346
TRAVEL REQUEST FY_2019_ BUDGETED 445-000
CITY OF WATERLOO EXPENDED YTD
THIS REQUEST
LEFT AFTER THIS
REQUEST
DATE
Original-Clerk/Finance Copy-Department
NAME(S)AND POSITION(S): DATE
Sgt. Erie Officers: Berryman B. Lippert A. Herkelman 9/20/18
B. Herkelman
NAME OF CLASS I MEETING: DESTINATIONJohnston, Iowa
Defensive Tactics Instructor Recert DEPARTURE POINT
IF NOT WATERLOO:
DEPARTURE DATE: Return Date: DATE(S) OF MEETING:
Sept. 26`h, 2018 September 26th, 2018 September 26th, 2018
PURPOSE OF TRAVEL:
Lt. Cirksena is requesting authorization to send Sgt. Erie and Officers Berryman, B. Lippert, A. Herkelman and
B. Herkelman to Defensive tactics Instructor recertification in Johnston, Iowa on September 26th, 2018. They
must be re-certified every three years and will teach Defensive tactics to WPD officers during annual training. A
city vehicle will be needed for this training.
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL: x COST$
YES NO
METHOD OF TRAVEL:
x CITY VEHICLE PRIVATE VEHICLE
AIRFARE DEPARTING FROM:
ESTIMATE OF COST: BUDGET LINE ITEM:
$.00 LODGING .00 Uniforms x GRANT REIMBURSABLE
$75.00 MEALS .00 Parking YES NO
$750.00 REGISTRATION .00 AIRFARE x REQUIRED CERTIFICATION
$.00 Fuel/mileage .00 Dues YES NO
TOTAL FOR ALL: $ 825.00 TOTAL: $ 165.00 PER PERSON
1 BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE I APPROVE THIS TRAVEL REQUEST
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WATERLOO
DEPARTMENT HEAD MAYOR
G - 'ZiO- '"p rt I `ill /1,5
DATE DATE
FINANCE DEPT. STAFF ONLY
LINE ITEM USED 010-11-1100-1346
TRAVEL REQUEST FY_2019_ BUDGETED �S,000
CITY OF WATERLOO EXPENDED YTD /V1 —
THIS REQUEST /&,5
LEFT AFTER THIS1! 5aREQUEST _ 3 /OS _
DATE yJ4.3
Original-Clerk/Finance Co -Department
NAME(S)AND POSITION(S): DATE
P.O. Saunders 9/20/18
NAME OF CLASS/MEETING: DESTINATION Johnston, Iowa
OC(Oleoresin Capsicum) Spray Instructor re-certification DEPARTURE POINT
IF NOT WATERLOO:
DEPARTURE DATE: Return Date: DATE(S) OF MEETING:
October 24`n, 2018 October 24th, 2018 October 24th, 2018
PURPOSE OF TRAVEL:
Lt. Cirksena is requesting authorization to send P.O Saunders to OC spray Instructor re-certification class in
Johnston, Iowa on October 24th, 2018. He must be re-certified every three years and will teach OC spray
tactics to WPD officers during annual training. A city vehicle will be needed for this training.
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL: x COST$
YES NO
METHOD OF TRAVEL:
x CITY VEHICLE PRIVATE VEHICLE
AIRFARE DEPARTING FROM:
ESTIMATE OF COST: BUDGET LINE ITEM:
$.00 LODGING .00 Uniforms x GRANT REIMBURSABLE
$15.00 MEALS .00 Parking YES NO
$150.00 REGISTRATION .00 AIRFARE x REQUIRED CERTIFICATION
$.00 Fuel/mileage .00 Dues YES NO
TOTAL FOR ALL: $ 165.00 TOTAL: $ 165.00 PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE I APPROVE THIS TRAVEL REQUEST
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WATERLOO
�i
DEPARTMENT HEAD MAYOR
q ' '"
DATE DATE
FINANCE DEPT. STAFF ''ONLY
LINE ITEM USED XQ,2(O `f"��5 /✓T��_
TRAVEL REQUEST Fv;�K/4 BUDGETED 70
CITY OF WATERLOO EXPENDED YTD — -
THIS REQUEST
LEFT AFTER THIS / 7
REQUEST
DATE f� 9
original-Clerk/Finance Copy-Department
NAME(S)AND POSITION(S): DATE:
Elizabeth Andrews, Registrar September 20, 2018
NAME OF CLASS/MEETING: DESTINATION: Cedar Falls, IA
Attend Iowa Museum Association Conf.
DEPARTURE POINT
IF NOT WATERLOO:
DEPARTURE DATE: RETURN DATE: DATE(S) OF MEETING:
Monday Oct. 8, 2018 UYe Oct 7, 8, 9 (Sun, Mon, Tues)
-rueI Ort- 9
PURPOSE OF TRAVEL/TRAINING:
Attend sessions led by Midwest and Iowan Museum Professionals about Museum Collection Management and Museum
Exhibit Development.
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL: X COST$
YES NO
METHOD OF TRAVEL:
CITY VEHICLE x PRIVATE VEHICLE
AIRFARE DEPARTING FROM:
ESTIMATE OF COST: 26STG.osG
BUDGET LINE ITEM: 0102642651346
LODGING TAXI GRANT REIMBURSABLE
Registration
includes meals MEALS PARKING YES NO
225 REGISTRATION AIRFARE REQUIRED CERTIFICATION
MILEAGE/FUEL MISC/TOLLS YES NO
TOTAL FOR ALL: $ 225 TOTAL: $ PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE I APPROVE THIS TRAVEL REQUEST
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WATERLOO
D PARTMENT HEAD MAYOR
DATE DATE
K:\Shared Goodies\Forms\Travel Request Form January 2010
FINANCE DEPT. STAFF ONLY
LINE ITEM USED 010-11-1100-1346
TRAVEL REQUEST FY_2019_ BUDGETED 6T
CITY OF WATERLOO EXPENDED YTD �✓�(i�� a
THIS REQUEST
LEFT AFTER THIS
REQUEST
DATE
Original-Clerk/Finance? Co --Department
NAME(S) AND POSITION(S): DATE
Sgt. Hoelscher 9/26/18
NAME OF CLASS I MEETING: DESTINATIONJohnston, Iowa
Firearms Instructor Recertification DEPARTURE POINT
IF NOT WATERLOO:
DEPARTURE DATE: Return Date: DATE(S) OF MEETING:
November 28t", 2018 November 28�h, 2018 November 2e, 2018
PURPOSE OF TRAVEL:
Lt. Cirksena is requesting authorization to send Sgt. Hoelscher to Firearms instructor re-certification class in
Johnston, Iowa on November 28`h, 2018. He must be re-certified every three years and will teach Firearms to
WPD officers during annual training. A city vehicle will be needed for this training.
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL: x COST$
YES NO
METHOD OF TRAVEL:
x CITY VEHICLE PRIVATE VEHICLE
AIRFARE DEPARTING FROM:
ESTIMATE OF COST: BUDGET LINE ITEM:
$.00 LODGING .00 Uniforms x GRANT REIMBURSABLE
$15.00 MEALS .00 Parking YES NO
$150.00 REGISTRATION .00 AIRFARE x REQUIRED CERTIFICATION
$.00 Fuelimileage .00 Dues YES NO
TOTAL FOR ALL: $ 165.00 TOTAL: $ 165.00 PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE I APPROVE THIS TRAVEL REQUEST
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF W ERLOO
DEPA NT HEAD MAYOR
c) —2-6 U
DATE DATE
FINANCE DEPT, STAFF ONLY
LINE ITEM USED _010-11-1100-1346
TRAVEL REQUEST FY_2019_ BUDGETED 44 -�� '=
CITY OF WATERLOO EXPENDED YTD -7 S,
THIS REQUEST
LEFT AFTER THIS S�
REQUEST �yvs5
DATE 2fju/
Original-Clerk/Finance Copy- Department
NAME(S) AND POSITION(S): DATE
Sgt. Richter 9/26/18
NAME OF CLASS/ MEETING: DESTINATIONJohnston, Iowa
Rifle Instructor Recertification DEPARTURE POINT
IF NOT WATERLOO:
DEPARTURE DATE: Return Date: DATE(S) OF MEETING:
November 29h, 2018 November 29th, 2018 November 29th, 2018
PURPOSE OF TRAVEL:
Lt. Cirksena is requesting authorization to send Sgt. Richter to Rifle instructor re-certification class in Johnston,
Iowa on November 29h, 2018. He must be re-certified every three years and will teach Rifle tactics to WPD
officers during annual training. A city vehicle will be needed for this training.
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL: x COST $
YES NO
METHOD OF TRAVEL:
x CITY VEHICLE PRIVATE VEHICLE
AIRFARE DEPARTING FROM:
ESTIMATE OF COST: BUDGET LINE ITEM:
$.00 LODGING .00 Uniforms x GRANT REIMBURSABLE
$15.00 MEALS .00 Parking YES NO
$150.00 REGISTRATION .00 AIRFARE x REQUIRED CERTIFICATION
$.00 Fuel/mileage .00 Dues YES NO
TOTAL FOR ALL: $ 165.00 TOTAL: $ 165.00 PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE I APPROVE THIS TRAVEL REQUEST
AND IS NECESSARY AND BENEFICIAL TO THE
CITY O A RLOO
71
�r-�..
DEP HEAD MAYOR
DATE DATE
City Clerk Use Only
Finance Committee
Approval Date I 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 Bldg Maint Department to expend
$ 4,350.00 plus est. shipping costs of $ to pay for or purchase
This purchase or expenditure is being made because:
Purchase of 60 LED kits to finish conversion of lighting to LED fixtures at City Hall &
Library- Installation by Building Maintenance (eligible for MidAmerican Energy Rebate)
Vendor selected for this purchase: Van Meter
Bids or written quotes were taken on this purchase, as follows:
❑X 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:
EI General Fund ❑ Road Use Tax F� Sewer ❑ Sanitation
FX Bonds 1:1 Federal/other grants El Other(specify)
This expenditure is to be coded to the following budget line-item:
417-22-8800-2152
(Fund - Department-Activity-Account Number) (Project Code)
in which the budgeted amount is $ / / ee I"e ✓
and the current available balaQce $
is 4�
� 5 �yav
Respes ukmfte d,
(Signature Dept. Head or Designee) Date (Signature Finance Dept. Review) Date
KAshared goodies\forms\Expenditure Pre-Authorization.xls(Mar 2010)
City Clerk Use Only
Finance Committee
Approval Date ) i U
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 Clerk's Office Department to expend
$ 13,262.00 plus est. shipping costs of $ to pay for or purchase
Annual Contract: Laserfiche Software Assurance & Phone Support (12/18/18 - 12/17/2019)
This purchase or expenditure is being made because:
Vendor selected for this purchase: Advanced Systems, Inc.
❑ Bids or written quotes were taken on this purchase, as follows:
x Bids or quotes were not taken on this purchase because:
Advanced Systems is our Laserfiche support vendor.
Prior Committee Actions (Dates):
Please check the following box(es) as appropriate to describe the funding for this expense:
LI General Fund El Road Use Tax ❑ Sewer F—] Sanitation
❑ Bonds ❑ Federal/other grants ❑ Other(specify)
This expenditure is to be coded to the following budget line-item:
010-03-8400-1520
(Fund - Department-Activity-Account Number) (Project Code)
in which the budgeted amount is $
and the current available balance is $ �S�06
Res ectfully submitted,
(Signature D t. Head or Designee) Date (Slighature Finance Dept. Review) Date
K:\shared goodies\forms\Pre-Authorizatio n.Laserfiche Annual Contract 12.18.17-12.17.18.xls(Mar 2010)
I
CONTRACT INVOICE
Invoice Number: 636521
ADVANCED Invoice Date: 09/19/2018
SYSTEMS,, INC.
5801 Westminster Dr.
PO Box 219 Cedar Falls, IA 50613
P: 319-260-4100, 800-274-2047 F: 319-260-2110
Bill To: City Of Waterloo Clerk Customer: City Of Waterloo Clerk
715 Mulberry St 715 Mulberry St
Waterloo, IA 50703-5783 Waterloo, IA 50703-5783
Account No Payment Terms Due Date Invoice Total Balance Due
92914323 Net 60 11/18/2018 $ 13,262.00 $ 13,262.00
Invoice Remarks
Contract Number Contact Contract Amount P.O.Number Start Date Exp.Date
21486 01 $ 13,262.00 1 12/18/2014 12/17/2019
Contract Remarks
ANNUAL CONTRACT;ANNIVERSARY DATE DECEMBER 18TH
LASERFICHE SOFTWARE ASSURANCE&PHONE SUPPORT
Summary:
Contract base rate charge for the 12/18/2018 to 12/17/2019 billing period $13,262.00
*Sum of equipment base charges $13,262.00
Detail:
Equipment included under this contract
Misc/Software Contract
Number Serial Number Base Charge Location
EQU9172 EQU9172 $13,262.00 City Of Waterloo Clerk 715 Mulberry St
Waterloo,IA 50703-5783
Remit To:
Invoice SubTotal $13,262.00
Advanced Systems,Inc.
5801 Westminster Dr. Tax: $0.00
PO Box 219 Invoice Total $13,262.00
Cedar Falls,IA 50613 Balance Due. $13,262.00
800-274-2047 Page 1 of 1
ity er c se n y
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 Central Garage Department to expend
$ NTE 4,500.00 plus est. shipping costs of $ to pay for or purchase
Repair parts for 194BO5 John Deere Motor Grader
This purchase or expenditure is being made because:
Repair motor grader for street operations including snow removal.
Vendor selected for this purchase: Murphy Tractor
QX Bids or written quotes were taken on this purchase, as follows:
Murphy Tractor Waterloo, IA NTE $4,500.00
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:
OX General Fund F-I Road Use Tax F� Sewer ❑ Sanitation
Bonds 0 Federal/other grants F-] Other(specify)
This expenditure is to be coded to the following budget line-item:
010-18-7955-1571
(Fund - Department-Activity-Account Number) (Project Code)
in which the budgeted amount is $ 240,000.00 ✓
and the current available balance is $ !�'a ��/� 8' ✓
Respectfully submitted,
411'tJA mill hf�' kcc6f'('GGA- Au-t ht44
Ig ature Dept. Head or Designee) Date' " (Signature Finance Dept. Review) Date
K:\shared goodies\forms\2018-September-Pre-Auth-Garage(Street)-Murphy Tractor-194605 Grader Parts-010-18-7955-1571-
NTE$4,500.00.xis(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 Engineering Department to expend
$ 31,159.00 plus est. shipping costs of $ 0.00 to pay for or purchase
repair of existing storm sewer in the 1200 block of Katoski Drive.
This purchase or expenditure is being made because:
The existing storm sewer has failed causing the street to be undermined near the
manhole in the left north bound lane.
Vendor selected for this purchase: Vieth Construction Corporation, Cedar Falls, Iowa
FX Bids or written quotes were taken on this purchase, as follows:
Plans and specifications were delivered to six contractors with one bid
received. This was bid as an informal project since the engineer's estimate
was less than $25,000.00.
EI 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 El Road Use Tax ❑ Sewer EI Sanitation
❑ Bonds El Federal/other grants Ex Other(specify) Storm Water Fee
This expenditure is to be coded to the following budget line-item:
521-07-5300-2162
(Fund- Department-Activity-Account Number) (Project Code)
in which the budgeted amount is $ 500,000.00 '
and the current available balance is $ 500,000.00
Respectfully submitted
4/ Ignature D pt. Head or Designee) Date (Siglhature Finance Dept. Review) Date
hared goodies\forms\Katoski Pre-Authorization(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 MIS Department to expend
$ 1,657.85 plus est. shipping costs of $ to pay for or purchase
Dell Server Maintenance and Support for Time Keeping Server
This purchase or expenditure is being made because:
This is support and maintenance for the city's employee time keeping server.
Vendor selected for this purchase: Dell
❑ Bids or written quotes were taken on this purchase, as follows:
�X Bids or quotes were not taken on this purchase because:
Dell server- Dell Maintenance
Prior Committee Actions (Dates):
Please check the following box(es) as appropriate to describe the funding for this expense:
General Fund El Road Use Tax ❑ Sewer ❑ Sanitation
1-1 Bonds ❑ Federal/other grants ❑ Other (specify)
This expenditure is to be coded to the following budget line-item:
010-01-8220-1520
(Fund - Department-Activity-Account Number) (Project Code)
in which the budgeted amount is $ 38,870.00✓
and the current available balance is $ 38,720-6fl44 ,-
1� 7�2
Respectfully submitted,
(Signature D pt. Hibad or Designee) Date 'Signature Finance Dept. Review) Date
K:\shared goodies\forms\Pre-Auth Dell Time Keeping Server Annual Maintenance.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 Police Department to expend
$ 2,874.00 plus est. shipping costs of $ 15.00 to pay for or purchase
Replace 3 Access Points in the Police Department
This purchase or expenditure is being made because:
This equipment is necessary to handle all the wireless internet access
throughout the Police Department for computers and phones and needs to be replaced
Vendor selected for this purchase: Ray Allen Manufacturing
❑ Bids or written quotes were taken on this purchase, as follows:
Fx Bids or quotes were not taken on this purchase because:
Aces is the vendor we utilize for this type of equipment and this would be an
upgrade to our existing system within the Police Department
Prior Committee Actions (Dates):
Please check the following box(es) as appropriate to describe the funding for this expense:
❑ General Fund ❑ Road Use Tax D Sewer ❑ Sanitation
Fx Bonds ❑ Federal/other grants F Other(specify)
This expenditure is to be coded to the following budget line-item:
416-11-1100-2106/417-11-1100-2106
(Fund - Department-Activity-Account Number) (Project Code)
in which the budgeted amount is $ II)OW00�
/JG,o�7o
and the current available balance is $
Respectfully submitted,
�y
(Signature Dept. Head or Designee) Date (Signature Finance Dept. Review) Date
KAshared goodies\forms\Expenditure Pre-Authorization.xlsx(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 Police Department to expend
$ 2,099.99 plus est. shipping costs of $ 157.00 to pay for or purchase
K9 incert for squad car
This purchase or expenditure is being made because:
This equipment is necessary due to replacing an older K9 vehicle with a current SUV
squad car and the older incert will not fit in the new K9 vehicle
Vendor selected for this purchase: Ray Allen Manufacturing
❑ Bids or written quotes were taken on this purchase, as follows:
0 Bids or quotes were not taken on this purchase because:
Ray Allen Manufacturing is the provider used by the Police Department for K9
equipment needs
Prior Committee Actions (Dates):
Please check the following box(es) as appropriate to describe the funding for this expense:
❑ General Fund EI Road Use Tax ❑ Sewer ❑ Sanitation
❑ Bonds ❑ Federal/other grants FX Other(specify) K9 Fund
This expenditure is to be coded to the following budget line-item:
010-11-1160-1528 11 PROPDK9
(Fund - Department-Activity-Account Number) (Project Code)
in which the budgeted amount is $
;d0I0�
and the current available balance is $
Respectfully submitted,
ho
(Signature Dept. Head-or Designee) ate (Signature Finance Dept. Review) Date
K:\shared good i es\forms\Expend iture Pre-Authorization.xlsx(Mar 2010)
City Clerk Use Only
Finance Committee
Approval Date k-A(I
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
$ 14.283.00 plus ext. shipping cost of $ 400.00 to pay for or purchase
One Indoor Hach sampler, One Outdoor Hach sampler, two Cables and one Power Supply
This purchase or expenditure is being made because:
For sampling of Easton Inffluent flow before plant recycle flow and sampling of
Satellite effluent flow.
Vendor selected for this purchase:
Hach
Bids or written quotes were taken on this purchase, as follows
®Bids or quotes were not taken on this purchase because:
We have purchased other Hach samplers and would like to continue to use there
samplers.
Prior Committee Actions (Dates):
Please check the following box(es)as appropriate to describe the funding for this expense:
❑General Fund: oaUse Tax: ewer: ❑
❑Rd S
Sanitation:
Bonds: ❑Federauother grants: ❑Other(speclfy):
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 $ 400,000.00+0
and the current available balance is $ 320:96� .311871o�
Respectfully ssu-ybmit�ted,
(Signature Dept. HeadOr Desi--�gne ) Date (Signature Finance Dept. Review) Date
-=
- v
I
Quotation
Be Right"
Hach
PO Box 608
Loveland,CO 80539-0608
Quote Number:100380247v2 Phone: (800)227-4224
Use quote number at time of order to ensure Email: quotes@haeh.eom
that you receive prices quoted Website: www,hach.com
Quote Date:12-Sep-2018 Quote Expiration:11-Nov-2018
City Of Waterloo WW
Name:John Hyman
Phone:3192914553
Fax:3192914523
Emall:kLshop@waterloo-la.org
Sales Contact:Shelley White Email:shwhite@hach.com Phone:515-338-0859
PRICING-QUOTATION
e
1 .CXXX1111XX JAS950 FRIG,115V,5.56AL POLY.Standard lead time 5 days. 1 6,129,001 6,129.00
528500 ICABLE ASSY,AUX HALF,713 F,SIFT.Standard lead time 3 days. 1 151 00 151.00
TERMS OF +
Freight:Ground Prepay and Add FCA:Hach's facility
All purchases of Hach Company products and/or services are expressly and without limitation subject to Hach Company's Terms 6 Conditions of Sale("Hach TCS'),Incorporated
herein by reference and published on Hach Company's website at www.hach.comlterms, Hach TCS are contained directly andior by reference in Hach's offer,order acknowledgment,
and invoice documents.The first of the following acts constitutes on aceeptarlee of Hash's offer and not a counteroffer and creates a contract of sale"Comract"in accordance with the
Hach TCS:(1)Buyer's issuance of a purchase order document against Hach's offer;(ti)acknowledgement of Buyer's order by Hach;w fill)commencement of any performance by Hach
pursuant to Buyer's order.Provisions contained in Buyer's purchase documents(including electronic commerce Interfaces)that materially alter,add to or subtract
from the provisions of the Hach TCS are not part of the Contract.
Due to International regulations,a U.S.Department of Commerce Export License may be required.Hach reserves the right to approve specific shipping agents.Wooden boxes suitable
for ocean shipment are extra.Specify final destination to ensure proper documentation and packing suitable for International transport In addition.Hach may require:1).A statement
of intended end-use;2).Cartificatlon that the Intended end-use does not relate to proliferation of weapons of mass destruction(prohibited nuclear end use,chemical/biological
weapons,missile technology);and 3).Certification that the goads will not be diverted contrary to U.S.law.
ORDER TERMS:
Terms are Subject to Credit Review
Please reference the quotation number on your purchase order.
Sales tax is not Included.Applicable sales tax will be added to the Invoice based on the U.S.destination,It applicable provide a resalelexemption certificate.
Shipments will be prepaid and added to invoices unless otherwise specified.
Equipment quoted operates with standard U.S.supply vohage.
Hach standard terms and conditions apply to all sales.
Additional terms and conditions apply to orders for service partnerships.
Prices do not Include delivery of product. Reference attached Freight Charge Schedule and Collect Handling Fees.
Standard lead time is 313 days.
This Quote is good for a one time purchase.
Sales Contact:
Name: Shelley White
Page t of 2
0
Quotation
Be Right-
Hach
PO Box 608
Quote Number:100380247v1 Loveland,CO 80534.0608
Use quote numbertime order to ensure
that you receive prices quoted
Phone: (800)227-4224
ed Email: quotes@hach.com
Website: www.hach.com
Quote Date:12-Sep-2018 Quote Expiration:11-Nov-2018
City Of Waterloo WW
Name:John Hyman
Phone:3192914553
Fax:3192914523
Email:iclshop@waterloo-ia.org
Sales Contact:Shelley White Email:shwhite@hach.com Phone:515-338-0859
PRICING r A
AS.A.CXXX2XHXX AS950AWRS,115V W/HTR S.SGAL POLY.Standard lead time 5 days. 1 7,425.00 7,425.00
2 8528500 CABLE ASSY,AUX HALF,7P F,9FT.Standard lead time 3 days. 1 151.00 151.00
Power Supply,w/3 Pin Conn 115v US a AC POWER CONVERTER 100.120VAC
3 875450005 MANUAL IN ENGLISH DOC306.53.00801 MANUAL ALSO AVAILABLE IN OTHER 1 427.00 427.00
LANGUAGES,ORDER SEPARATELY aNRD 6964200.Standard lead time 5 days.
TERMSa
Freight:Ground Prepay and Add FCA:Hach's facility
All purchases of Hach Company products and/or services are expressly and without emitaeon subject to Hach Company's Tema 8 Conditions of Sale("Hach TCS"),incorporated
herein by reference and published on Hach Company's website at p,nw.na cn.comherms. Hach TCS are contained directly andlor by reference in Hach's otter,order acknowledgment,
and invoice documents.The first of the following acts constitutes an acceptance of Haeh'e offer and not a counteroffer and creates a contract of Sale'Contract"in accordance with the
Hach TCS:(i)Buyers issuance of a purchase order document against Hach's otter;(71)acknowledgement of Buyer's order by Hach;or(iii)commencement of any performance by Hach
pursuant to Buyer's order.Provisions contained In Buyer's purchase documents(including electronic commerce interfaces)that materially alter,add to or subtract
from the provisions of the Hach TCS ars not part of the Contract.
Due to International regulations,a U.S.Department of Commerce Export License may be required.Hach reserves the right to approve specific shipping agents.Wooden boxes suitable
for ocean shipment are extra.Specify final destination to ensure proper documentation and packing suitable for International transport.In addition,Hach may require:1).A statement
of intended and-use;2).Certification that the Intended end-use does not relate to proliferation of weapons of mass destruction(prohibited nuclear end use,chemical/biological
weapons,missile technology);and S).Certification that the goods will not be diverted contrary to U.S,law.
ORDER TERMS:
Terms are Subject to Credit Review
Please reference the quotation number on your purchase order.
Sales tax is not Included.Applicable sales tax will be added to the invoice based on the U.S.destination,if applicable provide a resalelexemption certificate.
Shipments will be prepaid and added to invoices unless otherwise specified.
Equipment quoted operates with standard U.S.supply vohage.
Hach standard terms and conditions apply to all sales.
Additional terns and conditions apply to orders for service partnerships.
Prices do not include delivery of product. Reference attached Freight Charge Schedule and Collect Handling Fees_
Standard lead time is ag days.
This Quote is good for a one time purchase_
Pare I of 2
Budget Amendment Descriptions for 10/1/2018 Finance Committee Meeting Agenda:
1. Approve the project budget for the Alcohol Incentive Grant Task 48 project, funded by a grant from
the Governor's Traffic Safety Bureau in the amount of$50,900, as submitted by the Police
Department.
Please use this for project budget descriptions on Finance agenda. Do not need to include this cover
sheet in the Finance Committee packet.
CONSTRUCTION PROJECT BUDGET WORKSHEET
PAGE TWO
City Clerk Use Only
Finance Committee
Approval Date
Project Name(from page one) Police Grant-alcohol Incentive Grant Task 41
Department No. project will be budgeted under 11 To be assigned by the Finance Dept.
Activity No. project will be budgeted under 01011 1150 Project No. 11 GRT
01011 1160 Subproject No. IDCTK48
(Each column should only include amounts by fund)
Fund: Fund: Fund: Fund:
1150 1160 Total
REVENUES:
3000 Cash on Hand $
3112 Local Option Sales Tax
3350 Federal Grant
3357 Shared Program -County
3358 Shared Program -City
3360 Shared Program -State
3361 State Grant
3373 Fed Pass thru for Iowa 50,900.00 50,900.00
3111 Hotel Motel Tax
3377 EDA Grant
3720 Donations- Restricted
3873 Reimburse for Services _
3349 Byrne Grant-Tri Co _
TOTALS $ 50,900.00 $ - $ $ - $ 50,900.00
EXPENDITURES:
1111 Salaries - Regular $ _
1112 Salaries - Part Time _
1121 FICA _
11221PERS _
1123 Disability _
1125 Overtime 40,000.00 40,000.00
1346 Travel 1,000.00 1,000.00
1114 Overtime _
1130 Employee Benefits _
1302 Outside Agencies _
1563 In Car Video Camera 9,000.00 9,000.00
1573 PBTs 900.00 900.00
TOTALS $ 50,900.00 $ - $ - $ - $ 50,900.00
(Signature Dept. Head) Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\cs Project Budget Worksheets 15\Traffic TK48 pg1 (Mar 2010)
PROJECT BUDGET WORKSHEET -ALL PROJECTS
PAGE ONE
Project Name Police Grant-Alcohol Incentive Grant Task
City Contract No. To be assigned by the Finance Dept.
Project Manager Captain Dave Mohlis Project No. 11GRT
Project Budget Total $ 50,900.00 Subproject No. IDCTK48
1. How will this project be funded?
A. Federal Grant Yes = No FX CFDA# % Paid by federal grant
Grant Name Grant Agreement Number PAP 19-405d-M60T
B. State Grant Yes = No % Paid by state grant 100.00%
Grant Name Grant Agreement Number
C. City Match Source of Funding % Paid by City
D. Other Entities Yes 0 No % Paid by other entity
Name
Done None
2. Attach copies of any grant agreements that will fund the project(REQUIRED) Ex ❑
Yes No
3. Does the project include the purchase of right of way or other real property? ❑ FX
If yes, will real property purchases be reimbursable under the grant? ❑ EX
If yes, have you attached authorization to purchase real property to this document? 7 QX
4. Will this project include any non-participating expenses, such as:
A. Stormwater permit fees ❑ ❑X
B. Publication, or printing costs ❑ ❑X
C. Others, list ❑ ❑X
5. Does this project cover any regular full-time salaries or benefits? ❑ ER
6. Include a brief description of the project in the space below: (REQUIRED)
This grant will cover directed overtime enforcement, training related travel &in-car video cameras and PBT's.
Page 2 must be attached and signed.
K:lshared goodieslformslcs Project Budget Worksheets 151Traffic TK48 pg 2 (Mar 2010)
GOVERNOR'S TRAFFIC SAFETY BUREAU
IOWA DEPARTMENT OF PUBLIC SAFETY
CONTRACT NUMBER: Impaired Driving Countermeasures Grant,
PAP 19-405d-M60T, Task 48-00-00
ISSUING AGENCY: DPS/Governor's Traffic Safety Bureau
PROJECT CONTRACTOR: Waterloo Police Department
FISCAL SUMMARY: Highway Safety Funded Amount: $50,900.00
AGENCY/LAW/SOURCE: National Highway Traffic Safety Administration (NHTSA)
Public Law 114-94, Section 405d
DUNS # 07-584-1684
Submit Reimbursement Claims To: Issue Payment To:
Todd Olmstead, Program Administrator Waterloo, City of
Governor's Traffic Safety Bureau Police Department
215 East 7th Street, 3rd Floor 715 Mulberry Street
Des Moines, IA 50319-0248 Waterloo, IA 50702
Submit Reports To: Transmit Contract Information To:
Todd Olmstead, Program Administrator Captain Dave Mohlis
Governor's Traffic Safety Bureau Waterloo Police Department
215 East 7th Street, 3rd Floor 715 Mulberry Street
Des Moines, IA 50319-0248 Waterloo, IA 50702
515-725-6122, FAX 515-725-6133 319-291-4336, FAX 319-291-4332
The Contractor agrees to furnish and deliver all products and perform all services set forth in the
attached Special Conditions for the consideration stated herein. The rights and obligations of the
parties to this contract will be subject to and governed by the Special Conditions and the General
Conditions. To the extent that any specifications or other conditions which are made a part of this
contract by reference or otherwise conflict, the Special Conditions and the General Conditions
will control. To the extent that any inconsistency between the Special Conditions and the General
Conditions exists, the Special Conditions will control. When approved, the instrument becomes
a contract to accomplish the provisions contained within the Fiscal Year 2019 Highway Safety
Plan, Impaired Driving Countermeasures Grant 19-405d-M60T, Task 48-00-00, and thereby
constitutes an official program with the Governor's Traffic Safety Bureau. This activity meets the
requirements of Public Law 114-94 and the requirements set forth in the Governor's Traffic Safety
Bureau Procedures Manual, as amended.
IN WITNESS THEREOF, the parties hereto have executed this contract on the day and year last
specified below.
CONTRACTOR:
gY Date:
ISSUING AGENCy�� ,
r' f � p-
By V z, v Date: 14
Patrick J. Hoye, Bureau Chief -
Effective Date: 10/01/18 Expiration Date: 09/30/19
SPECIAL CONDITIONS
Article 1.0 Identification of Parties. This Contract is entered into by and between the Iowa
Department of Public Safety/Governor's Traffic Safety Bureau (hereafter referred to as DPS/
GTSB) and the Waterloo Police Department (hereinafter referred to as Contractor).
Article 2.0. Statement of Purpose.
WHEREAS, the Highway Safety Plan is the tool for developing and improving overall
safety capabilities; improving the program management and decision-making capabilities of
safety officials; addressing special problems or opportunities; and providing a coordination
mechanism for the purpose of reducing traffic-related property damage, personal injury and fatal
crashes, and
WHEREAS, the DPS/GTSB has been designated to administer the State and Community
Highway Safety Programs established under Section 405d of the Fixing America's Surface
Transportation Act, as amended, and
WHEREAS, the Contractor has the necessary ability to develop and carry out a portion of
that Highway Safety Plan,
THEREFORE, the parties hereto do agree as follows:
Article 3.0 Area Covered. The Contractor will perform all the work and services required
under this Contract in connection with and respecting the following areas:
City of Waterloo, Iowa and other jurisdiction(s) authorized by a shared enforcement
agreement.
Article 4.0 Reports and Products. The Contractor will submit the following reports and
products:
4.1 A Claim for Reimbursement (HSP-2) form, documentation and, if applicable, an
Equipment Accountability Report (HSP-3) form for reimbursement within 90 days
of the expense being paid by the Contractor with the exception of the final claim
which is due into the DPS/GTSB office no later than November 15, 2019.
4.2 A cumulative final report due November 1, 2019 covering accomplishments of
Statement of Work and Services.
4.3 Any reports and products deemed prudent by the Issuing Agency or Contractor.
4.4 A copy of all audit reports within 30 days of completion of said audit.
4.5 Monthly activity reports due the 15th of the following month on forms provided by
the DPS/GTSB that quantify project activities as well as total departmental effort.
Article 5.0 Designation of Officials.
5.1 DPS/GTSB -The Governor's Representative for Highway Safety and the Director
of the Governor's Traffic Safety Bureau are the only persons authorized to execute
and approve any changes in terms, conditions, or amounts specified in this
Contract.
5.2 Contractor Designee, Chief Daniel Trelka, is designated to approve in writing, on
behalf of the Contractor, the HSP-2 Claim for Reimbursement and any negotiated
changes in this Contract.
Article 6.0 Key Personnel. The Contractor hereby assigns the duties and responsibilities of
project administration to Captain Dave Mohlis, representing the Contractor in this agreement.
Article 7.0 Time of Performance. The services of the Contractor will commence on or after
the effective date stipulated on the signature page and will be completed before or by the
expiration date.
Article 8.0 Modification of General Conditions. None.
Article 9.0 Additional Special Conditions.
9.1 Expense Documentation. The Contractor will document the expenditure of such
funds authorized as eligible for reimbursement in accordance with the conditions
of this Contract upon submission of the HSP-2 and, for equipment, the HSP-3 as
supplied by the DPS/GTSB.
9.2 Policies and Procedures. The Contractor will comply with all policies and
procedures contained in the Iowa DPS/GTSB Policies and Procedures Manual, as
amended, including appropriate attachments provided by the DPS/GTSB in
accordance with Section 405d of the Fixing America's Surface Transportation Act,
and the Iowa Administrative Code, Section 661, Chapter 20.
9.3 Copyrights. The Federal awarding agency reserves a royalty-free, nonexclusive
and irrevocable license to reproduce, publish or otherwise use, and to authorize
others to use, for Federal Government purposes:
a. The copyright in any work developed under a grant, sub-grant, or contract
under a grant or sub-grant; and
b. Any rights of copyright to which a grantee, sub grantee or a contractor
purchases ownership with grant support.
9.4 Debarred, Suspended and Ineligible Status. The Contractor certifies that the
Contractor and/or any of its subcontractors have not been debarred, suspended or
declared ineligible by any agency of the State of Iowa or as defined in the Federal
Acquisition Regulation (FAR) 48 C.F.R. Ch.1 Subpart 9.4. The Contractor will
immediately notify DPS/GTSB if the Contractor is debarred by the State or placed
on the Consolidated List of Debarred, Suspended and Ineligible Contractors by a
federal entity.
9.5 Equipment acquired under this agreement for use in highway safety program areas
shall be used and kept in operation for highway safety purposes 23 CFR 1300.31.
a. Title. Except as provided in paragraphs (e) and (f) of this section, title to
equipment acquired under 23 U.S.C. Chapter 4 and Section 1906 will vest
upon acquisition in the State or its subrecipient, as appropriate, subject to the
conditions in paragraphs (b) through (d) of this section.
b. Use. All equipment shall be used for the originally authorized grant purposes
for as long as needed for those purposes, as determined by the Regional
Administrator, and neither the State nor any of its subrecipients or contractors
shall encumber the title or interest while such need exists.
c. Management and disposition. Subject to the requirements of paragraphs (b),
(d), (e), and (f) of this section, States and their subrecipients and contractors
shall manage and dispose of equipment acquired under 23 U.S.C. Chapter 4
and Section 1906 in accordance with State laws and procedures.
d. Majorpurchases and dispositions. Equipment with a useful life of more than
one year and an acquisition cost of $5,000 or more shall be subject to the
following requirements:
1) Purchases shall receive prior written approval from the Regional
Administrator;
2) Dispositions shall receive prior written approval from the Regional
Administrator unless the equipment has exceeded its useful life as
determined under State law and procedures.
e. Right to transfer title. The Regional Administrator may reserve the right to
transfer title to equipment acquired under this part to the Federal Government
or to a third party when such third party is eligible under Federal statute. Any
such transfer shall be subject to the following requirements:
1) The equipment shall be identified in the grant or otherwise made known
to the State in writing;
2) The Regional Administrator shall issue disposition instructions within 120
calendar days after the equipment is determined to be no longer needed
for highway safety purposes, in the absence of which the State shall follow
the applicable procedures in 2 CFR parts 200 and 1201.
f. Federally-owned equipment. In the event a State or its subrecipient is
provided federally-owned equipment:
1) Title shall remain vested in the Federal Government;
2) Management shall be in accordance with Federal rules and procedures,
and an annual inventory listing shall be submitted by the State;
3) The State or its subrecipient shall request disposition instructions from the
Regional Administrator when the item is no longer needed for highway
safety purposes.
9.6 Civil Rights Act - The Contractor will comply with all Federal statutes and
implementing regulations relating to nondiscrimination. These include but are not
limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits
discrimination on the basis of race, color or national origin (and 49 CFR Part 21);
(b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. §§
1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; (c)
Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. §794) and
the Americans with Disabilities Act of 1990 (42 USC § 12101, et seq.; PL 101-336),
which prohibits discrimination on the basis of disabilities (and 49 CFR Part 27); (d)
the Age Discrimination Act of 1975, as amended (42U.S.C. §§ 6101-6107), which
prohibits discrimination on the basis of age; (e) the Drug Abuse Office and
Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on
the basis of drug abuse; (f) the comprehensive Alcohol Abuse and Alcoholism
Prevention, Treatment and Rehabilitation Act of 1970(P.L. 91-616), as amended,
relating to nondiscrimination on the basis of alcohol abuse of alcoholism; (g) §§
523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. §§ 290 dd-3 and
290 ee-3), as amended, relating to confidentiality of alcohol and drug abuse patient
records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. §§ 3601 et seq.),
as amended, relating to nondiscrimination in the sale, rental or financing of
housing; (i) any other nondiscrimination provisions in the specific statute(s) under
which application for Federal assistance is being made; The Civil Rights
Restoration Act of 1987, which provides that any portion of a state or local entity
receiving federal funds will obligate all programs or activities of that entity to comply
with these civil rights laws; and, (k)the requirements of any other nondiscrimination
statute(s) which may apply.
9.7 Buy America Act - The Contractor will comply with the provisions of the Buy
America Act (23 U.S.C. 313) which contains the following requirements: Only
steel, iron and manufactured products produced in the United States may be
purchased with Federal funds unless the Secretary of Transportation determines
that such domestic purchases would be inconsistent with the public interest; that
such materials are not reasonably available and of a satisfactory quality; or that
inclusion of domestic materials will increase the cost of the overall project contract
by more than 25 percent. Clear justification forthe purchase of non-domestic items
must be in the form of a waiver request submitted to and approved by the Secretary
of Transportation.
9.8 Political Activity (Hatch Act) - The Contractor will comply, as applicable, with
provisions of the Hatch Act (5 U.S.C. §§1501-1508 and 7324-7328) which limit the
political activities of employees whose principal employment activities are funded
in whole or in part with Federal funds. As such, the Contractor will not subcontract
with any agency to conduct DPS/GTSB contract-related activities.
9.9 Lobbying Restrictions - None of the funds under this program will be used for any
activity specifically designed to urge or influence a State or local legislator to favor
or oppose the adoption of any specific legislative proposal pending before any
State or local legislative body. Such activities include both direct and indirect (e.g.
"grassroots") lobbying activities, with one exception. This does not preclude a
State official whose salary is supported with NHTSA funds from engaging in direct
communications with State or local legislative officials, in accordance with
customary State practice, even if such communications urge legislative officials to
favor or oppose the adoption of a specific pending legislative proposal.
9.10 Federal Lobbying. The undersigned certifies, to the best of his or her knowledge
and belief, that:
a. No Federal appropriated funds have been paid or will be paid, by or on behalf
of the undersigned, to any person for influencing or attempting to influence
and officer or employee of any agency, a Member of Congress, an officer of
employee of Congress, or an employee of a Member of Congress in
connection with the awarding of any Federal contract, the making of any
Federal grant, the making of any Federal loan, the entering into of any
cooperative agreement, and the extension, continuation, renewal,
amendment, of modification of any Federal contract, grant, loan, or
cooperative agreement;
b. If any funds other than Federal appropriated funds have been paid or will be
paid to any person for influencing or attempting to influence an officer or
employee of any agency, a Member of Congress, an officer of employee of
Congress, or an employee of a Member of Congress in connection with this
Federal contract, grant, loan, or cooperative agreement, the undersigned
shall complete and submit Standard Form-LLL, "Disclosure Form to Report
Lobbying," in accordance with its instructions;
c. The undersigned shall require that the language of this certification be
included in the award documents for all sub-award at all tiers) including
subcontracts, subgrants, and contracts under grant, loans, and cooperative
agreements) and that all subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was
placed when this transaction was made or entered into. Submission of this
certification is a prerequisite for making or entering into this transaction imposed
by section 1352, title 31, U.S. Code. Any person who fails to file the required
certification shall be subject to a civil penalty of not less than $10,000 and not
more than $100,000 for each such failure.
9.11 Prohibition on Using Grant Funds to Check for Helmet Usage. The Contractor
will not use 23 U.S.C. Chapter 4 grant funds for programs to check helmet usage
or to create checkpoints that specifically target motorcyclists.
Article 10.0 Conditions of Payment.
10.1 Maximum Payments. It is expressly understood and agreed the maximum amount
to be paid to the Contractor by the DPS/GTSB for any item of work or service will
be the amount specified under Article 12.0 subject to Article 11.0 herein. It is
further understood and agreed the total of all payments to the Contractor by the
DPS/GTSB for all work and services required under this Contract will not exceed
$50,900.00 unless modified by written amendment of this Contract as provided in
Section 1.0 of the General Conditions.
10.2 HSP-2 Form for Payment. All payments to the Contractor will be subject to the
DPS/GTSB's receipt of an HSP-2 and documentation. If claiming equipment, an
HSP-3 must also be submitted. The Contractor must perform services and receive
merchandise between the effective dates of the contract and pay for expenses
prior to submitting the claim for reimbursement. An HSP-2 will be submitted on a
form provided by the DPS/GTSB. No payments will be made if required reports
are more than two months past due unless approved by the DPS/GTSB Director.
10.3 Receipt of Federal Funds.
a. All payments hereunder will be subject to the receipt of federal funds by the
DPS/GTSB. The termination, reduction or delay of federal funds to the
DPS/GTSB may be reflected by a corresponding modification to the conditions
of this Contract.
b. Notwithstanding any other provisions of this Contract, if funds anticipated for
the continued fulfillment of this Contract are at any time not forthcoming or
insufficient, either through failure of the State of Iowa to appropriate funds,
discontinuance or material alteration of the program for which funds were
provided, the DPS/GTSB will have the right to terminate this Contract without
penalty by giving not less than thirty (30) days written notice documenting the
lack of funding, discontinuance or program alteration. Unless otherwise
agreed to by the parties, the Contract will become null and void on the last day
of the fiscal year for which appropriations were received, except that if an
appropriation to cover cost of this Contract becomes available within sixty (60)
days subsequent to termination under this clause, the DPS/GTSB agrees to
re-enter a Contract with the terminated Contractor under the same provisions,
terms and conditions as the original Contract.
c. In the event of termination of this Contract due to non-appropriation, the
exclusive, sole and complete remedy of Contractor will be payment for services
rendered prior to termination.
10.4 Non-Performance Termination. If, through any cause, the Contractor shall fail to
fulfill in a timely and proper manner its obligation under this contract, or if the
Contractor shall violate any of the agreements or stipulations of this contract, the
DPS/GTSB shall thereupon have the right to terminate this contract and withhold
further payment of any kind by giving written notice to the Contractor of such
termination and specifying the effective date thereof, at least thirty(30)days before
such date. The DPS/GTSB shall be the sole arbitrator of whether the Contractor
or its subcontractor is performing its work in a proper manner with reference to the
quality of work performed by the Contractor or its subcontractor under the
provisions of this contract. The Contractor and the DPS/GTSB further agree that
this contract may be terminated by either party by giving written notice of such
termination and specifying the effective date thereof, at least thirty(30)days before
such date.
10.5 The Contractor will arrange for a single audit to be performed in accordance with
OMB Circular A-133 when, as a non-federal entity, the Contractor receives
$750,000.00 or more in federal funds. The federal agency, National Highway
Traffic Safety Administration, Department of Transportation, passes funds through
the Department of Public Safety, Governor's Traffic Safety Bureau. The Catalog
of Federal Domestic Assistance (CFDA) number 20.616 applies to Impaired
Driving Countermeasures Grants. A copy of the audit report will be submitted to
the DPS/GTSB within thirty (30) days after the completion of the audit.
Article 11.0 Statement of Work and Services. The Contractor will perform in a satisfactory
and proper manner, as determined by the DPS/GTSB the following work and services:
11.1 The Contract will be monitored by the National Highway Traffic Safety
Administration (NHTSA) and the DPS/GTSB. All records and documents
pertaining to the project are subject to auditing and evaluation by those agencies
or their designees.
11.2 The Contractor will absorb all costs not contained in this contract.
11.3 The project will be evaluated on all items contained in the Statement of Work and
Services and the Budget.
11.4 There will be no change in the Statement of Work and Services or Budget without
prior written approval of the DPS/GTSB.
11.5 The Contractor will comply with all requirements contained within the Policies and
Procedures Manual of the DPS/GTSB.
11.6 All documents relative to fiscal claims will be maintained in the Contractor's office
and will be available for review during regular office hours.
11.7 Staffing plan:
a. Officers to conduct 754 hours of directed overtime high-visibility enforcement.
11.8 Contract activities:
a. Conduct 754 overtime hours of planned high visibility enforcement directed at
impaired driving during times and at locations that have been identified by your
agency, the Iowa DOT or the DPS/GTSB as high risk, including at least two
nighttime multi-agency saturation projects. Strong consideration should be
given to weekends and project hours between 6:00 p.m. and 3:00 a.m.
b. Conduct at least twelve public information/education activities aimed at
improving driver safety behaviors to reduce impaired driving.
c. Purchase two DPS-approved preliminary breath testers (PBTs) and two in-car
video cameras and utilize for impaired driving-related traffic enforcement.
d. Participate in traffic safety training with prior DPS/GTSB approval and submit
a trip report within two weeks following any out-of-state travel. All travel
reimbursement will be made at State of Iowa approved rates.
11.9 Key dates:
a. By November 15, 2018 and the 15th of each subsequent month through
October 15, 2019, submit a monthly report as specified in Article 4.5.
b. By September 30, 2019, receive two PBTs and two in-car video cameras as
specified in Article 11.8(c).
c. By November 1, 2019, submit an annual report as specified in Article 4.2.
d. By November 15, 2019, submit final claim for reimbursement.
11.10 Objective/performance measures:
a. At least 754 hours of overtime enforcement conducted and all overtime and
agency traffic enforcement contacts reported showing a sustained effort based
on past performance.
b. Twelve public information activities conducted and reported.
c. Two PBTs and two in-car video cameras purchased and utilized.
d. At least one officer attended DPS/GTSB approved training and a trip report
submitted if travel out-of-state.
Article 12.0 Project Budget.
Highway Safety
Funds
Personal Services
Directed overtime enforcement $ 40,000.00
Training-related travel $ 1,000.00
Equipment
Two PBTs and two in-car video cameras $ 9,900.00
TOTAL $ 50,900.00
FEDERAL FUNDING ACCOUNTABILITY &TRANSPARENCY ACT (FFATA)
Instructions for Completing Sub-Recipient Informational Form
Agency/Institution Name and Address
• Enter the name and address for the agency or institution receiving the federal funding.
• Do NOT give a name or address of an individual working at the agency or institution.
Sub-Recipient DUNS Number
• The DUNS number is a unique nine-character number that identified your organization. It is a tool
of the federal government to track how federal money is distributed. Most large organizations,
libraries, colleges and research universities already have DUNS numbers. Ask your grant
administrator or chief financial officer to provide your organization's DUNS number or other
information required as noted below
• If your organization does not have a DUNS number, use the Dun & Bradstreet (D&B) online
registration to receive one free of charge: http://fedgov.dnb.com/webform.
• For more information on DUNS numbers, please visit the federal government's grant
administration website: http://fedgov.dnb.com/webform/pages/dunsnumber.jsp.
Sub-Recipient MPIN/CCR Number
• The Central Contractor Registration (CCR) is a Web-enabled government wide application that
collects,validates, stores and disseminates business information about the federal government's
trading partners in support of the contract award, grants and the electronic payment processes.
• If your agency or institution does not have a CCR number,please register at the following website:
https://www.sam.gov/portal/SAM/##Il.
Sub-Recipients Annual Gross Revenues Exceed 80%or more in Federal Awards
• Check YES if, in the preceding fiscal year, your agency or institution received 80 percent or more of
its annual gross revenues in federal awards.
• Check NO if, in the preceding fiscal year, your agency or institution did not receive 80 percent or
more of its annual gross revenues in federal awards.
Sub-Recipients Annual Gross Revenues Equal or Exceed $25,000,000 in Federal Awards
• Check YES if, in the preceding fiscal year, your agency's or institution's annual gross revenues
equaled or exceeded $25,000,000 in federal awards.
• Check NO if, in the preceding fiscal year, your agency's or institution's annual gross revenues
equaled or exceeded $25,000,000 in federal awards.
Sub-Recipient Highly Compensated Officer
• If you answered NO to the two questions in #9 above, this information is not required.
• If you answered YES to the questions in #9 above and, if the public does not have access to this
information through periodic reports filed under section 13 (a) or 15 (d) of the Securities Exchange
Act of 1934 (15 U.S.C. Section 78m (a), 78 o (d)) or section 6104 of the Internal Revenue Code of
1986, list the names and compensation amounts of the five most highly compensated employees
within your agency or institution.
Federal Financial Accountability and Transparency Act Information Form
To be completed by Sub-recipient(GTSB grantee):
1. Agency Name Waterloo Police Department
Waterloo Iowa
2. City 3. State
4. Congressional District 1st 5. County Black Hawk
6. DUNS Number 075841684
(http://www.dnb.com/us)
7. Location of primary place of performance of project (if different than above):
City State
Congressional District County
8. Central contractor registration completed? Yes X No
9. The names and total compensation of the five most highly compensated officers of the entity (and parent if
owned by another entity) if:
(i) The entity in the preceding fiscal year received;
(a) 80 percent or more of its annual gross revenues in Federal awards; and
(b)$25,000,000 or more in annual gross revenues from Federal awards: and
(ii) The public does not have access to information about the compensation of the senior executives of
the entity through periodic reports filed under section 13(a)or 15(d)of the Securities Exchange Act
of 1934(15 U.S.C. 78m(a), 78o(d) or section 6104 of the Internal Revenue Code of 1986).
Officer Name Total Compensation
#1
#2
#3
#4
#5
10. Signature of Agency Representative
To be completed by Sub-Grantor(GTSB) ** FOR GTSB USE ONLY ** DO NOT WRITE BELOW **
1. Amount of Award$ 2. Federal$
3. Match or State Share $ 4. Award Title
5. Award number 6. Transaction type
7. CFDA number 8. Program source
GTSB Form 102—Federal FATA Report Form
STATE OF IOWA
DEPARTMENT OF PUBLIC SAFETY
M E M O R A N D U M GTSB
Governor's Traffic Safety Bureau
TO: FFY 2019 Highway Safety Contractor
FROM: Crystal Young, Grants Administrator
Governor's Traffic Safety Bureau
SUBJECT: Signing of Highway Safety Contracts
Enclosed are 2 copies of your FFY 2019 highway safety contract with the Governor's Traffic
Safety Bureau. Please read and follow these instructions:
1. Check the contract to verify that it is accurate. Pay special attention to the Transmit
Contract Information on Page 1 and the persons listed in Articles 5.2 and 6.0 as well as
Article 12.0 (Budget). If changes are needed, please call me at 515-725-6126 or send
the correct information to cyoun-g .dos.state.ia.us immediately.
2. Have both copies of your contract signed and dated by the appropriate person in your
agency (usually the Chief, Sheriff or Head of the Agency).
3. RETURN THE FOLLOWING BY OCTOBER V, 2018 to the Governor's Traffic Safety
Bureau at 215 East 7th Street, Des Moines, IA 50319-0248.
✓ One signed copy of the contract. The other is for you to keep.
✓ Federal Accountability form (if applicable you will have it in your packet)
Forms needed to manage your contract (HSP-2, Claim Checklist, HSP-3, Report Form, etc.)
will be sent via e-mail in mid-October to the contact listed on Page 1. Do NOT use forms
from the previous year. These forms can also be found on Iowa Grants under the "Program
Documents" link. Also, it is very important that you keep me updated on the correct e-mail
address for your contact since almost all information will be e-mailed.
Reimbursement claims (HSP-2s) can be mailed or submitted online through
www.iowagrants.gov. Please include four signed copies of the HSP-2 and one set of the
required supporting documents. Claims must be submitted within 90 days of the expense
being paid by the Contractor. Activity reports must be submitted via e-mail to your Program
Administrator and to me at cyounq(cDdps.state.ia.us.
Your contract is effective October 1, 2018. If equipment is ordered prior to that date,
we will not be able to reimburse your agency for it. The contractor must obtain a signed
letter of approval from GTSB before they purchase any equipment over $5,000. Failure to
secure prior approval will result in the contractor being responsible for the cost of the
equipment purchase, retroactive approval from NHTSA is not an option.