HomeMy WebLinkAboutApproved Documents 08.02.2021City Clerk Use Only
Finance Committee
Approval Date 08/02/2021
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
$ 2,679.54 plus est. shipping costs of $ to pay for or purchase
1 - Fuel Pump for Tandem Street Dept. Truck #191103
This purchase or expenditure is being made because:
To replace fuel pump in truck #191103
(only local vendor to have fuel pump available in stock)
Vendor selected for this purchase: Truck Center Companies
�■ Bids or written quotes were taken on this purchase, as follows:
Truck Center Companies Elk Run Heights, IA
$2,679.54
IT 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 IT Road Use Tax n Sewer n Sanitation
❑ Bonds ❑ Federal/other grants ❑ 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 $ 354,500.00
and the current available balance is $ 311,511.28
Respectfully submitted,
Sandie Greco 7/21/2021 i
e�e IJ01.A1 er
08/02/2021
(Signature Dept. Head or Designee)
Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\Expenditure Pre-Authorization.xls (Mar 2010)
Page 25 of 290
City Clerk Use Only
Finance Committee
Approval Date 8/2/2021
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 Finance Department to expend
$ NTE 3,500 plus est. shipping costs of $ to pay for or purchase
arbitrage testing for general obligation bonds.
This purchase or expenditure is being made because:
Compliance testing is required to maintain the tax-exempt status of the city's bond issues and to determine
whether an arbitrage payment is owed to the IRS.
Vendor selected for this purchase:
n Bids or written quotes were taken on this purchase, as follows:
IT Bids or quotes were not taken on this purchase because:
A quote was received from Berens -Tate for an amount not to exceed $3,500. The city has
used Berens -Tate for this service for many years. They maintain files of all city bond
issues and transaction date, minimizing the cost.
Prior Committee Actions (Dates):
Please check the following box(es) as appropriate to describe the funding for this expense:
▪ General Fund IT Road Use Tax IT Sewer n Sanitation
. Bonds ❑ Federal/other grants ❑ Other (specify)
This expenditure is to be coded to the following budget line -item:
417-03-8980-1750
(Fund - Department - Activity - Account Number) (Project Code)
in which the budgeted amount is
and the current available balance is
Respectfully submitted,
Michelle Weidner 7/23/2021
$ 203,155.43
$ 203,155.43
8/2/2021
(Signature Dept. Head or Designee)
Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\Expenditure Pre-Authorization.xls (Mar 2010)
City Clerk Use Only
Finance Committee
Approval Date 08/02/2021
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
$ 16,850.00 plus est. shipping costs of $ to pay for or purchase
Chemicals and fertilizers for turf management at City parks and ball parks..
Strategy 4.5 Maintain city facilities.
This purchase or expenditure is being made because:
These products are needed to properly maintain turf in the City areas.
Products will be purchased from vendors based on bid prices for that product.
Vendor selected for this purchase:
Various
�■ Bids or written quotes were taken on this purchase, as follows:
Bids were received from D&K Des Moines, Van Diest Webster City and
Zimco Supply Des Moines.
IT 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 IT Road Use Tax n Sewer n Sanitation
❑ Bonds ❑ Federal/other grants ❑ Other (specify)
This expenditure is to be coded to the following budget line -item:
010-37-4100 1537
(Fund - Department - Activity - Account Number) (Project Code)
in which the budgeted amount is
and the current available balance is
Respectfully submitted,
Pual Huting 7/13/2021
$ 17,000.00
$ 16,850.05
" 08/02/2021
(Signature Dept. Head or Designee)
Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\Expenditure Pre-Authorization.xls (Mar 2010)
Page 27 of 290
City Clerk Use Only
Finance Committee
Approval Date 08/02/2021
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
$ 9,020 plus est. shipping costs of $ to pay for or purchase
Chemicals and fertilizers for turf management in the downtown maintenance areas.
Strategy 4.5 Maintain city facilities.
This purchase or expenditure is being made because:
These products are needed to properly maintain turf in the City areas.
Products will be purchased from vendors based on bid prices for that product.
Vendor selected for this purchase:
Various
�■ Bids or written quotes were taken on this purchase, as follows:
Bids were received from D&K Des Moines, Van Diest Webster City and
Zimco Supply Des Moines.
IT 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 IT Road Use Tax n Sewer n Sanitation
❑ Bonds ❑ Federal/other grants ❑ Other (specify)
This expenditure is to be coded to the following budget line -item:
010-37-4110 1537
(Fund - Department - Activity - Account Number) (Project Code)
in which the budgeted amount is
$ 9,020
and the current available balance is $ 9,020
Respectfully submitted,
Pual Huting 7/13/2021
08/02/2021
(Signature Dept. Head or Designee)
Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\Expenditure Pre-Authorization.xls (Mar 2010)
Page 35 of 290
City Clerk Use Only
Finance Committee
Approval Date 8/2/2021
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
$ 60,000
Leisure Services
Department to expend
plus est. shipping costs of $ to pay for or purchase
Chemicals and fertilizers for turf management at municipal golf courses.
Strategy 4.5 Maintain city facilities.
This purchase or expenditure is being made because:
These products are needed to properly maintain Waterloo's three municipal golf courses.
Products will be purchased from vendors based on bid prices for that product.
Vendor selected for this purchase:
Various
�■ Bids or written quotes were taken on this purchase, as follows:
Bids were received from D&K Des Moines, Van Diest Webster City and
Zimco Supply Des Moines.
IT 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 IT Road Use Tax IT Sewer n Sanitation
ElBonds ❑ Federal/other grants ❑ Other (specify)
This expenditure is to be coded to the following budget line -item:
010-37-4120 1537
(Fund - Department - Activity - Account Number) (Project Code)
in which the budgeted amount is
$ 60,000
and the current available balance is $ 60,000
Respectfully submitted,
Pual Huting 7/13/2021
rn 161,eWe VielcV,k
8/2/2021
(Signature Dept. Head or Designee)
Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\Expenditure Pre-Authorization.xls (Mar 2010)
City Clerk Use Only
Finance Committee
Approval Date 08/02/2021
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 Department to expend
$ 60,000.00 plus est. shipping costs of $ to pay for or purchase
funding for operations at Fairview Cemetery. Fiscal Year 2022
This purchase or expenditure is being made because:
The cemetery is not able to pay their expenses. The number of burials has decreased,
causing their revenue to decrease.
Vendor selected for this purchase:
Fairview Cemetery
❑ Bids or written quotes were taken on this purchase, as follows:
IT Bids or quotes were not taken on this purchase because:
The City subsidizes the current cemetery operations as an alternative to operating
the cemetery directly.
Prior Committee Actions (Dates):
Please check the following box(es) as appropriate to describe the funding for this expense:
• General Fund IT Road Use Tax n Sewer n Sanitation
❑ Bonds ❑ Federal/other grants ❑ Other (specify)
This expenditure is to be coded to the following budget line -item:
010-01-4405-1393
(Fund - Department - Activity - Account Number) (Project Code)
in which the budgeted amount is
and the current available balance is
Respectfully submitted,
$ 60,000.00
$ 60,000.00
Paul Huting 07/13/2021 ( ele We14,01' 08/02/2021
(Signature Dept. Head or Designee)
Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\Expenditure Pre-Authorization.xls (Mar 2010)
Page 51 of 290
City Clerk Use Only
Finance Committee
Approval Date 08/02/2021
City of Waterloo
Expenditure Pre -Authorization Request Form
The Finance Committee of the City Council is hereby requested to authorize the following
purchase or expenditure submitted by the Leisure Services Department to expend
$ NTE 5,000.00 plus est. shipping costs of $ to pay for or purchase
Repair and replacement of damaged components in high tension stainless steel cable railing
system at the amphitheater.
This purchase or expenditure is being made because:
Logs or ice jambs during flood events have damaged 11 of the upright supports and have
broken off bolts and loosened cables in portions of the fence along the river.
Vendor selected for this purchase:
Chyma's Machine & Welding Shop Inc. Toledo IA
❑ Bids or written quotes were taken on this purchase, as follows:
IT Bids or quotes were not taken on this purchase because:
Chyma's Machine & Welding Shop Inc was the original installer of this fence and has
expertise in working with high tension steel railing systems and is able to complete the
repairs in a timely manner.
Prior Committee Actions (Dates):
Please check the following box(es) as appropriate to describe the funding for this expense:
• General Fund IT Road Use Tax n Sewer n Sanitation
❑ Bonds ❑ Federal/other grants ❑ Other (specify)
This expenditure is to be coded to the following budget line -item:
010-37-4110-1371
(Fund - Department - Activity - Account Number) (Project Code)
in which the budgeted amount is
$ 20,940.00
and the current available balance is $ 20,940.00
Respectfully submitted,
Paul Huting 7/13/2021 ickele War 08/02/2021
(Signature Dept. Head or Designee)
Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\Expenditure Pre-Authorization.xls (Mar 2010)
Page 53 of 290
City Clerk Use Only
Finance Committee
Approval Date 8/2/2021
City of Waterloo
Expenditure Pre -Authorization Request Form
The Finance Committee of the City Council is hereby requested to authorize the following
purchase or expenditure submitted by the Planning Department to expend
$ 10,000.00 plus est. shipping costs of $ 0.00 to pay for or purchase
Cleaning out 300 Allen Street (657A property) in preparation of asbestos survey and
asbestos abatement
This purchase or expenditure is being made because:
The house (657A) we must clean out prior to survey and abatement
Vendor selected for this purchase: Lehman
Bids or written quotes were taken on this purchase, as follows:
Lehman Trucking & Excavating - $10,000 ($8,000-house; $2,000 (garage)
Junk King - $450 per truck load w/ minimum of 20 trucks or $10,000 flat fee
Frickson Brohers - were asked to submit; did not receive
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 IT Road Use Tax IT Sewer n Sanitation
❑X Bonds ❑ Federal/other grants ❑ Other (specify)
This expenditure is to be coded to the following budget line -item:
419 08 5150 1396
(Fund - Department - Activity - Account Number)
(Project Code)
in which the budgeted amount is $ 350,000.00
and the current available balance is $ 226,419.46
Respectfully submitted,
Noel Anderson
(Signature Dept. Head or Designee)
I114. Weigher
8/2/2021
Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\300_Allen_clean_out (1).xls (Mar 2010)
City Clerk Use Only
Finance Committee
Approval Date 08/02/2021
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
$ 20,228.00 plus est. shipping costs of $ 00 to pay for or purchase
Renewal of annual Benchmark Solutions software and First Sign Early Intervention system.
This purchase or expenditure is being made because:
Annual renewal for software and support used by the Police Department for personnel,
training, internal affairs and performance evaluations.
Vendor selected for this purchase:
Benchmark Solutions, LLC dba, Benchmark Analytics
❑ Bids or written quotes were taken on this purchase, as follows:
IT Bids or quotes were not taken on this purchase because:
The police department has a contract with Benchmark Analytics and their software is
proprietary to their company.
Prior Committee Actions (Dates):
Please check the following box(es) as appropriate to describe the funding for this expense:
• General Fund IT Road Use Tax n Sewer n Sanitation
❑ Bonds ❑ Federal/other grants ❑ Other (specify)
This expenditure is to be coded to the following budget line -item:
010-1100-1105-1520
(Fund - Department - Activity - Account Number) (Project Code)
in which the budgeted amount is
and the current available balance is
Respectfully submitted,
$ 116,355.00
$ 116,355.00
Dave Mohlis, Police Captain 7/20/2021 "hlic4 ViaKa 08/02/2021
(Signature Dept. Head or Designee)
Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\Expenditure Pre-Authorization.xls (Mar 2010)
Page 55 of 290
City Clerk Use Only
Finance Committee
Approval Date 08/02/2021
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
$ 32,448.00 plus est. shipping costs of $ 2,600.00 to pay for or purchase
312 - Large Green Body Trash Carts and 312 - Brown Yard Waste Carts
This purchase or expenditure is being made because:
To replenish inventory of trash and yard waste carts.
Schafer Systems Intermational is bid thru Sourcewell and less expensive than Toter
Vendor selected for this purchase: Schaefer Systems International
�■ Bids or written quotes were taken on this purchase, as follows:
Schaefer Systems International Charlotte, NC
$32,448.00
IT 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 IT Road Use Tax n Sewer n Sanitation
❑ Bonds ❑ Federal/other grants ❑ Other (specify)
This expenditure is to be coded to the following budget line -item:
525-15-5400-1596
(Fund - Department - Activity - Account Number) (Project Code)
in which the budgeted amount is $ 120,000.00
and the current available balance is $ 120,000.00
Respectfully submitted,
Sandie Greco
7/22/2021 vie,041,- 08/02/2021
(Signature Dept. Head or Designee)
Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\Expenditure Pre-Authorization.xls (Mar 2010)
Page 58 of 290
Completed forms should be routed directly to the Finance Dept.
FINANCE DEPT. ONLY
Finance Committee approval required?
YES ® NO
If so, date approved: 08/02/2021
City of Waterloo
Line -Item Budget Amendment Request Form
The Finance Committee of the City Council and/or Finance Dept. is hereby requested to authorize the following line -item budget
amendment for FYE 6/30/2022 submitted by the Housing Authority 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
283 13 5452 3000
Cash on Hand
47,674.87
283 13 5452 1382
Bldg Improvements
3FAC.CARES
47,674.87
283 13 5452 3000
Cash on Hand
4,136.21
283 13 5452 2106
Computer Equip
3FAC.CARES
4,136.21
283 13 5452 3000
Cash on Hand
9,725.33
283 13 5452 1541
Janitorial Supplies
3FAC.CARES
9,725.33
283 13 5452 3000
Cash on Hand
2,398.90
283 13 5452 1561
Office Supplies
3FAC.CARES
2,398.90
283 13 5452 3000
Cash on Hand
9,982.01
283 13 5452 1343
Postage & Mailing
3FAC.CARES
9,982.01
283 13 5452 3000
Cash on Hand
50,083.37
283 13 5452 1573
fety & Protective Egt3FAC.CARES
50,083.37
TOTAL
$124,000.69
TOTAL
This amendment is being requested because:
These are carryover amendments for balances remaining in our first round of CARES Act Administrative Fee funding.
$124,000.69
Prior Committee Actions (Dates):
11
(Signature Dept. Head or Designee)
ate
IrticV�ee Weir
(Signature Finance Dept: Review)
08/02/2021
Date
sted (Finance Dept.)
Page 60 of 290
Completed forms should be routed directly to the Finance Dept.
FINANCE DEPT. ONLY
Finance Committee approval required?
YES F1 NO
If SO, date approved: 08/02/2021
City of Waterloo
Line -Item Budget Amendment Request Form
The Finance Committee of the City Council and/or Finance Dept. is hereby requested to authorize the following line -item budget
amendment for FYE 6/30/2022 submitted by the Housing Authority 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
283 13 5452 3000
Cash on Hand
46,771.76
283 13 5452 1520
Computer Software
FAC.CARES '
46,771.76
283 13 5452 3000
Cash on Hand
10,000.00
283 13 5452 1541
Janitorial Supplies
FAC.CARES'
10,000.00
283 13 5452 3000
Cash on Hand
10,000.00
283 13 5452 1561
Office Supplies
FAC.CARES'
10,000.00
283 13 5452 3000
Cash on Hand
5,000.00
283 13 5452 1343
Postage & Mailing
FAC.CARES'
5,000.00
283 13 5452 3000
Cash on Hand
10,000.00
283 13 5452 1573ifety
& Protective Egt,FAC.CARES'
10,000.00
283 13 5452 3000
Cash on Hand
76,605.00
283 13 5452 1111
Salaries - Regular
FAC.CARES '
76,605,00
283 13 5452 3000
Cash on Hand
10,000.00
283 13 5452 1301
Temp Agency Svcs
FAC.CARES '
10,000.00
TOTAL
$168,376.76
TOTAL
This amendment is being requested because:
These are carryover amendments for balances remaining in our second round of CARES Act Administrative Fee funding.
$168, 376.76
Prior Committee Actions (Dates):
Aginx467s-
(Signature Dept. Head or Designee)
Weave08/02/2021
Date (Signature Finance Dept. Review) Date
Date Posted (Finance Dept.)
Kauserslshared goodies 5forms\Carryover Budget Amendment CARES V2.xls (Apr 2003)
Page 62 of 290
Completed forms should be routed directly to the Finance Dept.
FINANCE DEPT. ONLY
Finance Committee approval required?
YES N NO
If so, date approved:
City of Waterloo
Line -Item Budget Amendment Request Form
The Finance Committee of the City Council and/or Finance Dept. is hereby requested to authorize the following line -item budget
amendment for FYE 6/30/2022 submitted by the Housing Authority 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
283 13 5450 3352
Federal HUD Grant
1,660.01
283 13 5450 1541
Janitorial Supplies
FAC.CARES
1,660.01
283 13 5450 3352
Federal HUD Grant
1,552.15
283 13 5450 1561
Office Supplies
FAC.CARES
1,552.15
283 13 5450 3352
Federal HUD Grant
1,184.94
283 13 5450 1573
ifety & Protective Eq'FAC.CARES
1,184,94
TOTAL
$4,397.10
TOTAL
This amendment is being requested because:
These are carryover amendements for balances authorized under the CARES Act for additional Operating Funds.
$4,397.10
Prior Committee Actions (Dates):
(Signature Dept. Head or Designee)
jjj /�I i.�'
Iri,Xee 08/02/2021
ate (Signature Finance Dept. Review) Date
Date Posted (Finance Dept.)
K3userstshared goodiestforms\Carryover Budget Amendment CARES RT.xls (Apr 2003)
Page 64 of 290
PROJECT BUDGET WORKSHEET- NON -CONSTRUCTION
PAGE TWO
City Clerk Use Only
Committee
Approval Date
Project Name (from page one) Police Grant -School Resource Officers- FY22
Department No. project will be budgeted under 11
Activity No. project will be budgeted under 1150
REVENUES:
3000 Cash on Hand
3350 Federal Grant
3352 Federal HUD Grant
3354 Shared Program - Local
3357 Shared Program - County
3358 Shared Program - City
3360 Shared Program - State
3361 State Grant
3720 Donations - Restricted
3750 Sale of Bonds
3370 School Share Liason
3873 Reimbursement for Service
EXPENDITURES:
To be assigned by the Finance Dept.
Project No. 11GRT
Subproject No. SR22
(Each column should only include amounts by fund)
Fund: 1150 Fund: Fund: Fund:
Total
299,081.00 299,081.00
30,250.00 30,250.00
TOTALS $ 329,331.00 $ $ - $ $ 329,331.00
1111 Salaries - Regular
1112 Salaries - Part Time
1315 Education & Training
1345 Travel - Official City
1346 Travel - Prof Training
1390 Contractual Services
1114 Time & Half Pay
1121 FICA -City Contribution
299,081.00 $ 299,081.00
30,000.00 30,000.00
250.00 250.00
TOTALS $ 329,331.00 $
Dave Mohlis, Police Captain 7/19/2021
$ $ 329,331.00
8/2/2021
(Signature Dept. Head) Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\SRO_Project_Budget_Worksheet (1).xls\Page 2 (Donat or NON-constr) (Mar 2010)
PROJECT BUDGET WORKSHEET - ALL PROJECTS
PAGE ONE
Project Name
City Contract No.
Project Manager
Project Budget Total
Police Grant -School Resource Officers- FY22
Chief Fitzgerald
$ 329,331.00
1. How will this project be funded?
A. Federal Grant Yes 1 1 No X CFDA #
Grant Name
B. State Grant Yes L� No
Grant Name
C. City Match Source of Funding
D. Other Entities Yes X No
Name
Waterloo Community Schools
To be assigned by the Finance Dept.
Project No. 11GRT
Subproject No. SR21
% Paid by federal grant
Grant Agreement Number
% Paid by state grant
Grant Agreement Number
% Paid by City
% Paid by other entity
2. Attach copies of any grant agreements that will fund the project (REQUIRED)
3. Does the project include the purchase of right of way or other real property?
If yes, will real property purchases be reimbursable under the grant?
If yes, have you attached authorization to purchase real property to this document?
4. Will this project include any non -participating expenses, such as:
A. Stormwater permit fees
B. Publication, or printing costs
C. Others, list
5. Does this project cover any regular full-time salaries or benefits?
If yes, employee/position to be covered.
Done None
❑X ❑
Yes No
❑ ❑X
❑ ❑X
❑ ❑X
❑ ❑X
❑ ❑X
❑ ❑X
❑X ❑
6. Include a brief description of the project in the space below: (REQUIRED)
This agreement is a cooperative agreement between the Waterloo Community School District and the City of Waterloo.
The School Resource Officer program provides for the assignment of (6) police officers within the district.
Primary assignment is at the middle school, high school and/or alternative school with each of the Resource Officers
providing additional services at the elementary level. This agreement is for 1 year.
Page 2 must be attached and signed.
K:\shared goodies\forms\SRO_Project_Budget_Worksheet (1).xls\Page 1 All Projects (Mar 2010)
PROJECT BUDGET WORKSHEET - ALL PROJECTS
PAGE ONE
Project Name F.Y. 2022 Lake Street Rise Project
City Contract No.
Project Manager
1051
Matt Schindel
Project Budget Total $ 783,904.00
1. How will this project be funded?
To be assigned by the Finance Dept.
Project No. 07STR
Subproject No. RM778
A. Federal Grant Yes No X CFDA # % Paid by federal grant
Grant Name Grant Agreement Number
B. State Grant Yes X No % Paid by state grant
50.00%
Grant Name RISE Grant Agreement Number 2021-R-014
C. City Match Source of Funding TIF
D. Other Entities Yes X No
Name
MidPort TIF Increment
% Paid by City 50.00%
% Paid by other entity 100.00%
2. Attach copies of any grant agreements that will fund the project (REQUIRED)
3. Does the project include the purchase of right of way or other real property?
If yes, will real property purchases be reimbursable under the grant?
If yes, have you attached authorization to purchase real property to this document?
4. Will this project include any non -participating expenses, such as:
A. Stormwater permit fees
B. Publication, or printing costs
C. Others, list
5. Does this project cover any regular full-time salaries or benefits?
If yes, employee/position to be covered.
6. Include a brief description of the project in the space below: (REQUIRED)
Done None
❑X ❑
Yes No
❑ 0
❑ ❑X
❑ ❑X
❑ 0
❑ ❑X
❑ ❑X
❑ ❑X
This project will construct a segment of new Lake Street.
Page 2 must be attached and signed.
K:\shared goodies\forms\1051_Lake_Street_RISE_Road_Project_Budget_Worksheet (1).xls\Page 1 All Projects (Mar 2010)
CONSTRUCTION PROJECT BUDGET WORKSHEET
PAGE TWO
City Clerk Use Only
inance Committee 8/2/2021
Approval Date
Project Name (from page one) F.Y. 2022 Lake Street Rise Project
Department No. project will be budgeted under 08/07
Activity No. project will be budgeted under 6260/7500
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
To be assigned by the Finance Dept.
Project No. 07STR
Subproject No. RM778
(Each column should only include amounts by fund)
Fund: 426 Fund: 290 Fund: 426 Fund:
08-6260 07-7500 08-6260
Total
3365 State RISE Grant 291,952.00 291,952.00
3368 EPA Grant
3377 EDA Grant
3720 Donations - Restricted
3750 Sale of Bonds
Sanitary TIF 100,000.00 100,000.00
Roadway TIF 391,952.00 391,952.00
EXPENDITURES:
TOTALS $ 100,000.00 $ 291,952.00 $ 391,952.00 $ $ 783,904.00
2103 Engineering & Consulting
2125 Traffic Control Equipment
2140 Land Acquisition
2144 Land Improvements
2146 Demolitions
2151 Building Construction
2156 Bikeway Construction
2162 Storm Sewers
2163 Sanitary Sewers
2164 Sidewalks
2165 Streets & Roadways
2199 Non -participating Misc
2173 Water Main
$ 28,500.00 $ 28,500.00 $ 57,000.00
100,000.00 100,000.00
263,452.00
263,452.00 526,904.00
100,000.00 100,000.00
TOTALS $ 100,000.00 $ 291,952.00 $ 391,952.00 $ $ 783,904.00
IhI,1'seWe I L v,Y
8/2/2021
(Signature Dept. Head) Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\1051_Lake_Street_RISE_Road_Project_Budget_Worksheet (1).xls\Page 2 (Constr Proj) (Mar 2010)
PUBLIC WORKS SANITATION DEPARTMENT
REFUND REQUEST GARBAGE/YARD WASTE
Name:
Address: ''0 l t't vt /L✓e_
City/State/Zip: r ikt (00 (VA_
Service Address:
'?oi S etr &&ft Ave -
Date: I _ 13
Phone:
60703
Refund Amount Requested: $ t ' g **Documentation Included: 'Yes No
** All requestforrefunds required�prroof of payment before refunds are processed.r
Comments: liked. MS. ;f, �ielaf 44, re_f Lt AIL e.Yl''(fi u R,i;.
She On. , p d -f `1.C- a Ve ( w ,v,,4- the_ fj-
-f is address, a&&&r ftLkt She \dots re v fhe, L v J
tr\cor\e,, redu.c .4vb e, -Fee_
Signature/Sanitation Department
Confirmed Refund Amount: $
'114e, lAle4ver
Date
e V Yes No
Confirmed w/Water Works:
08/02/2021
Finance Signature
Refund Amount Paid: $ 34.84
Date.
Page 66 of 290
PUBLIC WORKS SANITATION DEPARTMENT
REFUND REQUEST GARBAGE/YARD WASTE
Name: A 1 ber f Gil iqc v Date: -7 - f 4 -4-1
Address: !D E. gin Sreet- Phone: 3l 1- 6Z91 S 75-
City/State/Zip: a r r4115, .LDLd c 50(ol 3
Service Address: (09 (p L-U (ti v4 Ave, t"J t`4 e r 1 oo �, �( i'U 7) 3
J
Refund Amount Requested: $ Lig . ci Co **Documentation Included: v Yes No
** All request for refundsrequiredproof of payment before refunds are processed.
Comments: See 6"'let.c.tuAe,A.
Signature/Sanitation Department
Confirmed Refund Amount: $ 1.-/Y-6/co
c
(11ic4e Wei er
7-f`f'Lf
Date
Confirmed w/Water Works: " Yes No
08/02/2021
Finance Signature Date
Refund Amount Paid: $ 48.96
Page 76 of 290
Name:
Address:
PUBLIC WORKS SANITATION DEPARTMENT
REFUND REQUEST GARBAGE/YARD WASTE
Delores Bvdc
I1 c2t Byrvn Ave1
City/State/Zip: V1/46 tedOO J—Q a 5b7b3
Service Address:
II I P rvnAve.
Refund Amount Requested: $ 31. 46
Date: ` '`'1/
Phone: 31q a13 " os,
**Documentation included: /Yes No
** All request for refunds required proof of payment before refunds are processed.
Comments:
Signature/Sanitation Department Date
Confirmed Refund Amount: $ 3 l ' Confirmed w/Water Works: Yes No
��iche�e VVeicrher
SIGNED
08/02/2021
Finance Signature Date
Refund Amount Paid: $ 37.06
Page 81 of 290