HomeMy WebLinkAboutApproved Documents - 10/17/2022 City Clerk Use Only
Finance Committee
10/17/2022
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 Garage/Fire Department to expend
$ 3,468.02 plus est. shipping costs of $79.62 to pay for or purchase
1 - Alternator 14V 400A and Electronic Regulator for a 2006 Firetruck #121311
This purchase or expenditure is being made because:
Only Vendor to be able to supply Specific parts to replace alternator that failed in
truck #121311
Vendor selected for this purchase: Automotive Service Solutions
0■ Bids or written quotes were taken on this purchase, as follows:
Automotive Service Solutions Waterloo, IA $3,468.02
❑ 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:
F■ General Fund ❑ Road Use Tax ❑ Sewer F—] Sanitation
EIBonds ❑ 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) (Project Code)
in which the budgeted amount is $ 66,000.00
and the current available balance is $ 35,411.91
Respectfully submitted,
Sandie Greco 10/11/2022 'S 10/17/2022
(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
10/17/2022
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 Garage/Fire Department to expend
$ 12,465.00 plus est. shipping costs of $300.00 to pay for or purchase
1 - Complete Transmission for a 2000 Firetruck #121308
This purchase or expenditure is being made because:
Vendor Specific - Replace transmission that failed in truck #121308
Vendor selected for this purchase: Freightliner Truck Center Companies
0■ Bids or written quotes were taken on this purchase, as follows:
Freightliner Truck Center Companies Elk Run Heights, IA $12,465.00
❑ 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:
F■ General Fund ❑ Road Use Tax ❑ Sewer F—] Sanitation
EIBonds ❑ 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) (Project Code)
in which the budgeted amount is $ 66,000.00
and the current available balance is $ 36,834.44
Respectfully submitted,
Sandie Greco 10/4/2022 w� 10/17/2022
(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 10/17/2022
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 City Clerk Department to expend
$ 17083.60 plus est. shipping costs of $ 0.00 to pay for or purchase
Laserfiche Annual Support and Updates
This purchase or expenditure is being made because:
Electronic Record Keeping
Vendor selected for this purchase: CDI
❑ Bids or written quotes were taken on this purchase, as follows:
Q■ Bids or quotes were not taken on this purchase because:
Contract With Laserfiche
Prior Committee Actions (Dates):
Please check the following box(es) as appropriate to describe the funding for this expense:
0 General Fund Road Use Tax El Sewer 7 Sanitation
F1 Bonds Federallother grants El 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 $ 165,250.00
and the current available balance is $ 79,978.80
Respectfully submitted,
Kelley Felchle 10x3122 'S-6-ff NW sl `o 10/17/2022
(Signature Dept. Head or Designee) Date (Signature Finance Dept. Review) Date
K:lshared goodieslformslExpenditure Pre-Authorization.xls(Mar 2010)
City Clerk Use Only
Finance Committee
10/17/2022
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
$ 5,220.00 plus est. shipping costs of $ 0 to pay for or purchase
Waterloo Police Department Crime Lab Accreditation.
This purchase or expenditure is being made because:
This expenditure is for the final stages of the Waterloo POlice Department Crime Lab Accreditation
through the American Association for Labratory Accreditation.
Vendor selected for this purchase: American Association for Labratory Accreditation
Bids or written quotes were taken on this purchase, as follows:
F■ Bids or quotes were not taken on this purchase because:
The American Association for Labratory Accrediation is a national organization
used soley for the purpose of Accreditation.
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 F—] Sanitation
❑ Bonds ❑- Federal/other grants ❑ Other(specify) Coverdell Forensic Grant
This expenditure is to be coded to the following budget line-item:
010-11-1150-1391 11 GGT.FRNSC21
(Fund - Department-Activity-Account Number) (Project Code)
in which the budgeted amount is $ $23,000.00
and the current available balance is $ $10,3249.00
Respectfully submitted,
Aaron P. McClelland, Police Captain 9/27/22 T." w""`' 10/17/2022
(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 Committee10/17/2022
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
$ 7,494.60 plus est. shipping costs of $ 0 to pay for or purchase
Nikon Z 5 Mirrorless Camera w/24-50mm lens x4, Nikon EN-EL 15C Ion Battery x4, Nikon FTZ Adapter x4.
This purchase or expenditure is being made because:
This expenditure is for(4) new Cameras for the Waterloo PoLice Department Crime Lab along with
extra batteries(4) and adapters(4).
Vendor selected for this purchase: B&H Photo Video
Bids or written quotes were taken on this purchase, as follows:
F■ Bids or quotes were not taken on this purchase because:
This is an ongoing agreement for CRime Lab needs with B&H for photo equipment.
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 F—] Sanitation
❑ Bonds ❑- Federal/other grants ❑ Other(specify) Coverdell Forensic Grant
This expenditure is to be coded to the following budget line-item:
010-11-1150-2110/010-11-1150-2110 11 GGT.FRNSC21/22
(Fund - Department-Activity-Account Number) (Project Code)
in which the budgeted amount is $ 23,000.00/25,000.00
and the current available balance is $ $4,004.66/25,000.00
Respectfully submitted,
w
Aaron P. McClelland, Police Captain 9/28/22 10/17/2022
(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 10/17/2022
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 Traffic Operations Department to expend
$ 12,179.35 plus est. shipping costs of $ 1,200.00 to pay for or purchase
2 - Valmont 40 ft. street light poles - one with anchor bolts and one without anchor
bolts - with a 5 year paint warranty on the poles.
This purchase or expenditure is being made because:
Replace a damaged pole on University Ave. and to place one in inventory.
Vendor selected for this purchase: 3E
0■ Bids or written quotes were taken on this purchase, as follows:
3E Waterloo, IA $12,179.35
Crescent Electric Waterloo, IA NO BID
Van Meter Waterloo, IA NO BID
Bids or quotes were not taken on this purchase because:
Prior Committee Actions (Dates):
Please check the following box(es)as appropriate to describe the funding for this expense:
❑ General Fund ❑0 Road Use Tax ❑ Sewer F—] Sanitation
ElBonds ❑ Federal/other grants ❑ Other(specify)
This expenditure is to be coded to the following budget line-item:
266-17-7120-1521
(Fund - Department-Activity-Account Number) (Project Code)
in which the budgeted amount is $ 34,000.00
and the current available balance is $ 29,245.24
Respectfully submitted,
��
Sandie Greco 10/6/2022 � 1�110/17/2022
(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
10/17/2022
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 Traffic Department to expend
$ $5,277.36 plus est. shipping costs of $ 1,074.24 to pay for or purchase
1 - 40 ft. black Millerbernd Street Light Pole with LED Fixture
This purchase or expenditure is being made because:
To replace pole and fixture damaged by vehicle hitting pole at Mullan & Mulberry
(Lead time on pole, etc. is 12-14 weeks - will be paid from FY23 budget)
Vendor selected for this purchase: Crescent Electric
0■ Bids or written quotes were taken on this purchase, as follows:
Crescent Electric Waterloo, IA $5,277.36
Van Meter Waterloo, IA $6,104.88
❑ Bids or quotes were not taken on this purchase because:
Prior Committee Actions (Dates): Finance Approved 6/20/22 - $5,277.36 & $150.00 SH
Please check the following box(es)as appropriate to describe the funding for this expense:
❑ General Fund ❑E Road Use Tax ❑ Sewer F—] Sanitation
EIBonds ❑ Federal/other grants ❑ Other(specify)
This expenditure is to be coded to the following budget line-item:
266-17-7120-1521
(Fund - Department-Activity-Account Number) (Project Code)
in which the budgeted amount is $ 34,000.00
and the current available balance is $ 29,650.73
Respectfully submitted,
w 10/17/2022
Sandie Greco 10/3/2022 �
(Signature Dept. Head or Designee) Date (Signature Finance Dept. Review) Date
KAshared goodies\forms\Expenditure Pre-Authorization.xls(Mar 2010)
PROJECT BUDGET WORKSHEET - ALL PROJECTS
PAGE ONE
Project Name IDOT Air Service Development FY-23
City Contract No. To be assigned by the Finance Dept.
Project Manager Keith Kaspari Project No.
Project Budget Total $ 60,000.00 Subproject No.
1. How will this project be funded?
A. Federal Grant Yes 0 No 0 CFDA# % Paid by federal grant
Grant Name
B. State Grant Yes = No = % Paid by state grant 80.00%
Grant Name FY-23 Air Service Development Program Grant Agreement Number 91230AL0135
C. City Match Source of Funding Airport Operations Budget % Paid by City 20.00%
D. Other Entities Yes 0 No 0 % Paid by other entity
Name
Done None
Attach copies of any grant agreements that will fund the project(REQUIRED) FR El
Yes No
2. 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? ❑
Done None
If yes, attach authorization to purchase real property to this document. ❑ ❑
Yes None
3. Please indicate any non-participating expenses that you are aware will be incurred, such as:
A. Stormwater permit fees ❑ FX
B. Publication, or printing costs ❑ 'X
C. Others, list ❑ ❑X
4. Does this project cover any regular full-time salaries or benefits? ❑ �X
If yes, employee/position to be covered.
5. Include a brief description of the project in the space below: (REQUIRED)
This is an agreement between the Waterloo Regional Airport and the Iowa Department of Transportation for Air Service
Development funding. Pursuant to the terms of this agreement, the Iowa DOT agrees to provide authorized funding to help in
air service development activities to include: The promotion of passenger air service from the Waterloo Regional Airport
through strategic advertising in digital, social media, television, print, radio, and billboard mediums.
Page 2 must be attached and signed.
users\michelle-w\forms\Waterloo.35014.1.Project_Budget_Wkshts_IDOT_Air_Svc_Dev_FY-23\Page 1 All Projects (Feb 2007)
CONSTRUCTION PROJECT BUDGET WORKSHEET
PAGE TWO
Project Name (from page one)
Department No. project will be budgeted under To be assigned by the Finance Dept.
Activity No. project will be budgeted under Project No.
Subproject No.
(Each column should only include amounts by fund)
Fund:
_291 Fund: Fund: Fund:
Total
REVENUES:
3000 Cash on Hand $ -
3112 Local Option Sales Tax -
3350 Federal Grant -
3353 Federal U-Step Grant -
3358 Shared Program - City -
3360 Shared Program - State -
3361 State Grant -
3365 State RISE Grant -
3368 EPA Grant -
3377 EDA Grant -
3750 Sale of Bonds -
3800 Miscellaneous Revenue -
TOTALS $ - $ - $ - $ - $ -
EXPENDITURES:
2103 Engineering & Consulting $ -
2125 Traffic Control Equipment -
2140 Land Acquisition -
2144 Land Improvements -
2146 Demolitions -
2156 Bikeway Construction -
2161 Bridges -
2162 Storm Sewers -
2163 Sanitary Sewers -
2164 Sidewalks -
2165 Streets & Roadways -
2199 Non-participating Misc -
2169 Airport Improv -
1351 Advertising -
TOTALS $ - $ - $ - $ - $ -
10/17/2022
(Signature Dept. Head) Date (Signature Finance Dept. Review) Date
users\michelle-w\forms\Waterloo.35014.1.Project_Budget_Wkshts_IDOT_Air_Svc_Dev_FY-23\Page 2(Constr Proj) (April 2003)
PROJECT BUDGET WORKSHEET- NON-CONSTRUCTION
PAGE TWO
Project Name (from page one) IDOT Air Service Development FY-23
Department No. project will be budgeted under 29 To be assigned by the Finance Dept.
Activity No. project will be budgeted under 7760/7700 Project No.
Subproject No.
(Each column should only include amounts by fund)
Fund: Fund:
_291 010 Fund: Fund:
Total
REVENUES:
3000 Cash on Hand $ -
3350 Federal Grant -
3353 Federal U-Step Grant -
3358 Shared Program - City -
3360 Shared Program -State -
3361 State Grant 48,000.00 48,000.00
3365 State RISE Grant -
3720 Donations - Restricted -
3750 Sale of Bonds -
3800 Miscellaneous Revenue -
3111 Hotel/Motel Tax -
TOTALS $ 48,000.00 $ - $ - $ - $ 48,000.00
EXPENDITURES:
1111 Salaries - Regular $ -
1112 Salaries - Part Time -
1315 Education &Training -
1345 Travel - Official City -
1346 Travel - Prof Training -
1319 Other Prof -
1351 Advertising 48,000.00 12,000.00 60,000.00
TOTALS $ 48,000.00 $ 12,000.00 $ - $ - $ 60,000.00
-s-+& o 10/17/2022
Keith Kaspari 9/27/2022
(Signature Dept. Head) Date (Signature Finance Dept. Review) Date
users\michelle-w\forms\Waterloo.35014.1.Project_Budget_Wkshts_IDOT_Air_Svc_Dev_FY-23\Page 2(Donat-non constr) (April 2003)
PROJECT BUDGET WORKSHEET INSTRUCTIONS
The purpose of the project budget form is to set up a budget and project code that can be used to more specifically
account for certain construction or non-construction projects funded with state and federal grants, donations, or any
"restricted"type revenue sources. This form should be completed BEFORE any invoices are processed or payments
are made. It is also needed before any of the revenue is deposited. If you are not sure if a particular project needs
a project code, please contact the Finance Department. We are glad to help!
1.) Page 1 is REQUIRED for all projects. Complete the page 2 (constr proj)tab if you are requesting a budget for
a construction project. Complete page 2 (donat or NON-constr) if you are requesting a budget for any project,
other than one involving construction.
2.)You MUST provide the CFDA#for all federally-funded projects, including those that involve federal funds but
are passed on to the city from the State of Iowa. The grantor is required to provide that number to you.
Sometimes that number is provided in the grant application only, so that is a good place to look for it if you can't
find it in the grant award document.
3.) The revenue and expense account numbers provided on both page 2 tabs are commonly-used examples only.
You may change, add or edit those if there's a number you need that isn't listed. This form isn't meant to list all
possible account numbers, only those that are used the most often.
4.) Separate columns should be completed on the budget worksheet (page 2) if the project involves different
"funds" (e.g. GO bond fund and grant-fund/fund 290). Expenses and revenue for each fund should be separated
into columns and EACH column's revenue and expenses MUST EQUAL! You will get an "error" message
below the expense totals line if they don't. You need to make a correction if you get an error message.
5.) In general, the Finance Department will assign the project codes. However, if you have a request or
suggestion for the code you'd like to use, please discuss that with the Finance Department before submitting
your worksheets.
6. Please remember to forward the related grant award document to the Finance Department, along with the budget.
PROJECT BUDGET WORKSHEET - ALL PROJECTS
PAGE ONE
Project Name IDOT Commercial Service Vertical Infrastructure FY-23 Grant
City Contract No. To be assigned by the Finance Dept.
Project Manager Keith Kaspari Project No.
Project Budget Total $ 124,145.00 Subproject No.
1. How will this project be funded?
A. Federal Grant Yes 0 No 0 CFDA# % Paid by federal grant
Grant Name Grant Agreement Number
B. State Grant Yes = No = % Paid by state grant 100.00%
Grant Name IDOT Commercial Service Vertical Infrastructure Grant Agreement Number 91230AL0200
C. City Match Source of Funding % Paid by City
D. Other Entities Yes = No % Paid by other entity
Name
Done None
2. Attach copies of any grant agreements that will fund the project(REQUIRED) FX ❑
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?
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 FX
B. Publication, or printing costs El ❑X
C. Others, list ❑ FX
5. Does this project cover any regular full-time salaries or benefits? El ❑X
If yes, employee/position to be covered.
6. Include a brief description of the project in the space below: (REQUIRED)
The purpose of this agreement is for accomplishment of certain infrastructure improvements at the Waterloo Regional Airport,
indentified as: Hangar Rehabilitation, specifically Hangar 4 HVAC replacement and exterior tuck-point and paint.
Page 2 must be attached and signed.
K:\shared good ies\forms\Waterloo.35012.1.Project_Budget_Wkshts_IDOT_Vert_Infr_FY23\Page 1 All Projects (Mar 2010)
CONSTRUCTION PROJECT BUDGET WORKSHEET
PAGE TWO
City Clerk Use Only
Finance Committee 10/17/2022
Approval Date
Project Name (from page one) IDOT Commercial Service Vertical Infrastructure FY-23 Grant
Department No. project will be budgeted under 29 To be assigned by the Finance Dept.
Activity No. project will be budgeted under 7760 Project No.
Subproject No.
(Each column should only include amounts by fund)
Fund:
291 Fund: Fund: Fund:
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 124,145.00 124,145.00
3365 State RISE Grant -
3368 EPA Grant -
3377 EDA Grant -
3720 Donations- Restricted -
3750 Sale of Bonds -
TOTALS $ 124,145.00 $ - $ - $ - $ 124,145.00
EXPENDITURES:
2103 Engineering & Consulting $ 36,000.00 $ 36,000.00
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 -
2169 Airport Improvements 88,145.00 88,145.00
TOTALS $ 124,145.00 $ - $ - $ - $ 124,145.00
w0 " '
Keith Kaspari 9/27/2022 10/17/2022
(Signature Dept. Head) Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\Waterloo.35012.1.Project_Budget_Wkshts_IDOT_Vert_Infr_FY23\Page 2(Constr Proj) (Mar 2010)
PROJECT BUDGET WORKSHEET- NON-CONSTRUCTION
PAGE TWO
City Clerk Use Only
Finance Committee
10/17/2022
Approval Date
Project Name (from page one)
Department No. project will be budgeted under To be assigned by the Finance Dept.
Activity No. project will be budgeted under Project No.
Subproject No.
(Each column should only include amounts by fund)
Fund: Fund: Fund: Fund:
Total
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 -
TOTALS $ - $ - $ - $ - $ -
EXPENDITURES:
1111 Salaries- Regular $ -
1112 Salaries- Part Time -
1315 Education &Training -
1345 Travel - Official City -
1346 Travel - Prof Training -
1390 Contractual Services -
TOTALS $ - $ - $ - $ - $ -
w 10/17/2022
(Signature Dept. Head) Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\Waterloo.35012.1.Project_Budget_Wkshts_IDOT_Vert_Infr_FY23\Page 2(Donat or NON-constr) (Mar 2010)
Completed forms should be routed directly to the Finance Dept. FINANCE DEPT.ONLY
Finance Committee approval required?
YES No 10/17/2022
If so,dale 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 2023 submitted by the FIRE 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
12GRT
010 12 1412 3000 cash on hand 6,168.24 010 12 1412 1355 Wellness program KANE 6,168.24
TOTAL $6,168.24 TOTAL $6,168.24
This amendment is being requested because:
The wellness program budget is being utilized to improve the wellness and wellbeing of current firefighters.
We will be using project carry over cash.
Prior Committee Actions(Dates):
10/17/2022
(Signature Dept. Head 6r Designee) (/ Date (Signature Finance Dept. Review) Date
Date Posted(Finance Dept.)
K:\users\shared goodies\forms\Fire_Budget Amendment—GIRT Kane 23.xlsx(Apr 2003)
PROJECT BUDGET WORKSHEET INSTRUCTIONS
The purpose of the project budget form is to set up a budget and project code that can be used to more specifically
account for certain construction or non-construction projects funded with state and federal grants, donations, or any
"restricted"type revenue sources. This form should be completed BEFORE any invoices are processed or payments
are made. It is also needed before any of the revenue is deposited. If you are not sure if a particular project needs
a project code, please contact the Finance Department. We are glad to help!
1.) Page 1 is REQUIRED for all projects. Complete the page 2 (constr proj)tab if you are requesting a budget for
a construction project. Complete page 2 (donat or NON-constr) if you are requesting a budget for any project,
other than one involving construction.
2.)You MUST provide the CFDA#for all federally-funded projects, including those that involve federal funds but
are passed on to the city from the State of Iowa. The grantor is required to provide that number to you.
Sometimes that number is provided in the grant application only, so that is a good place to look for it if you can't
find it in the grant award document.
3.) The revenue and expense account numbers provided on both page 2 tabs are commonly-used examples only.
You may change, add or edit those if there's a number you need that isn't listed. This form isn't meant to list all
possible account numbers, only those that are used the most often.
4.) Separate columns should be completed on the budget worksheet (page 2) if the project involves different
"funds" (e.g. GO bond fund and grant-fund/fund 290). Expenses and revenue for each fund should be separated
into columns and EACH column's revenue and expenses MUST EQUAL! You will get an "error" message
below the expense totals line if they don't. You need to make a correction if you get an error message.
5.) In general, the Finance Department will assign the project codes. However, if you have a request or
suggestion for the code you'd like to use, please discuss that with the Finance Department before submitting
your worksheets.
6. Please remember to forward the related grant award document to the Finance Department, along with the budget.
PROJECT BUDGET WORKSHEET - ALL PROJECTS
PAGE ONE
Project Name Coverdell Forensic Science Improvement Grant
City Contract No. To be assigned by the Finance Dept.
Project Manager Interim Chief Leibold Project No. 11GRT
Project Budget Total $ 25,000.00 Subproject No. FRNSC22
1. How will this project be funded?
A. Federal Grant Yes 0 No CFDA# 16.742 % Paid by federal grant 100.00%
Grant Name US Department of Justice Grant Agreement Number
B. State Grant Yes 0 No % Paid by state grant
Grant Name Pass thru Iowa Governor's Office of Drug Control Poli( Grant Agreement Number 21-NFSI-03
C. City Match Source of Funding % Paid by City
D. Other Entities Yes = No 0 % Paid by other entity
Name
Done None
2. Attach copies of any grant agreements that will fund the project(REQUIRED) FX
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? ❑ ❑
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 ❑ FR
B. Publication, or printing costs ❑ FR
C. Others, list ❑ FR
5. Does this project cover any regular full-time salaries or benefits? ❑ FR
If yes, employee/position to be covered.
6. Include a brief description of the project in the space below: (REQUIRED)
These funds will be used to purchase a generator and assist in obtaining ISO/IEC 17025 accreditation in cooperation with
the American Association of Laboratory Accreditation and the American Society of Crime Lab Directors , as well as travel to
2022 IAI National Conference in Omaha.
Page 2 must be attached and signed.
K:\shared good ies\forms\Waterloo.35115.1.FY23_Coverdell_Forensic_Science_lm prove ment_Grant_11GRT.FRNSC22\Page 1 All Projects (Mar
2010)
PROJECT BUDGET WORKSHEET- NON-CONSTRUCTION
PAGE TWO
City Clerk Use Only
Finance Committee
10/17/2022
Approval Date
Project Name (from page one) Coverdell Forensic Science Improvement Grant
Department No. project will be budgeted under 11 To be assigned by the Finance Dept.
Activity No. project will be budgeted under 1150 Project No. 11GRT
Subproject No. FRNSC22
(Each column should only include amounts by fund)
Fund: 1150 Fund: Fund: Fund:
Total
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 -
3373 Fed Pass thru for Iowa 25,000.00 25,000.00
TOTALS $ 25,000.00 $ - $ - $ - $ 25,000.00
EXPENDITURES:
1111 Salaries- Regular $ -
1112 Salaries- Part Time -
1315 Education &Training -
1345 Travel - Official City -
1346 Travel - Prof Training -
1390 Contractual Services -
1391 Dues & Memberships 10,802.00 10,802.00
2110 Machinery& Equipment 14,198.00 14,198.00
TOTALS $ 25,000.00 $ - $ - $ - $ 25,000.00
Aaron McClelland, Police Capt. 9/29/2022
7� P 10/17/2022
(Signature Dept. Head) Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\Waterloo.35115.1.FY23_Coverdell_Forensic_Science_Improvement_Grant_11GRT.FRNSC22\Page 2(Donator
NON-constr) (Mar 2010)
PUBLIC WORKS SANITATION DEPARTMENT
REFUND REQUEST GARBAGE/YARD WASTE
NameJ& r11 ,S K(&-0eerl Date:
Address: ty r Ll� Phone:
City/State/Zip: " `U� i 5-07c) i
Service Address:_i6(�6- --
Refund Amount Requested: $ + ' U **Documentation Included: "/yes No
** All request for refunds required proofof paymentbeforerefunds are processed.
Comments: -f�},�"`'l��
am dyed R-6 rr- 2 rocs es Lo JtA( zoZo : T
Sf< <� be(�C C(/�,�k� �c.� �+� 1,�cc+e►r Ill�rs'�k � bi �l�� S.
Signature/Sanitation Department Date
Confirmed Refund Amount: $ (��' Confirmed w/Water Works: VIYes No
10/17/2022
Finance Signature Date
Refund Amount Paid: $ $84.00
September 12, 2022
Mr. Scott Brunson
625 Glenwood Street
Waterloo, IA 50703
Dear Mr, Brunson,
I am writing this letter to request a refund or credit to our account for overpaid Yard Waste/Recycle
Curbside Fees on our account from July 2020 through August 2022 . We had requested our yard waste
container to be picked up in July 2020. It was picked up by the city on July 22, 2020. We have not had
this service since then but were billed and paid those bills in full .
I am enclosing the Water Works quarterly statements since July 2020 to current which are highlighted
showing the service and the amount owed and paid .
After contacting the Water Works, they corrected the last bill (August 22, 2022 ) and will credit our
account on the next bill for that charge of $13 .60.
Jennifer in your office indicated that we needed to write this letter to obtain a refund for the other
quarterly charges we paid since July 2020. Please let us know if you have any questions. Thank you .
Sincer l,el
1A . Go
Thomas & K en Ferguson
1240 Partridge Lane
Waterloo, IA 50701
319-240-0231
Tferguson07@mchsi . com
'r2
WATERLOO WATER WORKS � ki
c Phone: (319) 232-6280
ww.waterloowater.org
325 Sycamore Street g3 LING Paee 1 of 1
P.O. Box 27
Waterloo, Iowa 50704 STATEMENT OF SERVICES
ACCOLINTSUMMARY
ustomer Name: Ferguson Kathleen Billing Frequency: Quarterly
ccount Number: 129494-503912 Billing Date: 08/22/2022
ervice Address: 1240 PARTRIDGE LN Billing Due Date: 09/13/2022
Waterloo Water Works Services
Previous Balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $169.94
Water . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $191.27 Credits/Payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -$169.94
Water Service Excise Tax . . . . . . . . . . . . . . . . . 4 0 . . 0 4 $11.48
Water Works Subtotal . 1 $202.75 Water Works Subtotal . . . . . . . . . . . . . . . . . . . . . . . . . . . $202 .75
City of Waterloo Services City of Waterloo Subtotal . . . . . . . . . . . . . . . . . . . . . . . . $126.26
SanitarVSewer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $61.76 Total Current service Charges . . . . . . . . . . . . . . . . . . . . $329.01
Storm Water Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $14.25 Total Amount Due . 1111 . . . . . . . . . . . . . . . . . . . . . . . . . $329.01
Yard Waste / Recycle Site Maintenance Fee . 4444 . . $15.00 Amount Due After 09/13/2022 . . . . . . . . . . . . . . . . . . . $344.88
Garbage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $35.25
City of Waterloo Subtotal . . . . . . . . . . . . . . . . . . . . . . $126.26
Previous Read Date Current Read Date Previous Read Previous Read Type Current Read Current Read Type Usage (CCF)
05/06/2022 08/09/2022 859 939 Actual 80
120 SPECIAL MESSAGES
mi
open Now Available Online 2021 Annual Drinking Water Quality Report
MOE http://iowa ccr.org/waterloo-waterworks
Off 201 111111111 111111111
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Please detach and return the bottom portion with your payment. See reverse side for additional information
MAKE CHECKS PAYABLE TO: Account Number: 129494-503912
WATERLOO W TER WORKS Total Amount Due: 329.01
_ Amount Due After : 344. 88
P.O. Box 27 Billing Due Date : 09/13/2022
Waterloo, Iowa 50704
Phone: (319) 232-6280 Amount Enclosed :
516
Ferguson Kathleen
1240 Partridge Ln '
Waterloo, IA 50701 WATERLOO WATER WORKS
P.O. BOX 27
❑ Please check box if contact Information requires WATERLOO, IOWA 50704
updating and indicate the change(s) on reverse side
' WATERLOO WATER WORKS Phone : (319) 232-6280
- - _ www.waterloowater.org
325 Sycamore Street Page 1 of 1
P.O. Box 27
Waterloo, Iowa 50704 STATEMENT OF SERVICES
ACCOUNT SUMMARY
ustomer Name: Ferguson Kathleen Billing Frequency: Quarterly
«aunt Number: 129494-503912 Billing Date: 05/20/2022
ervice Address: 1240 PARTRIDGE LN Billing Due Date: 06/13/2022
Waterloo Water Works Services CHARGE SUMMARY
Previous Balance . . . . . . . . . . . . . . . . . . . . . . . 11 . 11 . . . $180.18
Water . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $38.62 Credits/Payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -$180. 18
Water Service Excise Tax . . . . . . . . . . . . . . . . . . . . . . . $2.32
Water Works Subtotal . . . . . . . . . . . . . . . . . . . . . . . . $40.94 Water Works Subtotal . . . . . . . . . . . . . . . . . . . . . . . . . . . $40.94
City of Waterloo Services City of Waterloo Subtotal . . . . . . . . . . . . . . . . . . . . . . . . $129 .00
Sanitary Sewer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $53.25 Total Current Service Charges . . . . . . . . . . . . . . . . . . . . $169.94
Storm Water Fee . . . . . . . . . . . . . . . . . . . . . 6 . . 0 . 1 . 4 $13.50 Total Amount Due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $169.94
Yard Waste / Recycle Curbside . . . . . . . . . . . . . . . . . . $12.00 Amount Due After 06/13/2022 . . . . . . . . . . . . . . . . . . . $178.32
Yard Waste / Recycle Site Maintenance Fee . $15.00
Garbage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $35.25
City of Waterloo Subtotal . . . . . . . . . . . . . . . . . . . . . . $129.00
d Date Current Read Date Previous Read Previous Read Type Current Read current Read Type Usage (CCF)
02/08/2022 05/06/2022 850 Actual 859 Actual 9
120 SPECIAL MESSAGES
visa I Now Available Online 2021 Annual Drinking Water Quality Report
U 60
IA eo http://iowaccr.org/waterloo-waterworks
6 � o o� AL
Please detach and return the bottom portion with your payment. See reverse side for additional Information
MAKE CHECKS PAYABLE TO: law�� Account Number: 129494-503912
WATERLOO? WATER WORKS Total Amount Due : 169.94
Amount Due After : 178.32
P.O. Box 27 Billing Due Date : 06/13/2022
Waterloo, Iowa 50704
Phone: (319) 232-6280 Amount Enclosed :
Ferguson Kathleen
1240 Partridge Ln
Waterloo, IA 50701 WATERLOO WATER WORKS
P.O. BOX 27
❑ Please check box if contact information requires WATERLOO, IOWA 50704
updating and Indicate the change(s) on reverse side
' WATERLOOWATER W O RKS Phone: (319) 232-6280
www.waterloowater.org
325 Sycamore Street Page 1 of 1
P.O. Box 27
Waterloo. Iowa 50704 STATEMENT OF SERVICES
ACCdIJN*r Si MARY
M
Name: Ferguson Kathleen Billing Frequency: Quarterly
umber: 129494-503912 Billing Date : 02/22/2022
dress: 1240 PARTRIDGE LN Billing Due Date: 03/15/2022
Waterloo Water Works Services CHARGE SUMMARY
Previous Balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $296.05
Water . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $42.92 Credits/Payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -$296.05
Water Service Excise Tax . . . . . . . . . . . . . . . . . . . . . . . $2.58
Water Works Subtotal . . . . . . . . . . . . . . . . . . . . . . . . $45.50 Water Works Subtotal . . . . . . . . . . . . . . . . . . . . . . . . . . . $45.50
City of Waterloo Services City of Waterloo Subtotal . . . . . . . . . . . . . . . . . . . . . . . . $134.68
Sanitary Sewer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $58.93 Total Current Service Charges . . . . . . . . . . . . . . . . . . . . $180. 18
Storm Water Fee . I . . . . . . . . . . . . . . . . . . . . . . . . . . . $13.50 Total Amount Due . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . $180. 18
Yard Waste / Recycle Curbside . . . . . . . . . . . . . . . . . . $12.00 Amount Due After 03/15/2022 . . . . . . . . . . . . . . . . . . . $189.07
Yard Waste / Recycle Site Maintenance Fee . . . . . . . $15.00
Garbage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $35.25
City of Waterloo Subtotal . . . . . . . . . . . . . . . . . . . . . . $134.68
Previous Read Date Current Read Date Previous Read Previous Read Type Current Read Current Read Type Usage (CCF)
11/10/2021 02/08/2022 839 Actual 850 Actual 11
ixo SPECIAL MESSAGES
Now Available Online 2020 Annual Drinking Water Quality Report
man http://iowaccr.org/waterloo-waterworks
0 20
� ;
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Please detach and return the bottom portion with your payment. See reverse side for additional information
MAKE CHECKS PAYABLE TO: Account Number: 129494-503912
WATERLOO WATE R W O RKS Total Amount Due: 180.18
—^—+.–_�– Amount Due After : 189.07
P.O. Box 27 Billing Due Date: 03/15/2022
Waterloo, Iowa 50704
Phone: (319) 232-6280 Amount Enclosed :
Ferguson Kathleen
1240 Partridge Ln
Waterloo, IA 50701 WATERLOO WATER WORKS
P.O. BOX 27
❑ Please check box if contact Information requires WATERLOO, IOWA 50704
updating and Indicate the charge(s) on reverse side
' WATERLOO WATER W O R KS Phone: (319) 232-6280
www.w a t e r l o ow a t e r.o rg
325 Sycamore Street Paee 1 of 1
P.O. Box 27
Waterloo, Iowa 50704 STATEMENT OF SERVICES
ACCOUNTSUMMARY
ustomer Name: Ferguson Kathleen Billing Frequency: Quarterly
ccount Number: 129494-503912 Billing Date: 11/22/2021
ervice Address: 1240 PARTRIDGE LN Billing Due Date: 12/15/2021
Waterloo Water Works Services F7777777 CHARGE SUMMARY
Previous Balance . . . . . . . . . . . . 1 . . . . . . . . . . . . . . . . . . $399.08
Water . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $146.87 Credits/Payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -$399 .08
Water Service Excise Tax . . . . . . . . . . . . . . . . . . . . . . . $8.82
Water Works Subtotal . . . . . . . . . . . . . . . . . . . . . . . . $155 .69 Water Works Subtotal . . . . . . . . . . . . . . . . . . . . . . . . . . . $155 .69
City of Waterloo Services City of Waterloo Subtotal . . . . . . . . . . . . . . . . . . . . . . . . $140.36
SanitarV Sewer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $64.61 Total Current Service Charges . . . . . . . . . . . . . . . . . . . . $296.05
Storm Water Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $13.50 Total Amount Due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $296.05
Yard Waste / Recycle Curbside . . . . . . . . . . . . . . . . . . $12.00 Amount Due After 12/15/2021 . . . . . . . . . . . . . . . . . . . $310.41
Yard Waste / Recycle Site Maintenance Fee . . . . . . . $15.00
Garbage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $35.25
City of Waterloo Subtotal . . . . . . . . . . . . . . . . . . . . . . $140.36
FP�reviousRead Date Current Read Date Previous Read Previous Read Type Current Read Current Read Type Usage (CCF)
08/05/2021 11/10/2021 779 Actual 839 Actual 60
120 SPECIAL MESSAGES
C40o Now Available Online 2020 Annual Drinking Water Quality Report
60 http://iowaccr.org/waterloo-waterworks
e9 felp 41 Opp r rya ,o" rp
Please detach and return the bottom portion with your payment. See reverse side for additional information
MAKE CHECKS PAYABLE TO: Account Number: 129494-503912
WATERLOO WATER WORDS Total Amount Due: 296.05
_ Amount Due After : 310.41
P.O. Box 27 Billing Due Date: 12/15/2021
Waterloo, Iowa 50704
Phone: 319) 232-6280 Amount Enclosed :
Ferguson Kathleen
1240 Partridge Ln
Waterloo, IA 50701 WATERLOO WATER WORKS
P.O. BOX 27
❑ Please check box if contact Information requires WATERLOO. IOWA 50704
updating and indicate the change(s) on reverse side
'WATERLOO WATER WORI(S Phone: (319) 232-6280
www.waterl oowate r.o rg
325 Sycamore Street Pape 1 of 1
P.O. Box 27
Waterloo, Iowa 50704 STATEMENT OF SERVICES
ACCOUNTSUMMARY
ustomer Name: Ferguson Kathleen Billing Frequency: Quarterly
ccount Number: 129494-503912 Billing Date: 08/23/2021
ervice Address: 1240 PARTRIDGE LN Billing Due Date: 09/14/2021
Waterloo Water Works Services CHARGE SUMMARY
Previous Balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $223 . 18
Water . . . . $244.07 Credits/Payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
-$223. 18
Water Service Excise Tax . . . . . . . . . . . . . . . . . . . . . . . $14.65
Water Works Subtotal . . . . . . . . . . . . . . . . . . . . . . . . $258.72 Water Works Subtotal . . . . . . . . . . . . . . . . . . . . . . . . . . . $258.72
City of Waterloo Services City of Waterloo Subtotal . . . . . . . . . . . . . . . . . . . . . . . . $140.36
Sanitary Sewer . . 1011 . . . . . . . . . . . . . . . . . . . . . . . . . $64.61 Total Current Service Charges . . . . . . . . . . . . . . . . . . . . $399.08
Storm Water Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $13.50 Total Amount Due . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . $399 .08
Yard Waste / Recycle Curbside . . . . . . . . . . . . . . . . . . $12.00 Amount Due After 09/14/2021 . . . . . . . . . . . . . . . . . . . $418.30
Yard Waste / Recycle Site Maintenance Fee . 1111 . . $15 .00
Garbage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $35.25
City of Waterloo Subtotal . . . . . . . . . . . . . . . . . . . . . . $140.36
Previous Read Date Current Read Date Previous Read Previous Read Type Current Read Current Read Type Usage (CCF)
05/11/2021
. -
05/11/2021 08/05/2021 671 Actual 779 Actual 108
10D SPECIAL MESSAGES
uGal IIIIIIIII I Now Available Online 2020 Annual Drinking Water Quality Report
w 40 http://iowaccr.org/waterloo-waterworks
u � oa
�9 40 h M1oV eel, rye re.
Please detach and return the bottom portion with your payment. See reverse side for additional Information
MAKE CHECKS PAYABLE TO: Account Number: 129494-503912
WATERLOO WATERWORKS Total Amount Due: 399.08
_ Amount Due After : 418.30
P.O. Box 27 Billing Due Date: 09/14/2021
Waterloo, Iowa 50704
Phone: (319) 232-6280 Amount Enclosed :
Ferguson Kathleen
1240 Partridge Ln
Waterloo, IA 50701 WATERLOO WATER WORKS
P.O. BOX 27
❑ Please check box If contact Information requires WATERLOO, IOWA 50704
updating and Indicate the change(s) on reverse side
WATERLOO WATER WORKS Phone: (319) 232-6280
www.waterl oowate r.o rg
325 Sycamore Street Paee 1 of 1
P.O. Box 27
Waterloo, Iowa 50704 STATEMENT OF SERVICES
ACCOUNTSUMMARY
ustomer Name: Ferguson Kathleen Billing Frequency: Quarterly
%ccount Number: 129494-503912 Billing Date: 05/21/2021
ervice Address: 1240 PARTRIDGE LN Billing Due Date: 06/14/2021
Waterloo Water Works Services CHARGE SUMMARY
Previous Balance . . . . . . . . . . 111 . . . 6 . . . . . . . . . . . . . . $200.03
Water . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $85. 10 Credits/Payments . . . . . . . . . . . . . . . . . . . . . . . . . 4 . 644 -$203.03
Water Service Excise Tax . . . . . . . . . . . . . . . . . . . . . . . $5. 11 Balance Forward . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -$3 .00
Water Works Subtotal . I 1 $90. 21
City of Waterloo Services Water Works Subtotal . . . . . . . . . . . . . . . . . . . . . . . . . . . $90.21
Sanitary Sewer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $60.97
City of Waterloo Subtotal . . . . . . . . . . . . . . . . . . . . . . . . $135.97
Storm Water Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $12 .75 Total Current Service Charges . . . . . . . . . . . . . . . . . . . . $226.18
Yard Waste / Recycle Curbside . . . . . . . . . . . . . . . . . . $12 . 00 Total Amount Due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $223 .18
Yard Waste / Recycle Site Maintenance Fee . 1111 . . $15.00 Amount Due After 06/14/2021 . . . . . . . . . . . . . . . . . . . $234.09
Garbage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $35.25
City of Waterloo Subtotal . . . . . . . . . . . . . . . . . . . . . . $135.97
Previous Read Date Current Read • . Previous Read Previous Read Type Current Read Current Read Type Usage (CCF)
-
02/09/2021 05/11/2021 640 Actual 671 Actual 31
ioo 1 SPECIAL MESSAGES
C a 1 w Available Online 2020 Annual Drinking Water Quality Report
0 401 11111111htt3:Hiowaccr.org/waterloo-waterworks
� m
o
0 oa 0 o 0 0
9
ti ti^9 'N^ ^^ re,o tib , 016,
Please detach and return the bottom portion with your payment. See reverse side for additional information
MAKE CHECKS PAYABLE TO: Account Number: 129494-503912
WATERLOO WATER WORKS Total Amount Due: 22118
—�•-�. _ Amount Due After : 234. 09
P.O. Box 27 Billing Due Date: 06/14/2021
Waterloo, Iowa 50704
Phone: (319) 232-6280 Amount Enclosed :
• • •
Ferguson Kathleen
1240 Partridge Ln
Waterloo, IA 50701 WATERLOO WATER WORKS
P.O. BOX 27
❑ Please check box if contact Information requires WATERLOO. IOWA 50704
updating and Indicate the change(s) on reverse side
WATERLOO_ WATERWORKS Phone: (319) 232-6280
www,waterloowater.org
325 Sycamore Street Paee 1 of 1
P.O. Box 27
Waterloo, Iowa 50704 STATEMENT OF SERVICES
ACC
UNTSUMMARY
M
ame: Ferguson Kathleen • Billing Frequency: Quarterly
mber: 129494-503912 Billing Date: 02/23/2021
ress: 1240 PARTRIDGE LN Billing Due Date: 03/16/2021
Waterloo Water Works Services CHARGE SUMMARY
Previous Balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $312.07
Water . . . . . . . . . . . . $46.76
. . . . . . . . . . . . . . . . . . . . . . . . . . Credits/Payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -$312.07
Water Service Excise Tax . . . . . . . . . . . . . . . . . . . . . . . $2 .81
Water Works Subtotal . . . . . . . . . . . . . . . . . . . . . . . . $49.57 Water Works Subtotal . . . . . . . . . . . . . . . . . . . . . . . . . . . $49.57
City of Waterloo Services City of Waterloo Subtotal . . $150.46
Sanitary Sewer . $60.97 Total Current Service Charges . . . . . . . . . . . . . . . . . . . . $200.03
Storm Water Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $12.75 Total Amount Due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $200.03
Yard Waste / Recycle Curbside . . . . . . . . . . . . . . . . . . $12.00 Amount Due After 03/16/2021 . . . . . . . . . . . . . . . . . . . $209.90
Yard Waste / Recycle Site Maintenance Fee . . . . . . . $15.00
Garbage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $49.74
City of Waterloo Subtotal . $150.46
Date Current Read • . Previous Read Previous Read Type Current Read Current Read Type Usage (CCF)
-
11/06/2020 02/09/2021 627 Actual 640 Actual 13
100 —
SPECIAL MESSAGES
80 LOGAN AVENUE HY-VEE 15 NOW ABLE TO TAKE PAYMENTS CURRENT
" BILLS
m 4o
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al IIIIIIIII
0
a'
Please detach and return the bottom portion with your payment. See reverse side for additional Information
MAKE CHECKS PAYABLE TO: Account Number: 129494-503912
WATERLOO WAIF R W O RK5 Total Amount Due: 200.03
`- -- _ Amount Due After : 209. 90
P .O . Box 27 Billing Due Date: 03/16/2021
Waterloo, Iowa 50704
Phone: (319) 232-6280 Amount Enclosed :
�� Dlyjramw
Ferguson Kathleen
1240 Partridge Ln
Waterloo, IA 50701 WATERLOO WATER WORKS
P.O. BOX 27
❑ Please check box if contact information requires WATERLOO, IOWA 50704
updating and Indicate the change(s) on reverse side
WATERLOO WATER WORKS Phone: (319) 232-6280
www.waterloowater, 0 rg
325 Sycamore Street Page 1 of 1
P.O. Box 27
Waterloo, Iowa 50704 STATEMENT OF SERVICES
ACCOUNT SUMMARY
ustomer Name: Ferguson Kathleen Billing Frequency: Quarterly
ccouccount Number: 129494-503912 Billing Date: 11/23/2020
Address: 1240 PARTRIDGE LN Billing Due Date: 12/16/2020
Waterloo Water Works Services CHARGE SUMMARY
Previous Balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $351 .57
Water . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $159.26 Credits/Payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$351.57
Water Service Excise Tax . . . . . . . . . . . . . . . . . . . . . . . $9 .56
Water Works Subtotal . . . . . . . . . . . . . . . . . . . . . . . . $168.82 Water Works Subtotal . . . . . . . . . . . . . . . . . . . . . . . . . . . $168.82
City of Waterloo Services City of Waterloo Subtotal . . . . . . . . . . . . . . . . . . . . . . . . $143 .25
SanitarySewer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $50. 25 Total Current Service Charges . . . . . . . . . . . . . . . . . . . . $312.07
Garbage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $53.25 Total Amount Due . . . . . . . . . . $312.07
Storm Water Fee , $12.75 Amount Due After 12/16/2020 . . . . . . . . . . . . . . . . . . . $327. 19
Yard Waste / Recycle Curbside . . . . . . . . . . . . . . . . . . $12.00
Yard Waste / Recycle Site Maintenance Fee . . . . . . . $15.00
City ofWaterloo Subtotal . . . . . . . . . . . . . . . . . . . . . . $143 .25
• . M- 1 lilkwell► .
08/06/2020 11/06/2020 559 • Actual ' 627 Actual 68
280
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Please detach and return the bottom portion with your payment. See reverse side for additional Information
MAKE CHECKS PAYABLE TO: Account Number: 129494-503912
WATERLOO WATER WORKS Total Amount Due: 312.07
Amount Due After : 327. 19
P.O. Box 27 Billing Due Date: 12/16/2020
Waterloo, Iowa 50704
Phone: (319) 232-6280 Amount Enclosed :
DD
Ferguson Kathleen
1240 Partridge Ln
Waterloo, IA 50701 WATERLOO WATER WORKS
P.O. BOX 27
❑ Please check box if contact information requires WATERLOO, IOWA 50704
updating and Indicate the change(s) on reverse side