HomeMy WebLinkAboutApproved Documents - 5/15/2023TRAVEL REQUEST
CITY OF WATERLOO
FINANCE DEPT.
LINE ITEM USED
FY 23 BUDGETED
EXPENDED YTD
THIS REQUEST
LEFT AFTER THIS
REQUEST
DATE
Original - Clerk/Finance
STAFF ONLY
010-27-2505-1346
$15,700.00
$8,135.87
$2,670.00
$4,894.13
04/24/23
Copy - Department
NAME(S) AND POSITION(S):
Tasha Alexander, HRTS Staff
DATE:April 24, 2023
NAME OF CLASS / MEETING:
Human Rights Youth Summit
DESTINATION: NEW YORK, NY AND HARLEM, NY
DEPARTURE POINT
IF NOT WATERLOO:
DEPARTURE DATE:
JULY 5, 2023
RETURN DATE:
JULY 9, 2023
DATE(S) OF MEETING:
JULY 6-8, 2023
PURPOSE OF TRAVEL/TRAINING:
Staff member assigned to attend Youth Human Rights Summit to observe, investigate, learn key
mechanics of robust youth HR development and help the Human Rights Commission implement the
same in the local context.
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
x COST $
YES NO
METHOD OF TRAVEL:
CITY VEHICLE
AIRFARE
PRIVATE VEHICLE
DEPARTING FROM: Waterloo, IA
ESTIMATE OF COST:
1500. LODGING 120.0
350. MEALS
0 REGISTRATION 700.00
MILEAGE/FUEL
TOTAL FOR ALL: $ 2670.00
TAXI
PARKING YES NO
AIRFARE
MISC/TOLLS YES NO
BUDGET LINE ITEM: 010-27-2505-1346
x GRANT REIMBURSABLE
x REQUIRED CERTIFICATION
TOTAL: $ 2670.00
PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WATERLOO
Abraham L. Funchess, Jr.
DEPARTMENT HEAD
04/24/2023
DATE
K: \Shared Goodies\Forms\Travel Request Form
Date Approved by Finance Committee:
5/15/2023
DATE
Tu4eit Z0 `sva
TRAVEL REQUEST
CITY OF WATERLOO
FINANCE DEPT.
LINE ITEM USED
FY 24 BUDGETED
EXPENDED YTD
THIS REQUEST
LEFT AFTER THIS
REQUEST
DATE
Original - Clerk/Finance
STAFF ONLY
010-27-2505 1346
$15,700.00
$8,135.87
$1,000.00
$7,135.87
05/04/2023
Copy - Department
NAME(S) AND POSITION(S): DATE: 05/04/2023
Abraham L. Funchess, Jr. Human Rights Director
NAME OF CLASS / MEETING:
Advocacy Summit -Pan African Consultation
DESTINATION:
Washington, D.C.
DEPARTURE POINT
IF NOT WATERLOO:
DEPARTURE DATE:
June 11, 2023
RETURN DATE:
June 14, 2023
DATE(S) OF MEETING:
June 12-14, 2023
PURPOSE OF TRAVEL/TRAINING:
The theme of the Summit is the Power of Perseverance which undergirds and informs the Pan African Consultation theme
Of "Pan African Food Insecurity and the Farm Bill." The Consultation will identify ways in which communities persevere &
how the specific aspects of the Farm Bill that are timely for leadership from Pan African communities in the USA and
Globally.
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
X COST $
YES NO
METHOD OF TRAVEL:
CITY VEHICLE PRIVATE VEHICLE
AIRFARE DEPARTING FROM:
ESTIMATE OF COST:
LODGING
280.00 MEALS
REGISTRATION
MILEAGE/FUEL
BUDGET LINE ITEM: 010-27-2505 1346
120.00 TAXI X GRANT REIMBURSABLE
PARKING YES NO
600.00 AIRFARE X REQUIRED CERTIFICATION
MISC/TOLLS YES NO
TOTAL FOR ALL: $ 1,000.00
TOTAL: $ 1,000.00 PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WATERLOO
Date Approved by Finance Committee:
Abraham L. Funchess, Jr. 5/15/2023
DEPARTMENT HEAD DATE
05/04/2023
DATE
K: \Shared Goodies\Forms\Travel Request Form
(Wye& Z0(
FINANCE DEPT. STAFF ONLY
LINE ITEM USED 010-01-8200 1345
TRAVEL REQUEST
CITY OF WATERLOO
FY 23 BUDGETED $7,000.00
EXPENDED YTD $4,413.64
THIS REQUEST $1,616.55
LEFT AFTER THIS
REQUEST $969.81
DATE 05/11/23
Original - Clerk/Finance Copy - Department
NAME(S) AND POSITION(S):
Quent Hart, Mayor
DATE: May 10, 2023
NAME OF CLASS / MEETING:
Conference of Mayors
DESTINATION: Columbus OH
DEPARTURE POINT Cedar Rapids
IF NOT WATERLOO:
DEPARTURE DATE:
June 2, 2023
RETURN DATE:
June 4, 2023
DATE(S) OF MEETING:
June 1-5, 2023
PURPOSE OF TRAVEL/TRAINING:
Conference of Mayors
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
X COST $
YES NO
METHOD OF TRAVEL:
CITY VEHICLE PRIVATE VEHICLE
AIRFARE DEPARTING FROM: Cedar Rapids, IA
ESTIMATE OF COST:
538.15 LODGING 195 TAXI
200 MEALS 100 PARKING
0 REGISTRATION AIRFARE
MILEAGE/FUEL 578.40 MISC/TOLLS
TOTAL FOR ALL: $ 1616.55
BUDGET LINE ITEM: 010-01-8200-1345
X GRANT REIMBURSABLE
YES NO
X REQUIRED CERTIFICATION
YES NO
TOTAL: $ PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WATERLOO
Date Approved by Finance Committee:
Quentin Hart 5/15/2023
DEPARTMENT HEAD DATE
5/10/2023
DATE
K: \Shared Goodies\Forms\Travel Request Form
Vv ( [/vr C si�rvEo
TRAVEL REQUEST
CITY OF WATERLOO
FINANCE DEPT. STAFF ONLY
LINE ITEM USED 520-14-5200-1346
Fy 23 8U06ETED 7,000.00 (amended 1300.00y
EXPENDED VTb $6.318.33
THIS REQUEST $1,980.00
LEFT AFTER THIS
REQUEST 1.67
DATE 05/09/23
Qri.inal - Cierk/Finance Co. - De.'rtment
NAMES) AND POSITION(S):
DATE: 05/09/23
NAME OF CLASS / MEETING:
2023 IAWEA Annual Conference
DESTINATION: Waterloo. IA
DEPARTURE POINT
IF NOT WATERLOO:
DEPARTURE DATE:
06/07/23
RETURN DATE:
DATE(S) OF MEETING:
06/07/23-06/08/23
PURPOSE OF TRAVEUTRAINING:
Education
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
X COST $
YES NO
METHOD OF TRAVEL:
x CITY VEHICLE
AIRFARE DEPARTING FROM:
PRIVATE VEHICLE
ESTIMATE OF COST:
LODGING TAXI
MEALS PARKING
$1,980.00 REGISTRATION AIRFARE
MILEAGE/FUEL MISC/TOLLS
TOTAL FOR ALL: $ 1,980.00
BUDGET LINE ITEM: 520-14-5200-1346
x GRANT REIMBURSABLE
YES NO
x
YES NO
REQUIRED CERTIFICATION
TOTAL: $ 330.00
PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
CITY ATER
DEPARTMENT HEAD
DATE
K:\Shared Goodies\Forrns\Travel Request Form
Date Approved by Finance Committee:
5/15/2023
DATE
WiaWy t
r
SIGNED
TRAVEL REQUEST
CITY OF WATERLOO
FINANCE DEPT.
LINE ITEM USED
FY 2023 BUDGETED
EXPENDED YTD
THIS REQUEST
LEFT AFTER THIS
REQUEST
DATE
Original - Clerk/Finance
STAFF ONLY
010-11-1100-1346
$123,416.00
$94,156.18
$1,400.00
$27,859.82
4/10/32
Copy - Department
NAME(S) AND POSITION(S):
Sgt. Woodward, Officer(s) Thomas, Alex Bovy,
N. Payne, Nichols, Gasca-Muniz
DATE:
5/8/23
NAME OF CLASS / MEETING:
Advanced Law Enforcement Rapid Response Training
(ERASE) Exterior Response to Active Shooter Events
DESTINATION:
DEPARTURE POINT
IF NOT WATERLOO:
Mt. Pleasant, Iowa
DEPARTURE DATE:
5/22/23
RETURN DATE:
5/24/23
DATE(S) OF MEETING:
5/22/23 - 5/24/23
PURPOSE OF TRAVEL/TRAINING:
Lt. Bose is requesting to send Sergeant Woodward, Officer(s) S. Thomas, Alex Bovy, N. Payne,
C. Nichols, G. Gasca-Muniz to the ALERRT ERASE Training Course in Mt. Pleasant Iowa
This class will improve officers tactics during an active shooter threat. Total not to exceed $1,400.00
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
X COST $
YES NO
METHOD OF TRAVEL:
XXX CITY VEHICLE
AIRFARE
DEPARTING FROM:
PRIVATE VEHICLE
ESTIMATE OF COST:
700.00 LODGING
630.00 MEALS
REGISTRATION
70.00 MILEAGE/FUEL
TOTAL FOR ALL: $ 1,400.00
TAXI
PARKING
AIRFARE
MISC/TOLLS
BUDGET LINE ITEM:
X GRANT REIMBURSABLE
YES NO
X REQUIRED CERTIFICATION
YES NO
TOTAL: $ 233.33 PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WATERLOO
I APPROVE THIS TRAVEL REQUEST
Lt. Steve Bose 5/15/2023
DEPARTMENT HEAD MAYOR
5/8/23 7'(
DATE DATE
K:\Shared Goodies\Forms\Travel Request Form January 2010
City Clerk Use Only
Finance Committee
Approval Date 5/15/2023
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 Airport Department to expend
$ 4,929.00 plus est. shipping costs of $ 750.00 to pay for or purchase
Cryotech E36 Liquid Runway Deicer, two (2) totes.
This purchase or expenditure is being made because:
chemical is used for limiting the formation of ice on the movement and non -movement areas of the
airfield. Supply needs to be refilled before winter.
Vendor selected for this purchase: Cryotech
n Bids or written quotes were taken on this purchase, as follows:
IT Bids or quotes were not taken on this purchase because:
Cryotech is the industry standard and preferred supplier for this material.
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:
010-29-7700-1371
(Fund - Department - Activity - Account Number) (Project Code)
in which the budgeted amount is $ 294,698.00
and the current available balance is $ 101,335.66
Respectfully submitted,
Keith Kaspari 5/9/2023
'W Z
5/15/2023
(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 5/15/2023
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 Airport Department to expend
$ 5,916.00 plus est. shipping costs of $ to pay for or purchase
lighting improvements (to LED) in the Terminal entrances and canopy areas; also a garage
office and storage area to be leased to the FAA.
This purchase or expenditure is being made because:
entrance and canopy areas were red -flagged by TSA Inspector as not providing suffiecient light;
upgrades are needed to the areas FAA plans to lease for their new lease effective July 1, 2023.
Vendor selected for this purchase: Stickfort Electric
n Bids or written quotes were taken on this purchase, as follows:
Stickfort Electric $5,916.00
K & W Electric $6,602.00
n Bids or quotes were not taken on this purchase because:
Prior Committee Actions (Dates):
Please check the following box(es) as appropriate to describe the funding for this expense:
. General Fund 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:
010-29-7700-1371
(Fund - Department - Activity - Account Number) (Project Code)
in which the budgeted amount is $ 294,698.00
and the current available balance is $ 103,271.88
Respectfully submitted,
Keith Kaspari 5/5/2023
5/15/2023
(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 5/15/2023
City of Waterloo
Expenditure Pre -Authorization Request Form
The Finance Committee of the City Council is hereby requested to authorize the following
purchase or expenditure submitted by the Building Inspections
$ 3,000.00 plus est. shipping costs of $
Department to expend
to pay for or purchase
This purchase or expenditure is being made because:
Fire Alarm/Suppression System Plans Review - Waterloo Central Middle School Career
Center.
Vendor selected for this purchase:
Lund Fire Protection
n Bids or written quotes were taken on this purchase, as follows:
n Bids or quotes were not taken on this purchase because:
City of Waterloo has a contract with Lund Fire Protection
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:
010-22-5100-1390
(Fund - Department - Activity - Account Number) (Project Code)
in which the budgeted amount is $ 14,000.00
and the current available balance is
Respectfully submitted,
Greg Ahlhelm - Building Official 4/27/2023
$ 3,174.00
(Sued N004'
5/15/2023
(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 5/15/2023
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 Human Resources Department to expend
$ 10,900.00 plus est. shipping costs of $ to pay for or purchase
leadership development training
This purchase or expenditure is being made because:
This training is needed, at the Mayor's request, to improve leadership & management
skills for the City's Department Heads and Assistant Level Department heads.
Vendor selected for this purchase: Action Coach
❑ Bids or written quotes were taken on this purchase, as follows:
❑ Bids or quotes were not taken on this purchase because:
Prior Committee Actions (Dates):
Please check the following box(es) as appropriate to describe the funding for this expense:
General Fund
Bonds
• Road Use Tax ❑ Sewer Sanitation
▪ Federal/other grants ❑ Other (specify)
This expenditure is to be coded to the following budget line -item:
010-09-8250-1315
(Fund - Department - Activity - Account Number)
(Project Code)
in which the budgeted amount is $ 10,950.00
and the current available balance is $ 10, 950.00
Respectfully submitted,
�� �' A/'rn �� �3tifirtt Zug 5'� 5/15/2023
(Signature D. Head or Designee) Date (Signature Finance Dept. Review) Date
K:lshared goodieslforms\Expenditure Pre-Authorization.xls (Mar 2010)
City Clerk Use Only
Finance Committee
Approval Date 5/15/2023
City of Waterloo
Expenditure Pre -Authorization Request Form
The Finance Committee of the City Council is hereby requested to authorize the following
purchase or expenditure submitted by the Leisure Services Department to expend
$ 3,335.00 plus est. shipping costs of $ to pay for or purchase
Labor and materials to plant annual flowers in 27 of the saucer style planters at
Riverloop Expo Plaza.
This purchase or expenditure is being made because:
Leisure Services no -longer grows flowers "in house" and flowers are needed to
fill the planters.
Vendor selected for this purchase: Petersen & Tietz Florists & Greenhouses
n Bids or written quotes were taken on this purchase, as follows:
n Bids or quotes were not taken on this purchase because:
Petersen & Tietz Florists has completed this work for the City successfully for
the past several years. We have also experienced a lack of interested, qualified
bidders.
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:
010-37-4110-1371
(Fund - Department - Activity - Account Number) (Project Code)
in which the budgeted amount is
and the current available balance is
Respectfully submitted,
Paul Huting
$ 20,940.00
$ 9,395.56
05/08/2023 'Wye& Zug
5/15/2023
(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 5/15/2023
City of Waterloo
Expenditure Pre -Authorization Request Form
The Finance Committee of the City Council is hereby requested to authorize the following
purchase or expenditure submitted by the Leisure Services Department to expend
$ 6,459.00 plus est. shipping costs of $ 0.00 to pay for or purchase
Young Arena ammonia ice system annual preventative maintenance on the compressors
& evaporative condenser tower.
This purchase or expenditure is being made because:
this maintenance is performed to address any needed repairs due to worn parts or safety issues
with the ammonia ice system. Additional funding may be needed for worn or broken parts.
Vendor selected for this purchase:
All Temp Refrigeration, Cedar Rapids Iowa
n Bids or written quotes were taken on this purchase, as follows:
n Bids or quotes were not taken on this purchase because:
All Temp Refrigeration is the only certified Vilter ammonia compressor ice service business in the area .
They have the proper equipment & maintenance records for the Young Arena Ice System dating
back to construction in 1994, and provide timely emergency response calls when needed.
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:
010-37-4500-1388
(Fund - Department - Activity - Account Number) (Project Code)
in which the budgeted amount is $ 29,300.00
and the current available balance is $ 10,881.63
Respectfully submitted,
Paul Huting 05/03/2023
ZOO
5/15/2023
(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 5/15/2023
City of Waterloo
Expenditure Pre -Authorization Request Form
The Finance Committee of the City Council is hereby requested to authorize the following
purchase or expenditure submitted by the Leisure Services Department to expend
$ 3,000.00 plus est. shipping costs of $ to pay for or purchase
Pool Chemicals for Byrnes pool.
This purchase or expenditure is being made because:
chemicals are required to operate swimming pools.
Vendor selected for this purchase:
ACCO Des Moines IA
n Bids or written quotes were taken on this purchase, as follows:
IT Bids or quotes were not taken on this purchase because:
ACCO is the only vendor that provide pool chemicals in this area and most of
eastern Iowa.
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:
010-37-4200 1557
(Fund - Department - Activity - Account Number) (Project Code)
in which the budgeted amount is
and the current available balance is
Respectfully submitted,
Paul Huting 04/27/2023
$ 7,500.00
$ 5,454.51
Tt4ete Z3o(
5/15/2023
(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 5/15/2023
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
$ 3,850.78
plus est. shipping costs of
Leisure Services
Department to expend
$ 0.00 to pay for or purchase
New condensing unit, evaporator & installation parts for Young Arena's walk-in cooler,
with installation performed in house by the City's building maintenance department.
This purchase or expenditure is being made because:
cooler was found to be non -repairable and needed emergency replacement prior to
playoff hockey games.
Vendor selected for this purchase:
Wayne Dennis Supply - Waterloo
�■ Bids or written quotes were taken on this purchase, as follows:
Wayne Dennis Supply Waterloo $3,850.78
Johnstone Supply Waterloo $5,935.04
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
ElBonds ❑ Federal/other grants ❑ Other (specify)
This expenditure is to be coded to the following budget line -item:
010-37-4500 1373
(Fund - Department - Activity - Account Number) (Project Code)
in which the budgeted amount is $ $7,400.00
and the current available balance is $ 5,283.17
Respectfully submitted,
Paul Huting 04/25/2023 �4 N5/15/2023
(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 5/15/2023
City of Waterloo
Expenditure Pre -Authorization Request Form
The Finance Committee of the City Council is hereby requested to authorize the following
purchase or expenditure submitted by the Leisure Services Department to expend
$ 3,063.60 plus est. shipping costs of $ to pay for or purchase
Two Prowler EXT Replacement Tracks for John Deere 333D Track Skid Loader.
This purchase or expenditure is being made because:
Current tracks are worn out.
Vendor selected for this purchase:
Prowler Mfg.
�■ Bids or written quotes were taken on this purchase, as follows:
Prowler Manufacturing Greensburg, IN
$3,063.60
Goodyear Commercial Tire
Waterloo, IA $4,290.00
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 IT Sewer n Sanitation
ElBonds ❑ Federal/other grants ❑ Other (specify)
This expenditure is to be coded to the following budget line -item:
010-37-4100-1569
(Fund - Department - Activity - Account Number) (Project Code)
in which the budgeted amount is
and the current available balance is
Respectfully submitted,
Paul Huting 5/3/23
$ 60,817.00
$ 20,800.75
(Wye& Nao, 5/15/2023
(Signature Dept. Head or Designee)
Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\Expenditure Pre-Authorization.xls (Mar 2010)
PROJECT BUDGET WORKSHEET - ALL PROJECTS
PAGE ONE
Project Name FY2023 Capital Fund Allocation
City Contract No.
Project Manager
Julie Dawson
Project Budget Total $ 85,898.00
1. How will this project be funded?
A. Federal Grant Yes X No
Grant Name Capital Fund Formula Grant
CFDA #
B. State Grant Yes No
Grant Name
C. City Match Source of Funding N/A
D. Other Entities Yes No
Name
To be assigned by the Finance Dept.
Project No.
Subproject No.
% Paid by federal grant 100.00%
Grant Agreement Number IA01 P05050123
% 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.
0.00%
0.00%
0.00%
Done None
❑X ❑
Yes No
❑ 0
❑ ❑X
❑ ❑X
❑ 0
❑ ❑X
❑ ❑X
❑ ❑X
6. Include a brief description of the project in the space below: (REQUIRED)
The 2023 Capital Fund Grant will fund unusual maintenance expenses and capital building improvements.
Page 2 must be attached and signed.
K:\shared goodies\forms\2023 Capital Fund Project Budget.xls\Page 1 All Projects (Mar 2010)
PROJECT BUDGET WORKSHEET- NON -CONSTRUCTION
PAGE TWO
City Clerk Use Only
Committee
Approval Date
5/15/2023
Project Name (from page one) FY 2023 Capital Fund Allocation
Department No. project will be budgeted under 13
Activity No. project will be budgeted under 5451
REVENUES:
3000 Cash on Hand
3350 Federal Grant
3352 Federal HUD Grant
3354 Shared Program - Local
3357 Shared Program - County
3358 Shared Program - City
3360 Shared Program - State
3361 State Grant
3720 Donations - Restricted
3750 Sale of Bonds
EXPENDITURES:
To be assigned by the Finance Dept.
Project No.
Subproject No.
(Each column should only include amounts by fund)
Fund:
Fund: Fund:
Fund:283 Total
85,898.00 85,898.00
TOTALS $ 85,898.00 $ $ $ $ 85,898.00
1111 Salaries - Regular
1112 Salaries - Part Time
1315 Education & Training
1345 Travel - Official City
1346 Travel - Prof Training
1390 Contractual Services
1382 Building Improvements
85,898.00 85,898.00
TOTALS $ 85,898.00 $ $ $ - $ 85,898.00
Julie Dawson 05/01/2023
(Sw+-it ZQa(
5/15/2023
(Signature Dept. Head) Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\2023 Capital Fund Project Budget.xls\Page 2 (Donat or NON-constr) (Mar 2010)