HomeMy WebLinkAboutApproved Documents - 1/16/2018 FINANCE DEPT. STAFF ONLY
LINE ITEM USED ,464, 07 ISM /34k.
TRAVEL REQUEST FY.910a BUDGETED 3400
CITY OF WATERLOO EXPENDED YTD 8/37 93
THIS REQUEST .27Q °J
LEFT AFTER THIS
REQUEST
DATE 2G, j-/"- j 8
Original-Clerk/Finance Copy- Department
NAME(S) AND POSITION(S): DATE:
Ben Neil, Engineering Technician January 9, 2018
NAME OF CLASS/ MEETING: DESTINATION: Cedar Rapids, IA
Iowa Department of Transportation recertifications
DEPARTURE POINT
IF NOT WATERLOO:
DEPARTURE DATE: RETURN DATE: DATE(S) OF MEETING:
February 7, 2018 February 27, 2018 February 27, 2018
March 16, 2018 March 16, 2018 March 16, 2018
PURPOSE OF TRAVEL/TRAINING:
To attend Iowa Department of Transportation recertifications
2/7/18 Soils Recertification (9am—4pm) $120.00
3/16/18 Level 11 PCC Recertification (9am—4pm) $120.00
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL: X COST$
YES NO
METHOD OF TRAVEL:
X CITY VEHICLE PRIVATE VEHICLE
AIRFARE DEPARTING FROM:
ESTIMATE OF COST: BUDGET LINE ITEM: 266-07-7830-1346
LODGING TAXI X GRANT REIMBURSABLE
30.00 MEALS PARKING YES NO
240.00 REGISTRATION AIRFARE X REQUIRED CERTIFICATION
MILEAGE/FUEL MISC/TOLLS YES NO
TOTAL FOR ALL: $ 270.00 TOTAL: $ 270.00 PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE I APPROVE THIS TRAVEL REQUEST
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF W2(TER
DEPARTMENT EAD/ 45s MAYOR
January 9, 2018 / i e
t Y
DATE DATE
K:\Shared Goodies\Foiius\Travel Request Form January 2010
FINANCE DEPT. STAFF ONLY
LINE ITEM USED Oa) /? /cy0 /3 ,
TRAVEL REQUEST F*20/g BUDGETED 600 2 °'
CITY OF WATERLOO EXPENDED YTD 3Srgi
THIS REQUEST 3 W
LEFT AFTER THIS
REQUEST /1%'
DATEw
Original-Clerk/Finance Copy- Department
NAME(S) AND POSITION(S): DATE:
Garrett Gingrich January 8, 2018
NAME OF CLASS/ MEETING: DESTINATION: Hiawatha, Iowa
EMS Refresher
DEPARTURE POINT
IF NOT WATERLOO:
DEPARTURE DATE: RETURN DATE: DATE(S) OF MEETING:
January 26, 2018 January28, 2018 January 26-28, 2018
PURPOSE OF TRAVEL/TRAINING:
Attend Paramedic continuing education conference
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL: x COST $ N/A
YES NO
METHOD OF TRAVEL:
x CITY VEHICLE PRIVATE VEHICLE
AIRFARE DEPARTING FROM:
ESTIMATE OF COST: BUDGET LINE ITEM: 6 Y2'4 -/. i)
LODGING TAXI x GRANT REIMBURSABLE
$45.00 MEALS PARKING YES NO
$299.00 REGISTRATION AIRFARE x REQUIRED CERTIFICATION
MILEAGE/FUEL MISC/TOLLS YES NO
TOTAL FOR ALL: $ 344.00 TOTAL: $ 344.00 PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE I APPROVE THIS TRAVEL REQUEST
AND IS NECESSARY AND BENEFICIAL TO THE
CITY e TE
.✓ L 1..�...)✓Y i t_ j2 L �'-
DEPARTMENT HEA MAYOR
— 9- ( (6/ t/
(0 ,8
DATE DATE
K:\Shared Goodies\Forms\Travel Request Form January 2010
City Clerk Use Only
'Finance Committee
Approval Date /i b /I g
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
$ 20,000.00 plus est. shipping costs of $ N/A to pay for or purchase
Staff is requesting permission to expend and additional $20,000 on Phase 2 for marketing
the airport as programmed for the remainder of the FY-2018 budget year.
This purchase or expenditure is being made because:
The approval for the expenditure is Phase 2, and would allow Staff to provide funds for
radio media, and other purchases that the IDOT grant would approve.
Vendor selected for this purchase: Area radio stations and other misc. items for purchase.
Bids or written quotes were taken on this purchase, as follows:
X Bids or quotes were not taken on this purchase because:
As of January 9, 2018, Staff is still awaiting the final determination from the USDOT
office on what airline (American or United) will be selected to serve the ALO-ORD
route. Once a decision is received, a more active campaign will be started.
Prior Committee Actions (Dates): 12/18/2017
Please check the following box(es) as appropriate to describe the funding for this expense:
X General Fund Road Use Tax Sewer Sanitation
Bonds X Federal/other grants Other(specify)
This expenditure is to be coded to the following budget line-item:
291 - 29 - 7760 - 1351 / 010 - 29 - 7700 - 1351 29 PRO/ADV-17
(Fund - Department-Activity-Account Number) (Project Code)
in which the budgeted amount is $ 37,000.00✓
a d th''' current available balance is $ 35,311.50 V
Re p tf I
1 , 441-1 -1006
(Signature D d or Designee) Date ( ipr`rature Finance Dept. Review) Date
K:\shared goodies\forms\01 09 2018 PreAuthorization for IDOT FY-2018 Marketing Program-Phase 2(Mar 2010)
City Clerk Use Only
Finance Committee
Approval Date VI I b
City of Waterloo
Expenditure Pre-Authorization Request Form
The Finance Committee of the City Council is hereby requested to authorize the following
purchase or expenditure submitted by the Engineering Department to expend
$ 2,740.00 plus est. shipping costs of $ N/A to pay for or purchase
2018 Iowa Storm Water Education Partnership (ISWEP) membership dues (half year)
(ISWEP is moving towards invoicing on the City fiscal, not calendar, year)
This purchase or expenditure is being made because:
As a charter member, Waterloo continues to benefit from membership with ISWEP
which provides education and training resources for staff and citizens.
Vendor selected for this purchase: ISWEP
Ti Bids or written quotes were taken on this purchase, as follows:
n Bids or quotes were not taken on this purchase because:
No other such storm water program exists in Iowa
Prior Committee Actions (Dates):
Please check the following box(es) as appropriate to describe the funding for this expense:
nGeneral Fund n Road Use Tax n Sewer Sanitation
Bonds pi Federal/other grants n Other(specify) Storm Water
This expenditure is to be coded to the following budget line-item:
521-07-7830-1391
(Fund - Department-Activity-Account Number) (Project Code)
in which the budgeted amount is $ (o SUd
and the current available balance is $ (#l$Q "
Respe m p
"�P-20 l/J1 '(-M1/t-'
(Si ture t. Head esignee) Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\ISWEP 2018 DUES_HALF Expenditure Pre-Authorization.xls(Mar 2010)
City Clerk Use Only
Finance Committee
Approval Date i t'/I a
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
$ 5,864.11 plus est. shipping costs of $ to pay for or purchase
Portable Parker Hydraulic Filter
This purchase or expenditure is being made because:
To be used on all hydraulic equipment to pump and filter oil thru cylinders.
Vendor selected for this purchase: Quest Engineering, Inc.
n Bids or written quotes were taken on this purchase, as follows:
Quest Engineering Inc. Cedar Rapids, IA $5,864.11
Force America Distributing Burnsville, MN $6,916.80
Bids or quotes were not taken on this purchase because:
Prior Committee Actions (Dates):
Please check the following box(es) as appropriate to describe the funding for this expense:
X General Fund Road Use Tax Sewer n Sanitation
Bonds n Federal/other grants Other(specify)
This expenditure is to be coded to the following budget line-item:
010-18-7950-1571
(Fund - Department-Activity-Account Number) (Project Code)
in which the budgeted amount is $ 60,000.00
and the current available balance is $ 32,683.35 ✓
Respectfully submitted,
(Signature Dept. ad or Designee) Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\2018-January-Expenditure Pre-Authorization-Parker Hydraulic Filter-Quest Enginnering-$5,864.11-010-18-7950-
1571.xIs(Mar 2010)
City Cie1K Use Only
Finance Committee
Approval Date )/f b 1g
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 $10,000 plus est. shipping costs of $ na to pay for or purchase
Emergency repairs to Young Arena's ice system microprocessor & glycol pump loop
This purchase or expenditure is being made because:
repairs were needed to keep the ice system operational.
& supports the city's strategic Plan,4.5-"Maintain City facilities that support quality of place".
Vendor selected for this purchase: All Temp Refrigeration, Cedar Rapids Iowa
Bids or written quotes were taken on this purchase, as follows:
X Bids or quotes were not taken on this purchase because:
All Temp Refrigeration is a Certified Vilter Ammonia Compressor Specialist. It's Staff
has performed all maintenance work on the Young Arena ice system since 1994
Prior Committee Actions (Dates):
Please check the following box(es) as appropriate to describe the funding for this expense:
General Fund Road Use Tax Sewer Sanitation
x Bonds Federal/other grants Other(specify)
This expenditure is to be coded to the following budget line-item:
417 37 4500 2117
(Fund - Department-Activity-Account Number) (Project Code)
in which the budgeted amount is $ 60,000.00 '`
and the current available balance is $ 26,050.00
Respectfully submitted,
(Signature Dept. ea or Designee) Date Signature Finance Dept. Review) Date
K:\shared goodies\forms\2018 Ice System Repairs Pre-Auth.xls(Mar 2010)
City Clerk Use Only
Finance Committee Approval Date Vic.I( ha
City of Waterloo
Expenditure Pre-Authorization Request Form
The Finance Committee of the City Council is hereby requested to authorize the following
purchase or expenditure submitted by the Leisure Services Department to expend
$ 2,100.00 plus est. shipping costs of $ n/a to pay for or purchase
used kettle bells, kickboxing bags and other miscellaneous equipment from a gym that
went out of business in Cedar Falls.
This purchase or expenditure is being made because:
we were able to purchase this equipment at less than half the cost of new and it is in
great condition.
Vendor selected for this purchase: North Twin LLC (DBA Kosama Cedar Falls)
Bids or written quotes were taken on this purchase, as follows:
x Bids or quotes were not taken on this purchase because:
this was a unique opportnity to purchase well maintained equipment at a great
price.
Prior Committee Actions (Dates):
Please check the following box(es) as appropriate to describe the funding for this expense:
x General Fund Road Use Tax Sewer Sanitation
Bonds Federal/other grants Other (specify)
This expenditure is to be coded to the following budget line-item:
010-37-4180-1567 37SPLX.OPER
(Fund - Department-Activity-Account Number) (Project Code)
in which the budgeted amount is $ 24,900.00 `v
and the current available balance is $ 13,488.90 f E s Gy
Respectfully submitted,
//J 'zt:eim,vi g"
(Signature Dept. Head Vesignee) Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\kosamIquipment pre auth.xls(Mar 2010)
City Clerk Use Only
Finance Committee
Approval Date i /i"1 16
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 Public Works Department to expend
$ 4,938.00 plus est. shipping costs of $ to pay for or purchase
Replace 42 various fire extinguishers throughout the Public Works Building - labor
and disposal fees
This purchase or expenditure is being made because:
Replace expired fire extinguishers as per insurance inspector's recommendation.
(equally divided by 4 departments - $1,234.50)
Vendor selected for this purchase: Proshield Fire & Security
n Bids or written quotes were taken on this purchase, as follows:
Proshield Fire & Security Waterloo, IA $4,938.00
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:
l^I General Fund X Road Use Tax ri Sewer ri Sanitation
nBonds ri Federal/other grants Other(specify)
This expenditure is to be coded to the following budget line-item:
010-18-7950-1371; 266-17-7120-1371; 266-19-7100-1371; 525-15-5400-1371
(Fund - Department-Activity-Account Number) (Project Code)
a10 zrsbter1 .2 6-f a /5
Oi A Jo-
in which the budgeted amount is $ eVOO Wood RO�0 3.cJ�
and the current available balance is $663 " /342° IQ‘Qt I /aSq-03
Respectfully submitte
dZazegevc- te2t1 1 81/
(Signature Dept. Had or Designee) ate (Sig6e Finance Dept. Review) Date
K:\shared goodies\forms\2018-January-Expenditure Pre-Authorization-Proshield-$4,938.00-266-17-2720;266-19-7100; 525-15-5400; 010-18-
7950-1371.xis(Mar 2010)
City Clerk Use Only
Finance Committee
Approval Date
City of Waterloo
Expenditure Authorization Request Form
The Finance Committee of the City Council is here by requested to authorize the following
purchase or expenditure submitted by the Sewer Department to expend
$ 4.332.80 plus ext. shipping cost of $ 120.00 to pay for or purchase
Replacement Hach Sampler AS950 Frig and cable assy for Easton effluent sampling
This purchase or expenditure is being made because:
To replace sonford sampler sampling at easton effluent parshall flume.
Vendor selected for this purchase:
Hach
nBids or written quotes were taken on this purchase, as follows
7-Bids or quotes were not taken on this purchase because:
Hach is rep. for puchase of replacement samplers. City Strategic Plan, Strategy 4.5
Maintain and develop community services and city facilities that support quality of place.
Prior Committee Actions (Dates):
Please check the following box(es) as appropriate to describe the funding for this expense:
nGeneral Fund: riRoad Use Tax: Sewer: ElSanitation:
Bonds: nFederal/other grants: nOther(specify):
This expenditure is to be coded to the following budget line-item:
520-14-5200-1571
(Fund - Department-Activity-Account Number) (Project Code)
in which budgeted amount is $ 400,000.00 4/
and the current available balance is $ 17. 495724 /59, K)0��5
Respectfully submitted,
Zan 0 z°1°° l-(o-<8
(Signature Dept. Head Or Designee) Date (Signature Finance Dept. Review) Date
City Clerk Use Only
Finance Committee
Approval Date t/110 (f b
City of Waterloo
Expenditure Authorization Request Form
The Finance Committee of the City Council is here by requested to authorize the following
purchase or expenditure submitted by the Sewer Department to expend
$ 15,695.10 plus ext. shipping cost of $ 0.00 to pay for or purchase
Pump repair parts, labor and trip charge for#4 Easton Raw Wastewater pump
This purchase or expenditure is being made because:
Pump worn, not pumping to capacity.
Vendor selected for this purchase:
Quality Pump & Control
piBidsor written quotes were taken on this purchase, as follows
Bids or quotes were not taken on this purchase because:
Quality Pump & Control is rep. for repair of this pump. City Strategic Plan, Strategy 4.5
Maintain and develop community services and city facilities that support quality of place.
Prior Committee Actions (Dates):
Please check the following box(es) as appropriate to describe the funding for this expense:
nGeneral Fund: Road Use Tax: Sewer: nSanitation:
nBonds: nFederal/other grants: Other(specify):
This expenditure is to be coded to the following budget line-item:
520-14-5200-1571
(Fund - Department-Activity-Account Number) (Project Code)
in which budgeted amount is $ 400,000.00
and the current available balance is $ 175,495.20 '/
Respectfully submitted,
c�.�n t 0 t 8 74/1LeAkkiL( 4)t-c4.44}%I //0�,30 g
(Signature Dept. Head Or Designee) Date Sig ature Finance Dept. Review) Date
City Clerk Use Only
Finance Committee
Approval Date t/i k,Il b
City of Waterloo
Expenditure Authorization Request Form
The Finance Committee of the City Council is here by requested to authorize the following
purchase or expenditure submitted by the Sewer Department to expend
$ 4,298.00 plus ext. shipping cost of $ 0.00 to pay for or purchase
Software license/support plan renewals for Granite users
This purchase or expenditure is being made because:
For continued CCTV inspection of the sanitary and storm sewers and for office
support software.
Vendor selected for this purchase:
Cues
]Bids or written quotes were taken on this purchase, as follows
EBids or quotes were not taken on this purchase because:
Cues is the rep. to purchase Granite software & service. City Strategic Plan, Strategy 4.5
Maintain and develop community services and city facilities that support quality of place.
Prior Committee Actions (Dates):
Please check the following box(es) as appropriate to describe the funding for this expense:
I]General Fund: ]Road Use Tax: ]Sewer: ]Sanitation:
]Bonds: —Federal/other grants: ]Qther(specify):
This expenditure is to be coded to the following budget line-item:
520-14-5200-1520
(Fund - Department - Activity-Account Number) (Project Code)
in which budgeted amount is $ 32,000.00 V
and the current available balance is $ 22,730.52 V
Respectfully submitted,
--31Aer,,....., U6-+A, 4 2-ors oLoA di.(_, t,LeA-1-itcA
(Signature Dept. Head Or Designee) Date (Signature Finance Dept. Review) Date
0 1- -/e
City Clerk Use Only
Finance Committee
Approval Date I f b(lb
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 Street Department to expend
$ 10,953.00 plus est. shipping costs of $ to pay for or purchase
100 - Motor Grader Blades for Snow Removal
This purchase or expenditure is being made because:
To replace worn out motor grader blades during snow removal season
Superior blade and lasts 4 times longer than other bidder's blade.
Vendor selected for this purchase: Altorfer
n Bids or written quotes were taken on this purchase, as follows:
Altorfer, Inc. Cedar Falls, Iowa $10,730.00
Murphy Tractor Waterloo, Iowa 8,453.00
n Bids or quotes were not taken on this purchase because:
Prior Committee Actions (Dates): $10,730 approved 11/6/17 (wrong part# given)
Please check the following box(es) as appropriate to describe the funding for this expense:
X General Fund n Road Use Tax Sewer Sanitation
Bonds Federal/other grants n Other(specify)
This expenditure is to be coded to the following budget line-item:
010-18-7955-1571
(Fund - Department-Activity-Account Number) (Project Code)
in which the budgeted amount is $ 240,000.00
and the current available balance is $ ✓S 97i a�
Respectfully submitted,
(9'ignature Des Head or Designee) Date (Signature Finance Dept. Review) Date
Aoen
K:\shared goodies\forms\2018-January-Expenditure Pre-Authorization-Altorfer-Motor Grader Blades-should have been$10,953 instead of
$10,730-010-18-7955-1571.xls(Mar 2010)
City Clerk Use Only
Finance Committee Approval Date '/1 b 1/
I e
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
$ 1,200.00 plus est. shipping costs of $ to pay for or purchase
Replace a Light pole base and sidewalk on the NE corner of Park Ave. and Commercial
This purchase or expenditure is being made because:
Specialized concrete contractor was needed to replace this base and sidewalk as it
was over a basement of the old Courier building that extended under the sidewalk.
Vendor selected for this purchase: B & B Builders
X Bids or written quotes were taken on this purchase, as follows:
B & B Builders Waterloo, IA $1,200.00
Kirk Gross Company Waterloo, IA $5,940.00
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:
nGeneral Fund Road Use Tax Sewer Sanitation
Bonds 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 $ 28,800.00
and the current available balance is $ 12,940.88
Respectfully submitted,
// /2 y� � /,L�, iiU
(Signature Dept. H ad or Designee) ate (Signature Finance Dept. Review) Date
K:\shared goodies\forms\2018-January-Expenditure Pre-Authorization-B&B Builders-Light Base&Sidewalk-Park AVe. &Commercial NE
corner-1,200.00-266-17-7120-1521.xIs(Mar 2010)
Completed forms should be routed directly to the Finance Dept. FINANCE DEPT ONLY
Finance committee approval required?
YES I NO 1 '
If so,date approved: I( I i
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 18 submitted by the POLICE Department:
EXPENSES/REVENUE
DECREASE EXPENDITURES(INCREASE REVENUE) INCREASE EXPENDITURES(DECREASE REVENUE)
Fund Dept Activity Acct# Acct Name Proj Code Amount Fund Dept Activity Acct# Acct Name Proj Code Amount
010 11 1150 3873 Reimb For Serv. 11GRT.ODEF 7,500.00 010 11 1150 1114 Overtime 11GRT.ODEF 7,500.00
TOTAL $7,500.00 TOTAL $7,500.00
This amendment is being requested because:
This is to conform with the City's budget line item control policy, See attached paperwork, new operation Olde Man-WC-IAN-0128 T-32
Prior Committee Actions(Dates):
1')/i 8 i I 1 sli*,adiA-
(Signat e Dept. He Designee) t ate (Signature Finance Dept. Review) Date
Date Posted (Finance Dept.)
K:\users\shared goodies\forms\csbudgetamendreqform(Apr 2003)
CONSTRUCTION PROJECT BUDGET WORKSHEET
PAGE TWO
City Clerk Use Only
Finance Committee
Approval Date t�` i
Project Name (from page one) Mark's Park Resurface
Department No. project will be budgeted under 37 To be assigned by the Finance Dept.
Activity No. project will be budgeted under 4105 4110 Project No. 37Gt`r
Subproject No. pipie6,,,,,eir,
(Each column should only include amounts by fund)
Fund: —' ater Fund: Fund:
�- Fund: Total
REVENUES: a1-0-37-4105 415-37-4110
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 -
3365 State RISE Grant -
3368 EPA Grant -
3377 EDA Grant -
3720 Donations- Restricted .,,4 7,00 u` - 25,000.00
3720 Donations - Restricted 20,500.00 20,500.00
3720 Donations - Restricted 5,746.00 5,746.00
3750 Sale of Bonds 10O04°— 10,000.00
TOTALS $ 51,246.00 $ 7,000e" $ - $ - $ 61,246.00
EXPENDITURES:
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 -
2168 Park Improvement 511,246.00 7, 6O0'— 61,246.00
TOTALS $ 54-246.00 $ '7 JD°:R `; $ - $ - $ 61,246.00
(Signature Dept. sa.eri Date (Signature Finance Dept. Review) Date
K:\shared goodies\forms\Project Budget Worksheet.xls\Page 2(Constr Proj) (Mar 2010)
PROJECT BUDGET WORKSHEET - ALL PROJECTS
PAGE ONE
Project Name Mark's Park Resurface
City Contract No. To be assigned by the Finance Dept.
Project Manager Travis Nichols JB Bolger Project No.
Project Budget Total $ 61,250.00 Subproject No.
1. How will this project be funded?
A. Federal Grant Yes No x CFDA# % Paid by federal grant
Grant Name Grant Agreement Number
B. State Grant Yes No X % Paid by state grant
Grant Name Grant Agreement Number
C. City Match Source of Funding GO Bonds % Paid by City
D. Other Entities Yes No X % Paid by other entity
Name Donations
Done None
2. Attach copies of any grant agreements that will fund the project (REQUIRED) ❑ ❑
Council awarded in April
Yes No
3. Does the project include the purchase of right of way or other real property? ❑ Q
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 ❑ El
B. Publication, or printing costs ❑ L1
C. Others, list ❑ ❑X
5. Does this project cover any regular full-time salaries or benefits? ❑ 0
If yes, employee/position to be covered.
6 Include a brief description of the project in the space below: (REQUIRED)
This project will include architect design/bid documents, removing and replacing the rubberized surface at the Splash Pad
at Mark's Park. The splash pad is heavily used and needs to be replaced.
Funding will be:
Young Family Foundation $25,000 and donor directed gift (Cathy Young) thru Wloo Comm Foundation $20,500
NEIA Community Foundation $5,746 Mark's Park Fund
GO Bonds $10,000
Page 2 must be attached and signed.
K:\shared goodies\forms\Project Budget Worksheet.xls\Page 1 All Projects (Mar 2010)