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HomeMy WebLinkAbout_41_Finance_Health_Insurance Docusign Envelope ID:9042B526-99EC-41AO-B6F5-043423AOD889 Completed forms should be routed directly to the Finance Dept. FINANCE DEPT.ONLY Finance Committee approval required? YES X NO 41/21/2025 If so,date approved: City of Waterloo Line-Item Budget Amendment Request Form The Finance Committee of the City Council and/or Finance Dept. is hereby requested to authorize the following line-item budget amendment for FYE 25 submitted by the Finance 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 03 8950 3625 Ins Refund 500,000.00 010 03 8950 1366 Prescription Claims 600,000.00 010 03 8950 3829 Employee Contributions 100,000.00 F_ TOTAL 600,000.00 TOTAL 600,000.00 This amendment is being requested because: Amend health insurance activity to more actual Prior Committee Actions(Dates): Signed by: Bridgett Wood 4/10/25 �y`° �°°d 4/21/202 5 (Signature Dept. Head or Designee) Date Ignature Finance Dept. Review) Date Date Posted (Finance Dept.) K:\users\shared goodies\forms\Copy of Budget Amendment Request Form(Apr 2003)