HomeMy WebLinkAboutHuman_Resources_(Biometric_Screenings)Docusign Envelope ID: F91144FC-DF45-47F2-9904-3FF4079EB469
City of Waterloo
Expenditure Pre -Authorization Request Form
City Clerk Use Only
Finance Committee
Approval Date 11 /17/2025
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
$ 5900.00 plus est. shipping costs of $ to pay for or purchase
Employee biometric screenings from the 2025 wellness fair
This purchase or expenditure is being made because:
Employee wellness
Vendor selected for this purchase:
MercyOne Wellness
n Bids or written quotes were taken on this purchase, as follows:
n Bids or quotes were not taken on this purchase because:
MercyOne is the primary wellness provider for the City
Prior Committee Actions (Dates):
Please check the following box(es) as appropriate to describe the funding for this expense:
ri General Fund El Road Use Tax Sewer Sanitation
nBonds El Federal/other grants n Other (specify)
This expenditure is to be coded to the following budget line -item:
010-03-8950-1368
(Fund - Department - Activity - Account Number) (Project Code)
in which the budgeted amount is
$ 9,150,000.00
and the current available balance is $ 5,936,131.83
Respectfully submitted,
(-SSigned by:
(/� A, C/I(4A f �' `C� I f� B ""loud 11/17/2025
(Signature D t. d or Designee) Date" / i i-i ilitrfni 9"ice ( 9 Dept.Review) Date
K:\shared goodies\forms\Expenditure Pre-Authorization.xls (Mar 2010)
Docusign Envelope ID: F91144FC-DF45-47F2-9904-3FF4079EB469
MtERCYONE:.
INVOICE FOR SERVICES RENDERED
To: City of Waterloo
Date: November 5, 2025.
Service provided- Complete Metabolic panel, Lipid and Glucose lab draws.
118 participants $50.00 = $5,900.00
45 A 1 C tests @ $20.00 =$900.00
51 CBC tests @ $15.00 =$765.00
20 Vit. D tests @ $50.00 = $1,000.00
50 PSA tests @ $32.00 = $1,600.00
31 TSH tests @ $32.00 = $992.00
PRD=$5,257.00
Total due=$11,157.00
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Notes: Please let me know if you have any questions regarding this invoice.
Thank you,
Merriam
Merriam.lake@mercyhealth.com or 319-272-2284
* In order to ensure that your account is properly credited please make a check payable
to: MercyOne Wellness
Please send payment to: MercyOne Wellness
d.b.a Wellness Services