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City Clerk Use Only
Finance Committee
Approval Date ________________
City of Waterloo
Expenditure Pre-Authorization Request Form
The Finance Committee of the City Council is hereby requested to authorize the following
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purchase or expenditure submitted by theDepartment to expend
25-291/542-1:4/43
$plus est. shipping costs of$to pay for or purchase
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%24-:93/26,%2-152/41T0I/Rvpufjodmvefe#vqup6&pwfsbhfgpsbeejujpobmzbsebhfqspevdfe#/
This purchase or expenditure is being made because:
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Vendor selected for this purchase:
Bids or written quotes were taken on this purchase, as follows:
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Bids or quotes were not taken on this purchase because:
20603137
Prior Committee Actions (Dates):
Please check the following box(es) as appropriate to describe the funding for this expense:
General FundRoad Use TaxSewerSanitation
Bonds Federal/other grants Other (specify)
This expenditure is to be coded to the following budget line-item:
3:2.3:.8871.327:3:QSP/WJ37
(Fund - Department - Activity - Account Number)(Project Code)
234-214/11
in which the budgeted amount is$
89-:7:/42
and the current available balance is$
Respectfully submitted,
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(Signature Dept. Head or Designee)Date(Signature Finance Dept. Review)Date
K:\\shared goodies\\forms\\Expenditure Pre-Authorization.xls (Mar 2010)