City of Nashua Central Purchasing Department
FINANCIAL SERVICES DIVISION
[x] Request to Include on Finance Committee Agenda [] Request to Solicit Bid or Proposal
Date of Request: 06/06/2016
Proposed Finance Meeting Date: 06/15/2016
Project or Item Title: _ Wastewater Chemical — Sodium Hypochlorite
Amount: $141,000
Lawson RQO# _ FY2017
Funding Description: Wastewater — Chemicals
Accounting (Finance Committee): 69.6200.670 - 61156
Acctg Unit Acct Sub Acct Activity Acct Category
Requesting Department:
("1 Information Technology (] Police Department
[(-] Engineering _] Fire Rescue
C) Streets [_] Community Development
(] Traffic ( Public Health
F] Park Recreation ["] Financial Services
Wastewater [4 Other
[] Solid Waste (J Other
[J Library
Are CDBG Funds being used for this item? (Yes No
Is this a time sensitive project? J yes C1 No
For Solicit Bid — is a list of bidders attached? C] Yes [] No
Reason for request:
______See attached BPW Motion ane
Other supporting comments:
Attach supporting documents (bid document, tabulation, contract, etc.)
Division Director: : ae
Date: gf 21 f b
Approval S natures: fr
Requester:
CFO (or designee}:
Note: This form will be returned unless fully completed.
