City of Nashua Central Purchasing Department
FINANCIAL SERVICES DIVISION
Request to Include on Finance Committee Agenda
Date of Request:
[_] Request to Solicit Bid or Proposal
06/06/2016
Proposed Finance Meeting Date: 06/15/2016
Project or Item Title:
Amount: $20,000
LawsonRQ# FY2017
Funding Description: Wastewater - Chemicals
Accounting {Finance Committee):
Wastewater Chemical —
Ferri¢ Chloride
69.6200,670 & 540 - 61156
Acctg Unit
Requesting Department:
[_] information Technology
[_] Engineering
L_] Streets
_] Traffic
[] Park Recreation
[>] Wastewater
(_] Solid Waste
L] Library
Are CDBG Funds being used for this item?
Is this a time sensitive project?
For Solicit Bid — is a list of bidders attached?
Reason for request:
See attached BPW Motion
Acct Sub Acct Activity Acct Category
L_] Police Department
[_] Fire Rescue
(_] Community Development
(_] Public Health
[] Financial Services
_] Other
__] Other
[] Yes ] No
Bd Yes (] No
[Ll Yes LJ No
Other supporting comments:
Attach supporting documents (bid document, tabulation, contract, etc.)
Approval son
if). £.
Requester: we Pa
CFO (or designee):
a
fo
4 Division Director: GSS.
RAE Date: bf. ofr / 6
Note: This form will be returned unless fully completed.
