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 — Polymer
Amount: $320,000
Lawson RQ# —FY2017
Funding Description: Wastewater ~ Chemicals
Accounting (Finance Committee): 69.6200.670 - 61156
Acctg Unit Acct Sub Acct Activity Acct Category
Requesting Department:
L] information Technology ) Police Department
["] Engineering (J Fire Rescue
T} Streets [“] Community Development
_] Traffic (_] Public Health
[_} Park Recreation L_] Financial Services
>] Wastewater [_] Other
(_] Solid Waste 1] Other
{_] Library
Are CDBG Funds being used for this item? [] Yes KX) No
Is this a time sensitive project? J Yes (] No
For Solicit Bid — is a list of bidders attached? C] Yes £] No
Reason for request:
See attached BPW Motion -
Other supporting comments:
Attach supporting documents (bid document, tabulation, contract, etc.)
Fe
Division Director:
Date: 6[2 [lb
Note: This form will be returned unless fully completed.
