Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 8/1/2023
2) Contract Type: Expense
3) Renewal Contract: No
4) Department Name: Information Technology
5) Department Contact: Misty Witmer
6) Description: Service Agreement for POTS Lines at Various County Locations
7) PEID No: 718993
8) Req No: N/A
9) Orgkey: 1101-1591-00
10) Object Code: 5492101
11) Vendor: Frontier Communications of the South, LLC
12) Vendor Contract No:
Expenditure Budget/Revenue Projections
13) Fund Name: Telephone Expense
14) Fund #: 1101
15) Current Year Budgeted: $250,300.00
16) Current Year Projected: $3,639.44
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals:
To Be Completed by Purchasing Department
22) Contract Start Date: 8/7/2023
23) Auto Renewal Contract: No
24) Bid No: N/A
25) Contract End Date: 8/6/2024
26) Contract # Issued by Purchasing Department: CM23374
NOTES:
HB1295 Requested