Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 1/2/2024
2) Contract Type: Other
3) Renewal Contract: No
4) Department Name: Facilities
5) Department Contact: Mark A. Garcia
6) Description: O’Haver Contractors Change Order No.: 20 -Road & Bridge Project
7) PEID No: 721831
8) Req No: FR105283
9) Orgkey: 3120312115
10) Object Code: 5781000
11) Vendor: The O’Haver Company LTD.
12) Vendor Contract No: CM20306
Expenditure Budget/Revenue Projections
13) Fund Name: 3120
14) Fund #:
15) Current Year Budgeted: $10,728.00
16) Current Year Projected:
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals:
To Be Completed by Purchasing Department
22) Contract Start Date: 5/3/2021
23) Auto Renewal Contract: No
24) Bid No: B201044
25) Contract End Date: 2/8/2024
26) Contract # Issued by Purchasing Department: CM20306
NOTES: - Change order # 20