Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 2/23/2024
2) Contract Type: Expense
3) Renewal Contract: No
4) Department Name: Information Technology
5) Department Contact: Misty Witmer
6) Description: Cognizant change order 4 Workday Implementation scope changes with Cognizant Technology Solutions submitted by Information Technology
7) PEID No: 722920
8) Req No: PO#F314752
9) Org key: 11011159100
10) Object Code: 5746100
11) Vendor: Cognizant
12) Vendor Contract No: CM23184
Expenditure Budget/Revenue Projections
13) Fund Name: General Fund
14) Fund #: 1101
15) Current Year Budgeted: $124,726.00
16) Current Year Projected: $124,726.00
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals:
To Be Completed by Purchasing Department
22) Contract Start Date: 3/4/2024
23) Auto Renewal Contract: No
24) Bid No: NA
25) Contract End Date: 8/4/2024
26) Contract # Issued by Purchasing Department: CM23184
NOTES: HB1295 on File - Change order #4