Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 3/13/2024
2) Contract Type: Expense
3) Renewal Contract: Yes
4) Department Name: Professional Services
5) Department Contact: Veronica Van Horn
6) Description: Project management for implementation of system improvement recommendations from justice system assessment
7) PEID No: 720375
8) Req No:
9) Orgkey: 1101-110000
10) Object Code: 5481000
11) Vendor: Meadows Mental Health Policy Institute for Texas
12) Vendor Contract No:
Expenditure Budget/Revenue Projections
13) Fund Name: General Govt
14) Fund #: 1101
15) Current Year Budgeted:
16) Current Year Projected: $86,200.00
17) Year 2: $86,200.00
18) Year 3: $86,200.00
19) Year 4:
20) Year 5:
21) Totals: $258,600.00
To Be Completed by Purchasing Department
22) Contract Start Date: 4/17/2021
23) Auto Renewal Contract: No
24) Bid No: NA
25) Contract End Date: 4/16/2025
26) Contract # Issued by Purchasing Department: CM21256
NOTES: HB1295 on File