Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 3/19/2024
2) Contract Type: Expense
3) Renewal Contract: Yes
4) Department Name: Veterans Treatment Court (VTC)
5) Department Contact: Christopher James
6) Description: National Screening Center provides the drug and alcohol testing program used by the Galveston County VTC (fully grant funded by the Texas Veterans Commission)
7) PEID No: 719127
8) Req No:
9) Orgkey: 2826120903
10) Object Code: 5414010
11) Vendor: National Screening Center
12) Vendor Contract No:
Expenditure Budget/Revenue Projections
13) Fund Name: Veterans Treatment Court
14) Fund #: 2826120900
15) Current Year Budgeted: $55,200
16) Current Year Projected: $55,200
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals: $55,200
To Be Completed by Purchasing Department
22) Contract Start Date: 4/30/2024
23) Auto Renewal Contract: No
24) Bid No: NA
25) Contract End Date: 5/1/2025
26) Contract # Issued by Purchasing Department: CM21454
NOTES: