Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 3/20/2024
2) Contract Type: Expense
3) Renewal Contract: Yes
4) Department Name: Information Technology
5) Department Contact: Misty Witmer
6) Description: Annual Maintenance renewal for Gang & Intelligence modules in RMS.A
7) PEID No: 720952
8) Req No: FR405511
9) Org key: 1101-159100
10) Object Code: 5419301
11) Vendor: CentralSquare Technologies LLC
12) Vendor Contract No: Quote Number: Q-165704 and Service Request Number: SR-27271
Expenditure Budget/Revenue Projections
13) Fund Name: General Fund
14) Fund #: 1101
15) Current Year Budgeted: $3700.00
16) Current Year Projected: $3638.26
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals:
To Be Completed by Purchasing Department
22) Contract Start Date: 5/9/2024
23) Auto Renewal Contract: No
24) Bid No: NA
25) Contract End Date: 5/10/2025
26) Contract # Issued by Purchasing Department: CM21415
NOTES: HB1295 on file