Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 3/26/2024
2) Contract Type: Revenue
3) Renewal Contract: Yes
4) Department Name: Facilities
5) Department Contact: Veronica Van Horn
6) Description: Congressman Randy Weber Lease Amendment
7) PEID No: 071282
8) Req No:
9) Orgkey: 1101-170100
10) Object Code: 4831015
11) Vendor: Galveston County
12) Vendor Contract No: CM23194
Expenditure Budget/Revenue Projections
13) Fund Name: General
14) Fund #: 1101
15) Current Year Budgeted: $19,143.00
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: 5/1/2024
23) Auto Renewal Contract: No
24) Bid No: NA
25) Contract End Date: 1/2/2025
26) Contract # Issued by Purchasing Department: CM23194
NOTES:
Lease Extension until 01/02/2025 - HB1295 Not Required