Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 4/5/2024
2) Contract Type: Expense
3) Renewal Contract: No
4) Department Name: Contract Services
5) Department Contact: Sergio Cruz
6) Description: 1ST FY24 AMENDMENT FOR FINANCIAL ASSISTANCE
7) PEID No: 720543
8) Req No: Salvation Army
9) Orgkey: 1101440100
10) Object Code: 5481000
11) Vendor: Salvation Army
12) Vendor Contract No: CM21368
Expenditure Budget/Revenue Projections
13) Fund Name: General Fund
14) Fund #: 1101
15) Current Year Budgeted: $160,000
16) Current Year Projected: $20,000
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals:
To Be Completed by Purchasing Department
22) Contract Start Date: 11/29/2021
23) Auto Renewal Contract: Choose an item.
24) Bid No: B212033A
25) Contract End Date: 9/30/2024
26) Contract # Issued by Purchasing Department: CM21368
NOTES: