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: IT
5) Department Contact: Lauren Michaels
6) Description: Web Application Firewall and Support
7) PEID No: 713601
8) Req No: 1101
9) Orgkey: 159100
10) Object Code: 5491301
11) Vendor: CARAHSOFT TECHNOLOGY
12) Vendor Contract No: Omnia R191902
Expenditure Budget/Revenue Projections
13) Fund Name: Information Technology
14) Fund #: 1101
15) Current Year Budgeted: 60,000
16) Current Year Projected: 65,363.28
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals:
To Be Completed by Purchasing Department
22) Contract Start Date: 4/16/2024
23) Auto Renewal Contract: No
24) Bid No: NA
25) Contract End Date: 4/30/2025
26) Contract # Issued by Purchasing Department: CM24181
NOTES: HB1295 Requested