Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 4/10/2024
2) Contract Type: Expense
3) Renewal Contract: Yes
4) Department Name: Fleet Services
5) Department Contact: Elizabeth Bryant
6) Description: Fuel Management Software
7) PEID No: 720041
8) Req No: FR406018
9) Orgkey: 1101 172111
10) Object Code: 5419301
11) Vendor: Multiforce Systems Corporation
12) Vendor Contract No:
Expenditure Budget/Revenue Projections
13) Fund Name: General Fund - Fleet Management
14) Fund #: 1101
15) Current Year Budgeted: 7,200.00
16) Current Year Projected: 7,200.00
17) Year 2: 7,200.00
18) Year 3: 7,200.00
19) Year 4: 7,200.00
20) Year 5: 7,200.00
21) Totals: 7,200.00
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: 4/30/2025
26) Contract # Issued by Purchasing Department: CM23406
NOTES: - HB1295 Requested