Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 4/19/2024
2) Contract Type: Expense
3) Renewal Contract: Yes
4) Department Name: IT
5) Department Contact: Lauren Michaels
6) Description: Change order #5 for staff augmentation for financials and payroll support with KOA Hills Consulting
7) PEID No: 722283
8) Req No: F403442
9) Orgkey: 1101159115
10) Object Code: 5481000
11) Vendor: KOA Hills Consulting
12) Vendor Contract No: CM21337
Expenditure Budget/Revenue Projections
13) Fund Name: General Fund
14) Fund #: 1101
15) Current Year Budgeted: 364200
16) Current Year Projected: 364200
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals:
To Be Completed by Purchasing Department
22) Contract Start Date: 11/15/2021
23) Auto Renewal Contract: No
24) Bid No: NA
25) Contract End Date: 11/30/2024
26) Contract # Issued by Purchasing Department: CM21337
NOTES: HB1295 is on file - Change Order #5