Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 4/30/2024
2) Contract Type: Expense
3) Renewal Contract: Yes
4) Department Name: Information Technology
5) Department Contact: Misty Witmer
6) Description: Pingdom monitoring tool for county hosted services
7) PEID No: 703308
8) Req No: FR406431
9) Org key: 1101-1591-00
10) Object Code: 5419301
11) Vendor: SHI GOVT Solutions
12) Vendor Contract No: DIR-TSO-4317
Expenditure Budget/Revenue Projections
13) Fund Name: General
14) Fund #: 1101
Current Year Budgeted: $3500.00
Current Year Projected: $738.42
15) Year 2:
16) Year 3:
17) Year 4:
18) Year 5:
19) Totals:
To Be Completed by Purchasing Department
20) Contract Start Date: 7/9/2024
21) Auto Renewal Contract: No
22) Bid No: NA
23) Contract End Date: 7/9/2025
24) Contract # Issued by Purchasing Department: CM23335
NOTES: HB1295 on file - DIR-TSO-4317