Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 5/7/2024
2) Contract Type: Expense
3) Renewal Contract: No
4) Department Name: Facilities
5) Department Contact: Mark A. Garcia
6) Description: O’Haver Contractors Change Order No. 21-Road & Bridge Project Manhole and base material
7) PEID No: 721831
8) Req No:
9) Orgkey: 3210312115
10) Object Code: 5781000
11) Vendor: The O’Haver Company LTD
12) Vendor Contract No: CM20306
Expenditure Budget/Revenue Projections
13) Fund Name:
14) Fund #: 3120
15) Current Year Budgeted:
16) Current Year Projected: $8,897.00
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals:
To Be Completed by Purchasing Department
22) Contract Start Date: 5/30/2021
23) Auto Renewal Contract: No
24) Bid No: B201044
25) Contract End Date: 8/31/2024
26) Contract # Issued by Purchasing Department: CM20306
NOTES:HB1295 on file