Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 5/14/2024
2) Contract Type: Expense
3) Renewal Contract: No
4) Department Name: Magistrate
5) Department Contact: Aaron Johnson (409)770-5437
6) Description: Authorizing Agreement for Shelby Scott Magistrate Services
7) PEID No: 701888
8) Req No:
9) Orgkey: 1101129400
10) Object Code: 5481000
11) Vendor: Shelby Scott
12) Vendor Contract No:
Expenditure Budget/Revenue Projections
13) Fund Name: Other Contract Services
14) Fund #: 5481000
15) Current Year Budgeted: $254,000.00
16) Current Year Projected: $254,000.00
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals:
To Be Completed by Purchasing Department
22) Contract Start Date: 7/1/2024
23) Auto Renewal Contract: No
24) Bid No: NA
25) Contract End Date: 6/30/2024
26) Contract # Issued by Purchasing Department: CM24210
NOTES: Month to Month Renewal - $300.00 per Docket - HB1295 Requested