Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 6/10/2024
2) Contract Type: Expense
3) Renewal Contract: No
4) Department Name: Information Technology
5) Department Contact: Misty Witmer
6) Description: Consideration for authorization to utilize cooperative purchasing agreement in lieu of competitive bidding requirements to procure Managed Print Services on behalf of the Information Technology Department submitted by the Purchasing Agent
7) PEID No: N/A
8) Req No: N/A
9) Orgkey: 1101159100
10) Object Code: 5481000
11) Vendor: Documation
12) Vendor Contract No: DIR-CPO-4439
Expenditure Budget/Revenue Projections
13) Fund Name: General
14) Fund #: 1101
15) Current Year Budgeted: $150,000.00
16) Current Year Projected: $44,460.00
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals:
To Be Completed by Purchasing Department
22) Contract Start Date: 6/10/2024
23) Auto Renewal Contract: Yes
24) Bid No: NA
25) Contract End Date: 6/11/2025
26) Contract # Issued by Purchasing Department: CM24220
NOTES: NO PEID - Vendor is Documation - HB1295 to be requested