Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 6/17/2024
2) Contract Type: Expense
3) Renewal Contract: No
4) Department Name: Facilities
5) Department Contact: Veronica Van Horn
6) Description: Fire Extinguisher repairs for Galveston County Jail
7) PEID No: 723688
8) Req No:
9) Orgkey: 1101 170100
10) Object Code: 5481000
11) Vendor: Summit Fire & Security
12) Vendor Contract No: BuyBoard 654-21
Expenditure Budget/Revenue Projections
13) Fund Name: General
14) Fund #: 1101
15) Current Year Budgeted:
16) Current Year Projected: $5,783.00
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals:
To Be Completed by Purchasing Department
22) Contract Start Date: 12/1/2018
23) Auto Renewal Contract: No
24) Bid No: NA
25) Contract End Date: 11/30/2024
26) Contract # Issued by Purchasing Department: CM24216
NOTES: BuyBoard 654-21 - HB1295 Requested