Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 7/8/2024
2) Contract Type: Expense
3) Renewal Contract: No
4) Department Name: Mosquito Control District
5) Department Contact: John Marshall
6) Description: Permethrin 31% & 66% Piperonyl Butoxide
7) PEID No: 715686
8) Req No:
9) Orgkey: 2410411100
10) Object Code: 5313301
11) Vendor: Rentolil North America Inc., DBA Target Specialty Products
12) Vendor Contract No:
Expenditure Budget/Revenue Projections
13) Fund Name: Insecticides and Repellants
14) Fund #: 2410
15) Current Year Budgeted: 550,000
16) Current Year Projected: 75,000
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals:
To Be Completed by Purchasing Department
22) Contract Start Date: 7/8/2024
23) Auto Renewal Contract: No
24) Bid No: B242020
25) Contract End Date: 7/7/2025
26) Contract # Issued by Purchasing Department: CM24186
NOTES: HB1295 Requested