Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 7/16/2024
2) Contract Type: Expense
3) Renewal Contract: No
4) Department Name: Facilities
5) Department Contact: Veronica Van Horn
6) Description: Change Order 24 for O’Haver Contractors LTD for Road & Bridge project for earthwork
7) PEID No: 721831
8) Req No:
9) Orgkey: 3210312115
10) Object Code:5781000
11) Vendor: O’Haver Company LTD
12) Vendor Contract No: CM20306
Expenditure Budget/Revenue Projections
13) Fund Name: County Building Projects
14) Fund #: 3210
15) Current Year Budgeted:
16) Current Year Projected: $114,505.00
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals:
To Be Completed by Purchasing Department
22) Contract Start Date: 5/3/2021
23) Auto Renewal Contract: No
24) Bid No: B201044
25) Contract End Date: 9/30/2024
26) Contract # Issued by Purchasing Department: CM20306
NOTES: HB1295 on file - Change Order 24