Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 8/7/2024
2) Contract Type: Expense
3) Renewal Contract: Yes
4) Department Name: District Attorney
5) Department Contact: Jack Roady
6) Description: Renewal contract for MHMR Prosecutor
7) PEID No: 711352
8) Req No:
9) Orgkey: 1101127100
10) Object Code: 5413000
11) Vendor: Christopher Johnsen
12) Vendor Contract No:
Expenditure Budget/Revenue Projections
13) Fund Name: Contract Legal Services
14) Fund #: 1101127100 - 5413000
15) Current Year Budgeted: 66,000
16) Current Year Projected: 66,000
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals: 66,000
To Be Completed by Purchasing Department
22) Contract Start Date: 10/1/2024
23) Auto Renewal Contract: No
24) Bid No: NA
25) Contract End Date: 9/30/2025
26) Contract # Issued by Purchasing Department: CM24263
NOTES: