Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 8/13/2024
2) Contract Type: Other
3) Renewal Contract: Yes
4) Department Name: Fleet Services
5) Department Contact: Elizabeth Bryant
6) Description: Consideration of approval of an interlocal agreement with the High Island Volunteer Fire Department for fuel access submitted by the Road & Bridge Department
7) PEID No: N/A
8) Req No: N/A
9) Orgkey: N/A
10) Object Code: N/A
11) Vendor: N/A
12) Vendor Contract No: N/A
Expenditure Budget/Revenue Projections
13) Fund Name: Fleet Management-Galveston
14) Fund #: 172111
15) Current Year Budgeted: $ 35,814.00
16) Current Year Projected: $ 1,000.00
17) Year 2: $ 6,000.00
18) Year 3: $ 6,000.00
19) Year 4: $ 6,000.00
20) Year 5: $ 6,000.00
21) Totals:
To Be Completed by Purchasing Department
22) Contract Start Date: 8/19/2024
23) Auto Renewal Contract: No
24) Bid No: NA
25) Contract End Date: 9/30/2026
26) Contract # Issued by Purchasing Department: CM24266
NOTES: HB1295 Not Required