Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 9/6/2024
2) Contract Type: Expense
3) Renewal Contract: No
4) Department Name: Fleet Services
5) Department Contact: Elizabeth Bryant
6) Description: Vehicle Repairs
7) PEID No: 123026
8) Req No:
9) Orgkey:
10) Object Code:
11) Vendor: Liggio’s Tire and Service Center, Inc.
12) Vendor Contract No: CM24239
Expenditure Budget/Revenue Projections
13) Fund Name: Fleet Management
14) Fund #: 1101 172111
15) Current Year Budgeted: $9,000.00
16) Current Year Projected: $9,000.00
17) Year 2: $100,000.00
18) Year 3: $100,000.00
19) Year 4: $100,000.00
20) Year 5: $100,000.00
21) Totals:
To Be Completed by Purchasing Department
22) Contract Start Date: 9/29/2024
23) Auto Renewal Contract: No
24) Bid No: 24-005
25) Contract End Date: 9/28/2024
26) Contract # Issued by Purchasing Department: CM24239
NOTES: HB1295 Requested