Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 9/9/2024
2) Contract Type: Expense
3) Renewal Contract: No
4) Department Name: Facilities
5) Department Contact: Veronica Van Horn
6) Description: Change Order 2 for sprinkler, plumbing, piping, etc due to structural elevation
7) PEID No: 721935
8) Req No:
9) Orgkey: 2901 412110
10) Object Code: 5781000
11) Vendor: Construction LTD
12) Vendor Contract No: CM24129
Expenditure Budget/Revenue Projections
13) Fund Name: ARPA
14) Fund #: 2901
15) Current Year Budgeted: $16,291,717.00
16) Current Year Projected: $11,010,247.21
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals:
To Be Completed by Purchasing Department
22) Contract Start Date: 2/19/2024
23) Auto Renewal Contract: No
24) Bid No: B241016
25) Contract End Date: 2/18/2025
26) Contract # Issued by Purchasing Department: CM24129
NOTES: Change Order #2 - HB1295 Requested