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: Yes
4) Department Name: County Clerk/Elections
5) Department Contact: Wendi Fragoso
6) Description: Data On-Demand License
7) PEID No: 716710
8) Req No:
9) Orgkey: 2103114031
10) Object Code: 5481000
11) Vendor: Compu-Data International LLC
12) Vendor Contract No: CM23367
Expenditure Budget/Revenue Projections
13) Fund Name: Other Contract Services
14) Fund #: 2103
15) Current Year Budgeted: 35,000.00
16) Current Year Projected: 30,000.00
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals:
To Be Completed by Purchasing Department
22) Contract Start Date: 10/1/2024
23) Auto Renewal Contract: Yes
24) Bid No: NA
25) Contract End Date: 9/30/2025
26) Contract # Issued by Purchasing Department: CM23367
NOTES: HB1295 Requested