Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 10/18/2024
2) Contract Type: Expense
3) Renewal Contract: Yes
4) Department Name: Facilities
5) Department Contact: Gus Anderson
6) Description: Alert Alarms for freezer and cooler temperature monitoring
7) PEID No: 013524
8) Req No:
9) Orgkey: 1101 170100
10) Object Code: 5481000
11) Vendor: Alert Alarms
12) Vendor Contract No:
Expenditure Budget/Revenue Projections
13) Fund Name: General
14) Fund #: 1101
15) Current Year Budgeted: $2,900.00
16) Current Year Projected:
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals:
To Be Completed by Purchasing Department
22) Contract Start Date: 10/28/2024
23) Auto Renewal Contract: No
24) Bid No: NA
25) Contract End Date: 10/27/2025
26) Contract # Issued by Purchasing Department: CM25017
NOTES: HB1295 Requested