Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 11/4/2024
2) Contract Type: Expense
3) Renewal Contract: No
4) Department Name: Road & Bridge Department
5) Department Contact: Lee Crowder
6) Description: Corrugated Polyethylene and Polypropylene Pipe for culverts.
7) PEID No: BIDCON
8) Req No:
9) Orgkey: 2370 296100
10) Object Code: 5353013
11) Vendor: Core & Main LP
12) Vendor Contract No:
Expenditure Budget/Revenue Projections
13) Fund Name: Flood Control
14) Fund #: 2370
15) Current Year Budgeted: 220,000
16) Current Year Projected: 45,000
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals:
To Be Completed by Purchasing Department
22) Contract Start Date: 12/21/2025
23) Auto Renewal Contract: No
24) Bid No: 24-016
25) Contract End Date: 12/20/2025
26) Contract # Issued by Purchasing Department: CM24321
NOTES: HB1295 to be requested