Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 11/13/2024
2) Contract Type: Other
3) Renewal Contract: No
4) Department Name: Professional Services
5) Department Contact: Betsy Thomas
6) Description: Interlocal Agreement with Bolivar Peninsula Special Utility District for match requirement of $15,000 for the CDBG Community Development Fund grant project from the Texas Department of Agriculture.
7) PEID No: 708995
8) Req No:
9) Orgkey:
10) Object Code:
11) Vendor: Bolivar Peninsula Special Utility District
12) Vendor Contract No:
Expenditure Budget/Revenue Projections
13) Fund Name: TBD upon grant award
14) Fund #: TBD upon grant award
15) Current Year Budgeted: TBD upon award
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: 11/25/2024
23) Auto Renewal Contract: No
24) Bid No: NA
25) Contract End Date: 11/24/2025
26) Contract # Issued by Purchasing Department: CM25054
NOTES: