Contract Approval Request Form
To Be Completed by Requesting Department (#1-22)
1) Date of Request: 6/9/2026
2) Contract Type: Expense
3) Renewal Contract: No
4) Department Name: tester test
5) Department Contact: TEST
6) Description (language as it will appear on agenda): Consideration of approval of test item number 4 submitted by the County Judge
7) Fund Name and Number: 00000
8) Cost Center: 00000
9) Ledger Account Summary: 00000
10) Spend Category: 11111
11) Project Worktag (when applicable): 22222
12) Grant Worktag (when applicable): 33333
13) Vendor: Tester
14) Vendor Contract Number: ☒ Yes ☐ No: Click or tap here to enter text.
Expenditure Budget/Revenue Projections
15) Budget Amendment Requested: ☐ Yes ☒ No (if yes, provide BA request details): Click or tap here to enter text.
16) Current Year Budgeted:
17) Current Year Projected:
18) Year 2:
19) Year 3:
20) Year 4:
21) Year 5:
22) Totals:
To Be Completed by Purchasing Department
23) Contract Start Date: Click or tap to enter a date.
24) Auto Renewal Contract: Choose an item.
25) Bid No:
26) Contract End Date: Click or tap to enter a date.
27) Contract # Issued by Purchasing Department:
NOTES: