Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 10/1/2024
2) Contract Type: Expense
3) Renewal Contract: No
4) Department Name: Road & Bridge Department
5) Department Contact: Lee Crowder
6) Description: Grader Blade for Skid Steer Loader
7) PEID No: 710899
8) Req No:
9) Orgkey: 2370 296100
10) Object Code: 5741000
11) Vendor: Mustang CAT
12) Vendor Contract No: Source Well 011723-CAT
Expenditure Budget/Revenue Projections
13) Fund Name: Flood Control
14) Fund #: 2370
15) Current Year Budgeted: 27,500
16) Current Year Projected: 24,997
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals:
To Be Completed by Purchasing Department
22) Contract Start Date: 10/15/2024
23) Auto Renewal Contract: No
24) Bid No: NA
25) Contract End Date: 10/14/2025
26) Contract # Issued by Purchasing Department: CM25001
NOTES: