Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 1/28/2025
2) Contract Type: Expense
3) Renewal Contract: No
4) Department Name: Information Technology
5) Department Contact: Misty Witmer
6) Description: Consideration of approval of Cognizant Change order 8 for Benefit plan changes and additional support for PATT and Benefits with Cognizant Technology Solutions submitted by Information Technology
7) PEID No: 722920
8) Req No: FR502061
9) Orgkey: 1101159100
10) Object Code: 5481000
11) Vendor: Cognizant Technology Solutions
12) Vendor Contract No:
Expenditure Budget/Revenue Projections
13) Fund Name: General
14) Fund #: 1101
15) Current Year Budgeted: $125,000.00
16) Current Year Projected: $19,902.00
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals:
To Be Completed by Purchasing Department
22) Contract Start Date: 3/20/2023
23) Auto Renewal Contract: No
24) Bid No: NA
25) Contract End Date: 6/19/2026
26) Contract # Issued by Purchasing Department: SC-0000346
NOTES: HB1295 on file - Change order #8 - SC-0000346 - 206609