Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 2/6/2025
2) Contract Type: Other
3) Renewal Contract: Yes
4) Department Name: Parks and Cultural Services
5) Department Contact: Julie Walker
6) Description: UTMB is going to provide clinical hours for students at our senior centers
7) PEID No: 402812
8) Req No:
9) Orgkey:
10) Object Code:
11) Vendor: UTMB
12) Vendor Contract No:
Expenditure Budget/Revenue Projections
13) Fund Name: N/A
14) Fund #:
15) Current Year Budgeted:
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: 2/17/2025
23) Auto Renewal Contract: No
24) Bid No: NA
25) Contract End Date: 2/16/2026
26) Contract # Issued by Purchasing Department: Bonfire # 207346 - SC-0000787
NOTES:
This is a no fee agreement. ML 2/6/2025 - HB1295 Not Required