Contract Approval Request Form
To Be Completed by Requesting Department (#1-22)
1) Date of Request: 9/17/2026
2) Contract Type: Expense
3) Renewal Contract: Yes
4) Department Name: Mosquito Control District
5) Department Contact: Ashley Wilson
6) Description (language as it will appear on agenda): Consideration of a Renewal of a Service Agreement with Mike Jones, a certificated airplane pilot for mosquito aerial spraying, submitted by Mosquito Control Manager
7) Fund Name and Number: Mosquito Control District 2410
8) Cost Center: 411100
9) Ledger Account Summary: 5481000 Miscellaneous Contract
10) Spend Category: Other Contract Services
11) Project Worktag (when applicable):
12) Grant Worktag (when applicable):
13) Vendor: Mike Jones
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: $50,000
17) Current Year Projected: $15,000
18) Year 2:
19) Year 3:
20) Year 4:
21) Year 5:
22) Totals: $15,000
To Be Completed by Purchasing Department
23) Contract Start Date: 10/1/2026
24) Auto Renewal Contract: No
25) Bid No: N/A
26) Contract End Date: 9/30/2027
27) Contract # Issued by Purchasing Department: SC-0001103
NOTES: