Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 5/12/2026
2) Contract Type: Revenue
3) Renewal Contract: No
4) Department Name: Tax Office
5) Department Contact: Cheryl E. Johnson
6) Description: Interlocal Collection Agreement for City of Dickinson for Bayou Bend No. 4 PID
7) PEID No: 406676
8) Req No: N/A
9) Orgkey: 1101 151553
10) Object Code: 4401000
11) Vendor: City of Dickinson
12) Vendor Contract No: Interlocal Collection Agreement for City of Dickinson for Bayou Bend No. 4 PID
Expenditure Budget/Revenue Projections
13) Fund Name: Collection Contract Fee
14) Fund #: 4401000
15) Current Year Budgeted: Annual amount not to exceed $0.27 per parcel
16) Current Year Projected: Annual amount not to exceed $0.27 per parcel
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals: Annual amount not to exceed $0.27 per parcel
To Be Completed by Purchasing Department
22) Contract Start Date: Click or tap to enter a date.
23) Auto Renewal Contract: Choose an item.
24) Bid No:
25) Contract End Date: Click or tap to enter a date.
26) Contract # Issued by Purchasing Department:
NOTES: Revenue Agreement