Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 7/28/2025
2) Contract Type: Expense
3) Renewal Contract: No
4) Department Name: Information Technology
5) Department Contact: Misty Witmer
6) Description: Consideration of approval of CorEMR Professional Services to assist with migrating the CorEMR application with CorEMR submitted by Information Technology
7) PEID No: N/A
8) Req No: N/A
9) Orgkey: 1101159100
10) Object Code: 5481000
11) Vendor: CorEMR
12) Vendor Contract No:
Expenditure Budget/Revenue Projections
13) Fund Name: General
14) Fund #: 1101
15) Current Year Budgeted: $1,187,651.94
16) Current Year Projected: $900.00
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals:
To Be Completed by Purchasing Department
22) Contract Start Date: 8/4/2025
23) Auto Renewal Contract: No
24) Bid No: N/A
25) Contract End Date: 8/3/2026
26) Contract # Issued by Purchasing Department: 230635
NOTES: HB1295 to be requested - CorEMR Professional Services - proprietary and can only be managed by CorEMR technical staff