Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 9/26/2024
2) Contract Type: Revenue
3) Renewal Contract: Yes
4) Department Name: Sheriff’s Office
5) Department Contact: Margo Ihde
6) Description: Amendment to Interlocal Agreement with Hitchcock Police
7) PEID No: 033027
8) Req No: N/A
9) Orgkey: 1101211171
10) Object Code: 4301028
11) Vendor: City of Hitchcock
12) Vendor Contract No: Amendment
Expenditure Budget/Revenue Projections
13) Fund Name: Interlocal Agrmt - Hitchcock
14) Fund #: 1101211171 4301028
15) Current Year Budgeted: $227,615.31
16) Current Year Projected: $227,615.31
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals: $227,615.31
To Be Completed by Purchasing Department
22) Contract Start Date: 10/1/2024
23) Auto Renewal Contract: Yes
24) Bid No: NA
25) Contract End Date: 9/30/2025
26) Contract # Issued by Purchasing Department: CM23295
NOTES: