Contract Approval Request Form
To Be Completed by Requesting Department (#1-22)
1) Date of Request: 7/21/2026
2) Contract Type: Expense
3) Renewal Contract: No
4) Department Name: Professional Services
5) Department Contact: Diana Huallpa
6) Description (language as it will appear on agenda): Consideration of approval of FY26 Second Amendment to Financial Assistance Program Contract RFP #24-009 with St. Vincent's House submitted by Professional Services.
7) Fund Name and Number: General Fund 1101
8) Cost Center: 440100
9) Ledger Account Summary: 5481000: Miscellaneous Contract Services
10) Spend Category: Other Contract Services
11) Project Worktag (when applicable):
12) Grant Worktag (when applicable):
13) Vendor: St. Vincent’s House
14) Vendor Contract Number: ☒ Yes ☐ No: CM24318
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: 160,000
17) Current Year Projected: 30,000
18) Year 2:
19) Year 3:
20) Year 4:
21) Year 5:
22) Totals:
To Be Completed by Purchasing Department
23) Contract Start Date: 10/1/2024
24) Auto Renewal Contract: No
25) Bid No: 24-009
26) Contract End Date: 9/30/2027
27) Contract # Issued by Purchasing Department: SC-0000696 (CM24318)
NOTES: Awarded in CC - Item 100 (9/16/2024 MF)