Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 3/3/2026
2) Contract Type: Expense
3) Renewal Contract: No
4) Department Name: Professional Services
5) Department Contact: Diana Huallpa
6) Description: FY26 1st additional request financial assistance award
7) PEID No: 716081
8) Req No:
9) Orgkey: 1101440100
10) Object Code: 5481000
11) Vendor: M.I. Lewis
12) Vendor Contract No: CM24319
Expenditure Budget/Revenue Projections
13) Fund Name: General Fund
14) Fund #: 1101
15) Current Year Budgeted: $160,000
16) Current Year Projected: $40,000
17) Year 2: $40,000
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals:
To Be Completed by Purchasing Department
22) Contract Start Date: 10/1/2024
23) Auto Renewal Contract: No
24) Bid No: 24-009 (CM24318)
25) Contract End Date: 9/30/2026
26) Contract # Issued by Purchasing Department: 217731 (SC-0000697)
NOTES: