Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 12/29/2023
2) Contract Type: Expense
3) Renewal Contract: Yes
4) Department Name: Information Technology
5) Department Contact: Misty Witmer
Description: OneSolution Remote Service Processing (RSP) Annual Maintenance with CentralSquare Technologies LLC submitted by Information Technology”
6) PEID No: 720912
7) Req No: FR403521
8) Org key: 1101-1591-00
9) Object Code: 5419301
10) Vendor: CentralSquare Technologies
11) Vendor Contract No: Service Request Number - SR-237726 and Quote Number QQ-159307
Expenditure Budget/Revenue Projections
12) Fund Name: General
13) Fund #: 1101
14) Current Year Budgeted: $163,700.00
15) Current Year Projected: $163,688.31
16) Year 2:
17) Year 3:
18) Year 4:
19) Year 5:
20) Totals:
To Be Completed by Purchasing Department
21) Contract Start Date: 4/1/2024
22) Auto Renewal Contract: Yes
23) Bid No: NA
24) Contract End Date: 3/31/2025
25) Contract # Issued by Purchasing Department: CM23211
NOTES: - HB1295 Not required - Public Company