Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 12/11/2023
2) Contract Type: Expense
3) Renewal Contract: Choose an item.
4) Department Name: Information Technology
5) Department Contact: Misty Witmer
6) Description: Network Consulting Services with Datavox
7) PEID No: 700678
8) Req No: 1101
9) Org key: 159100
10) Object Code: 5481000
11) Vendor: DataVox
12) Vendor Contract No: DIR-TSO-4167
Expenditure Budget/Revenue Projections
13) Fund Name: General Fund
14) Fund #: 1101
15) Current Year Budgeted: $30,000.00
16) Current Year Projected: $25,000.00
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals:
To Be Completed by Purchasing Department
22) Contract Start Date: 1/8/2024
23) Auto Renewal Contract: No
24) Bid No: NA
25) Contract End Date: 1/7/2025
26) Contract # Issued by Purchasing Department: CM24121
NOTES:
Quotes Included and do not require signature Presidio & Carahsoft
HB1295 Requested