Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 6/24/2024
2) Contract Type: Other
3) Renewal Contract: No
4) Department Name: Professional Services
5) Department Contact: Betsy Thomas
6) Description: Grant-funded contract amendment to reduce the scope of work and contract amount to allow the County to pursue other eligible activities.
7) PEID No: 431945
8) Req No: NA
9) Orgkey: 2803-211157
10) Object Code: 5481000
11) Vendor: Galveston County Health District
12) Vendor Contract No: CM23181
Expenditure Budget/Revenue Projections
13) Fund Name: Jail Confinement COVID19
14) Fund #: 2803-211157
15) Current Year Budgeted: $2,660,000.00 - Grant Amount
16) Current Year Projected: $2,400,000.00 reduced to $850,000 & now reduced to $800,000
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals: $800,000.00
To Be Completed by Purchasing Department
22) Contract Start Date: 5/15/2023
23) Auto Renewal Contract: No
24) Bid No: No Bid
25) Contract End Date: 7/31/2024
26) Contract # Issued by Purchasing Department: CM23181
NOTES: