Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 9/3/2024
2) Contract Type: Expense
3) Renewal Contract: Yes
4) Department Name: Information Technology
5) Department Contact: Misty Witmer
6) Description: Consideration of approval of SIP trunk change for voice communication with Centurylink Communications LLC submitted by Information Technology
7) PEID No: 709642
8) Req No: F401911
9) Orgkey: 1101159100
10) Object Code: 5492101
11) Vendor: Centurylink Communications LLC
12) Vendor Contract No: CM21386
Expenditure Budget/Revenue Projections
13) Fund Name: General
14) Fund #: 1101
15) Current Year Budgeted: $232,000.00
16) Current Year Projected: -$44.60
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals:
To Be Completed by Purchasing Department
22) Contract Start Date: 11/5/2021
23) Auto Renewal Contract: No
24) Bid No: NA
25) Contract End Date: 11/5/2025
26) Contract # Issued by Purchasing Department: CM21386
NOTES: DIR-TELE-CTSA-004 previously in CC 11/05/2021