Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 12/2/2025
2) Contract Type: Expense
3) Renewal Contract: No
4) Department Name: Road & Bridge
5) Department Contact: Zach Smith
6) Description: Cementitious Slurry Material
7) PEID No:
8) Req No:
9) Orgkey: 2301312120
10) Object Code: 5324000
11) Vendor: Southern Cement Slurry
12) Vendor Contract No:
Expenditure Budget/Revenue Projections
13) Fund Name: FM Lateral Roads
14) Fund #: 2301
15) Current Year Budgeted: 1,280,000.00
16) Current Year Projected: 110,000
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals:
To Be Completed by Purchasing Department
22) Contract Start Date: 1/29/2026
23) Auto Renewal Contract: No
24) Bid No: 25-066
25) Contract End Date: 1/28/2029
26) Contract # Issued by Purchasing Department: 237906
NOTES: HB1295 requested