Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 6/27/2025
2) Contract Type: Expense
3) Renewal Contract: Yes
4) Department Name: Information Technology
5) Department Contact: Misty Witmer
6) Description: Consideration of approval of Palo Threat Prevention for 415’s renewal with MGT Impact Solutions LLC submitted by Information Technology
7) PEID No: Pending PEID
8) Req No: N/A
9) Orgkey: 1101159100
10) Object Code: 5423000
11) Vendor: MGT Impact Solutions LLC
12) Vendor Contract No: TIPS 230105
Expenditure Budget/Revenue Projections
13) Fund Name: General
14) Fund #: 1101
15) Current Year Budgeted: $10,000
16) Current Year Projected: $11,453.29
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals:
To Be Completed by Purchasing Department
22) Contract Start Date: 9/1/2025
23) Auto Renewal Contract: No
24) Bid No: N/A
25) Contract End Date: 8/30/2026
26) Contract # Issued by Purchasing Department: 227771
NOTES: TIPS 230105