Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 7/22/2024
2) Contract Type: Expense
3) Renewal Contract: No
4) Department Name: Information Technology
5) Department Contact: Misty Witmer
6) Description: Consideration of approval of change order to integrate Chase payments API with OpenGov system with Vertosoft submitted by Information Technology
7) PEID No: 722857
8) Req No: FR408102
9) Orgkey: 1101159100
10) Object Code: 5419301
11) Vendor: Vertosoft
12) Vendor Contract No: DIR-CPO-5327
Expenditure Budget/Revenue Projections
13) Fund Name: General
14) Fund #: 1101
15) Current Year Budgeted: $25,415.00
16) Current Year Projected: $25,138.12
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals:
To Be Completed by Purchasing Department
22) Contract Start Date: 5/2/2024
23) Auto Renewal Contract: No
24) Bid No: NA
25) Contract End Date: 5/2/2030
26) Contract # Issued by Purchasing Department:
NOTES: - HB1295 Requested - DIR-CPO-5327 contract term dates (05/02/2024 - 05/02/2030)