Contract Approval Request Form
 
To Be Completed by Requesting Department (#1-21)
 
1)                     Date of Request: 10/4/2024
2)                     Contract Type: Expense
3)                     Renewal Contract: Yes
4)                     Department Name: Criminal Investigations Division
5)                     Department Contact: Hargrove 5245
6)                     Description: Investigations System
 
7)                     PEID No: 716169
8)                     Req No: N/A
9)                     Orgkey: 1101211121
10)                     Object Code: 5481000
11)                     Vendor: Leads Online LLC
12)                     Vendor Contract No: 
 
Expenditure Budget/Revenue Projections
 
13)                     Fund Name: 
14)                     Fund #: 
15)                     Current Year Budgeted: $18,208.00  
16)                     Current Year Projected: $18,208.00
17)                     Year 2: 
18)                     Year 3: 
19)                     Year 4: 
20)                     Year 5: 
21)                     Totals: 
 
To Be Completed by Purchasing Department
 
22)                     Contract Start Date: 11/1/2024
23)                     Auto Renewal Contract: Yes
24)                     Bid No: NA
25)                     Contract End Date: 10/31/2025
26)                     Contract # Issued by Purchasing Department: CM20053
 
NOTES: HB1295 on file