Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 8/4/2025
2) Contract Type: Expense
3) Renewal Contract: No
4) Department Name: Information Technology
5) Department Contact: Misty Witmer
6) Description: Consideration of approval of CorEMR Electronic Medical Records application with CorEMR submitted by Information Technology
7) PEID No: Pending
8) Req No: N/A
9) Orgkey: 1101159100
10) Object Code: 5481000
11) Vendor: CorEMR
12) Vendor Contract No:
Expenditure Budget/Revenue Projections
13) Fund Name: General
14) Fund #: 1101
15) Current Year Budgeted: $3300.00
16) Current Year Projected: $3300.00
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals:
To Be Completed by Purchasing Department
22) Contract Start Date: 8/1/2025
23) Auto Renewal Contract: No
24) Bid No: N/A
25) Contract End Date: 7/31/2026
26) Contract # Issued by Purchasing Department: 230635
NOTES: CorEMR Professional Services - UTMB / Jail Medical, approved in CC on 08/04/2025 - HB1295 to be requested upon supplier PEID.