Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 12/19/2023
2) Contract Type: Expense
3) Renewal Contract: Yes
4) Department Name: Information Technology
5) Department Contact: Misty Witmer
Description: Lenel Support Maintenance renewal with Securitas Technology
6) PEID No: 710680
7) Req No: FR402955
8) Org key: 1101159100
9) Object Code: 5423000
10) Vendor: Securitas Technology Corporation
11) Vendor Contract No: SourceWell Contact 030421-SCS
Expenditure Budget/Revenue Projections
12) Fund Name: General Fund
13) Fund #: 1101
14) Current Year Budgeted: $8300.00
15) Current Year Projected: $4095.65
16) Year 2:
17) Year 3:
18) Year 4:
19) Year 5:
20) Totals:
To Be Completed by Purchasing Department
21) Contract Start Date: 12/12/2023
22) Auto Renewal Contract: No
23) Bid No: NA
24) Contract End Date: 12/11/2024
25) Contract # Issued by Purchasing Department: CM23114
NOTES: