Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 3/4/2025
2) Contract Type: Expense
3) Renewal Contract: Yes
4) Department Name: County Clerk/Elections
5) Department Contact: Wendi Fragoso
6) Description: Poll Pads
7) PEID No: 406853
8) Req No:
9) Orgkey: 2103-114031
10) Object Code: 5750000
11) Vendor: Hart Intercivic
12) Vendor Contract No:
Expenditure Budget/Revenue Projections
13) Fund Name: Election Srvs Contract Fund
14) Fund #: 2103
15) Current Year Budgeted: 400,000
16) Current Year Projected:
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals:
To Be Completed by Purchasing Department
22) Contract Start Date: 3/17/2025
23) Auto Renewal Contract: No
24) Bid No: N/A
25) Contract End Date: 3/16/2026
26) Contract # Issued by Purchasing Department: SC-0000803 - Bonfire # 214168
NOTES: HB1295 Requested