Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 5/27/2025
2) Contract Type: Expense
3) Renewal Contract: No
4) Department Name: Engineering
5) Department Contact: Michael Shannon
6) Description: Algoa Alta Loma & Culvert Replacement - Amendment # 2
7) PEID No: 720465
8) Req No: B221001
9) Orgkey: 2901316120
10) Object Code: 5787000
11) Vendor: Schaumburg & Polk
12) Vendor Contract No:
Expenditure Budget/Revenue Projections
13) Fund Name: ARPA
14) Fund #: 2901
15) Current Year Budgeted: $2,096,025.00
16) Current Year Projected: $349,389.00
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals: $349,389.00
To Be Completed by Purchasing Department
22) Contract Start Date: 3/7/2022
23) Auto Renewal Contract: No
24) Bid No: B221001
25) Contract End Date: 12/31/2025
26) Contract # Issued by Purchasing Department: CM21412
NOTES: Previously Awarded 12/13/2021 - Item 42b1& Executed 3/7/2022 - Item 37b - HB1295 On File - Change Order #2 is for increase of $18,240.50. New Total is $415,204.00.