Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 11/1/2024
2) Contract Type: Expense
3) Renewal Contract: Yes
4) Department Name: Information Technology
5) Department Contact: Misty Witmer
6) Description: Consideration of approval of Nessus Professional Vulnerability Assessment, Configuration Assessment, and Malware Detection with SHI Govt Solution submitted by Information Technology
7) PEID No: 703308
8) Req No: FR501983
9) Orgkey: 1101159100
10) Object Code: 5419301
11) Vendor: SHI Gov Solution
12) Vendor Contract No: OMNIA 2024056-02
Expenditure Budget/Revenue Projections
13) Fund Name: General
14) Fund #: 1101
15) Current Year Budgeted: $5000.00
16) Current Year Projected: $3570.00
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals:
To Be Completed by Purchasing Department
22) Contract Start Date: 12/15/2024
23) Auto Renewal Contract: No
24) Bid No: NA
25) Contract End Date: 12/14/2025
26) Contract # Issued by Purchasing Department: CM25033
NOTES: HB1295 Requested