Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 8/5/2024
2) Contract Type: Expense
3) Renewal Contract: No
4) Department Name: Emergency Management
5) Department Contact: Brad Burness
6) Description: Transportation services during disasters
7) PEID No: 723661
8) Req No: NA
9) Orgkey: NA
10) Object Code: NA
11) Vendor: GBJ INC. dba AFC TRANSPORTATION
12) Vendor Contract No: NA
Expenditure Budget/Revenue Projections
13) Fund Name: NA
14) Fund #: NA
15) Current Year Budgeted:
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: 8/19/2024
23) Auto Renewal Contract: No
24) Bid No: B242016
25) Contract End Date: 8/18/2025
26) Contract # Issued by Purchasing Department: CM24214
NOTES: HB1295 to be requested - Awarded in CC on 05/24/2024, Item 29