Contract Approval Request Form
To Be Completed by Requesting Department (#1-22)
1) Date of Request: 10/26/2026
2) Contract Type: Expense
3) Renewal Contract: No
4) Department Name: Facilities
5) Department Contact: Misty Witmer
6) Description: Consideration of approval to award RFP 26-116, Plumbing Equipment and Supplies submitted by the Purchasing Agent.
7) Fund Name and Number: General, 1101
8) Cost Center: 170100
9) Ledger Account Summary: 5354000
10) Spend Category: Repairs and Maintenance for buildings- goods
11) Project Worktag (when applicable):
12) Grant Worktag (when applicable):
13) Vendor: Hajoca Moore Supply
14) Vendor Contract Number: ☐ Yes ☐ No: Click or tap here to enter text.
Expenditure Budget/Revenue Projections
15) Budget Amendment Requested: ☐ Yes ☐ No (if yes, provide BA request details): Click or tap here to enter text.
16) Current Year Budgeted: $5,000.00
17) Current Year Projected: $5,000.00
18) Year 2:
19) Year 3:
20) Year 4:
21) Year 5:
22) Totals:
To Be Completed by Purchasing Department
23) Contract Start Date: 10/26/2026
24) Auto Renewal Contract: Yes
25) Bid No: 26-116
26) Contract End Date: 10/25/2031
27) Contract # Issued by Purchasing Department: SC-0001169
NOTES: Three (3) years with two (2) one (1) year automatic extensions