Information Resource Request (Irr) # - -

INFORMATION RESOURCE REQUEST (IRR) #______

To: From: District ____ Office Symbol ______The Ounce of Prevention Fund of Florida Healthy Families Florida PROJECT NAME HF #15-16-__ Terry Rhodes Telephone: Telephone: 850-921-4494 x 138 Fax Connectivity: Strategic Plan: ___LAN ___LAN with Gateway ___Statewide (Resources Referenced on Page ______) ___Mainframe ___District (Resources Referenced on Page ______) Specify Mainframe System ______If not in any Strategic Plan, please see below. Requirements/Benefits (If not in any Strategic Plan): The funds for this IT equipment/software are allocated in the contract budget for contract #LJ910 with the Ounce of Prevention Fund of Florida, Inc. (Healthy Families Florida). This equipment is needed to in order to maintain consistent, effective Healthy Families program operations and meet contractual requirements.

*Attach 3 Vendor Quotes * 4 Year warranty on all computers * All new laptops require a 4-year license for Computrace or GHE Endpoint encryption software

1) What the issue is, ie, what we are trying to accomplish 2) How we propose to fix the issue, ie, the product and why we selected it. If possible how it will work with existing systems. - 3) Who/where the items will be installed. 4) If replacing hardware, what will happen to what is replaced, surplus? re-deployed ? 5) What the impact to the Department will be if the items aren't approved. 6) Request adheres to DCF standards yes or no, if no, explain

1. Requestor Date 2. Supervisor/Manager Date

3. Budget Director Date 4. Provider/Contract Representative Date

5. Provider/Contract Representative Date Valid Until: Total: $ IT Approval

1 OCW Revised 02/20/14

(A) Product Costs (list each item separately) Unit Total Line Qty Description/Vendor/Purchase Method Price Price 1.

(B) Support Costs Cost (A) Subtotal $ Product Costs Installation $ (B) Subtotal $ Training $ Support Costs Maintenance $ Total (A+B) $

Applies to Line Item Number(s) Applies to Line Item Number(s) Applies to Line Item Number(s) (C) Funding OCA Category Organization Code L1,GF,SF,FID,%, if needed Budget Entity District Fund Source Code For Department Use Only:

Contract Manager:

Concur ______Non-Concur ______Reviewer ______Date ______

Senior Management:

Budget:

As of ______there are funds and support available for this IRR. ______

2 OCW Revised 02/20/14

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Information Resource Request (Irr) # - -