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AVN Form S53, OCT 2015 FOR OFFICIAL USE ONLY 1

JUSTIFICATION FOR OTHER THAN FULL AND OPEN COMPETITION

FOR SOLE SOURCE AND LIMITED COMPETITION

1. Agency: _________________________________________ Contracting Activity: _______________________________________ Document Identification Number: _______________________ Solicitation Number: _______________________________________

☐ FAR Part 15 ☐ FAR Part 12 ☐ FAR Part 13.5

2. The action being approved is the acquisition of supplies/services on other than a full and open competition basis.

☐ New Action ☐ Amendment: _______________________________________________________

3. The supplies/services required to meet the using activity’s needs are described as follows:

BRIEF DESCRIPTION NSN/PN QUANTITY ESTIMATED VALUE

*If too numerous, attach list of NSNs and AMSC codes.

This acquisition:

☐ will not include an option.

☐ will include a ______% option for increased quantity. Total estimated dollar value of option quantity is $____________.

☐ will include an option to extend the term of the contract for a period of _______ months, exercisable in increments of _______ months. Total estimated dollar value of all option periods is $ ___________. The maximum dollar value of all option periods is $ __________.

The total estimated dollar value of this acquisition is: (inclusive of any options) $ ____________ The maximum dollar value of this acquisition is: (inclusive of any options) $ ____________

4. The statutory authority permitting other than full and open competition is 10 U.S.C. 2304(c)(1) – Available from only one or limited number of sources.

5. The acquisition is restricted to the only source(s) of supply known to have the capability of furnishing the required supplies/services. Source(s) are:

CAGE COMPANY NAME

The use of authority 10 U.S.C. 2304(c)(1) is based on:

☐ AMC 1. Suitable for competitive acquisition for the second or subsequent time.

☐ AMC 2. Suitable for competitive acquisition for the first time.

☐ AMC 3. Acquire, for the second or subsequent time, directly from the manufacturer.

☐ AMC 4. Acquire, for the first time, directly from the manufacturer.

☐ AMC 5. Acquire directly from the sole source contractor, who is not the manufacturer.

☐ AMSC A. The Government’s right to use data in its possession is questionable. This code is under review and will be updated when the review is complete.

☐ AMSC B. This must be acquired from a manufacturing source(s) specified on a source control drawing.

☐ AMSC C. This part required engineering source approval by the design control activity in order to maintain the quality of the part.

☐ AMSC D. The data needed to acquire this part is not economically available.

☐ AMSC H. The Government does not have sufficient, accurate, or legible data to purchase this part from other than the current source. This code is under review and will be updated when the review is complete.

Type of Contract (may include number of base years)_______________________________________________________

AVN Form S53, OCT 2015 FOR OFFICIAL USE ONLY 2

☐ AMSC K. This part must be produced from class 1 castings under MIL-STD-2175.

☐ AMSC L. The annual buy value of this part falls below the screening threshold established by DoD.

☐ AMSC M. Manufacture of this part requires use of master or coordinated tooling.

☐ AMSC N. Manufacture of this part requires special test and/or inspection facilities to maintain function or system integrity.

☐ AMSC P. The rights to use the data needed to purchase this part from additional source(s) are not owned by the Government and cannot be purchased, developed, or otherwise obtained.

☐ AMSC Q. The Government does not have adequate data, lacks rights to data, or both. It is not economical to buy the data or rights to the data.

☐ AMSC R. The Government does not own the data or rights to the data needed to purchase this part from another source. It is not economical to procure the data or rights to the data.

☐ AMSC S. Acquisition of this item is restricted to Government approved source(s) because the item involves military sensitive technology.

☐ AMSC U. The cost to the Government to breakout this part and acquire it competitively has been determined to exceed the projected savings over the life span of the part.

☐ AMSC V. This part has been designated a high reliability part. Probability of failure would be unacceptable. The engineering activity has determined that data to define and control reliability limits cannot be obtained.

☐ AMSC Y. The design of this part is unstable. Engineering, manufacturing, or performance characteristics indicate that the required design objectives have not been achieved.

☐ AMSC Z. This part is a commercial/no-developmental/off-the-shelf item.

☐ Other:___________________________________________________________________________________

6. Efforts to ensure that offers are solicited from as many sources as practicable are:

☐ The acquisition will be synopsized on or about _________________ and any firm requesting a solicitation copy will be provided one.

☐ A synopsis exception cited in FAR 5.202 applies: (Explain) ________________________________________________

☐ Manufacturers of similar products identified in the market survey will be solicited.

☐ Dealers of the manufacturers will be solicited.

☐ Other: (Explain) ___________________________________________________________________________________

7. I hereby determine that the anticipated cost to the Government will be fair and reasonable. (Explain) _________________________

8. A market survey as defined by FAR 10:

☐ was conducted, and firms indicating an interest in the acquisition will be solicited. Market research efforts, include:

☐ was not conducted due to: ___________________________________________________________________________

9. Additional facts supporting other than full and open competition are:

☐ Based upon the technical certification on file, technical data is not available and cannot be developed to permit full and open competition. The data presently available reflects the minimum needs of the Government.

☐ When FAR 6.302-1 is cited for follow-on acquisitions as described in 6.302-1(a)(2)(ii), an estimate if the cost to the

Government that would be duplicated and how the estimate was derived. ______________________________________