2-Pages from 216300- DataAxle Extension Part 8 for posting.pdf

Part 8 Form Version Dated 10/16/2025 i Not for Public Posting

PART 8 EXCEPTIONS REQUEST FORM

ACWESPP (SOLE SOURCE), TRIAL USE CONTRACTS, CONTRACT EXTENSIONS, CONTRACT INCREASES

Only the Utah Division of Purchasing can approve an Award of Contract Without Engaging in a Standard Procurement Process (“ACWESPP”) for an individual item that exceeds $5,000. An agency can complete the purchase using the Small Purchase Standard Procurement Process when individual item(s) are $5,000 or less and when the aggregate total does not exceed $10,000. An agency can complete quotes for small purchases when the individual item(s) exceed $5,000, and when the aggregate total for all items does not exceed $10,000.

• Email this completed form along with a copy of the quote from the vendor to purchasingsolicitations@utah.gov. The

RQM or RQS number must be in the subject line of the email.

• An urgent or unexpected circumstance or requirement for a procurement item does not justify the award of contract without engaging in a standard procurement process.

• The first two pages of this form will not be posted; however, all the subsequently numbered pages may be posted for public notice and comment. Be complete in your answers.

• WARNING: An approved and signed ACWESPP/Part 8 form does not constitute a contract. The contract or PO must be executed before any work can begin.

INCLUDE WITH THIS FORM THE FOLLOWING (as applicable):

Proposed Scope of Work or Specifications (required for all new contracts)

Quote received from the vendor. Quotes cannot be marked as confidential, as they may be published.

Any justification provided by or correspondence with the vendor.

- The requesting public entity must demonstrate an internal analysis for its justification that is not derived from vendor material or messaging.

- Any undue support, coaching or coordination provided by the vendor outside general research and inquiries may result in rejection including denial of sole source or vendor being ineligible for contract award regardless of methodology used. See Utah Administrative Rules R33-104-103(3).

Disclosure of any personal, financial, or fiduciary relationship with the vendor. If no relationship no disclosure is required.

Copy of the terms and conditions if agency requires specific or unique terms and conditions for resulting contract/PO.

Complete the following vendor information:

Vendor Name: INFOGROUP DBA DATA AXLE Vendor Contact Person: VALENCIA GUISHARD AND KEELIA SCHUMACHER Vendor E-mail Address: Valencia.Guishard@data-axle.com AND Keelia.Schumacher@data-axle.com Vendor Telephone Number: 402-836-3798

Vendor Ordering Address: 13155 NOEL ROAD, SUITE 1750

DALLAS, TX 75240

Vendor Remittance Address: PO Box 957742 St. Louis, MO 63195

Vantage Vendor Number (if available): 31694CB All items in the above section are required.

Complete the following if no Vantage number exists:

Vendor Federal Tax ID# (TIN): (9 Digits):

Type of Vendor: For-Profit Corporation

Conducting Procurement Unit Contact Information:

Department/Division Name: DPS - Division of Emergency Management (DEM)

Contact Person and Title: Denice Smith - DPS Purchasing Agent

E-mail Address: denicesmith@utah.gov Telephone Number: 801-965-4471

DTS Contact (Required for IT related ACWESPP):

mailto:purchasingsolicitations@utah.gov

Part 8 Form Version Dated 10/16/2025 ii Not for Public Posting

Technology Acquisition Approval Form (for IT purchases only): Completed - Attached Not Completed Not required/DTS pre-approved

Part 8 Form Version Dated 10/16/2025 iii Not for Public Posting

Agency Contract Insert the RQM Number: RQM 180216-8 If this request is related to an expiring or expired contract, provide the contract number and expiration date here:

Purchase Order Insert the RQS Number:

Agency Documents: Other, provide a copy to the Division of Purchasing Business Associate Agreement

Scope of Work: Is the Scope of Work attached to this Request Form? Yes No (If required State Purchasing will not process this request until it has received the proposed Scope of Work)

TO BE COMPLETED BY THE DIVISION OF PURCHASING

The public notice period shall be (Check the box that applies):

a. Procurement exceeds $50,000. Public notification must be made in accordance with Section 63G-6a-112.

b. Procurements of $50,000.00 or less are not required to be published, but may be published at the discretion of the procurement official. Published: Not Published:

c. Publication is not required for a procurement pursuant to a trial use contract.

d.

Publication is waived for an award of contract without engaging in a standard procurement process procurement:

For any procurement item identified in R33-108-101e.(2a) For other circumstances as determined in writing by the procurement official.

e. Publication was not required because this is an extension request for an existing contract and there are no funds being added.

f. Publication was not required because this is a funds increase and/or an extension request for an existing contract which was established through a competitive procurement process.

The Terms and Conditions that will be attached to the awarded agency contract/purchase order:

Agency Contract: Goods & Services Att. B IT (include Technology Acquisition Approval)

Purchase Order: Goods & Services Att. B IT (include Technology Acquisition Approval)

For Division of Purchasing Use Agent: Jody Fetzer

Solicitation #:

Commodity Code(s) (if publicly posted):

# of Vendors Sent To (if publicly posted):

Additional Research, Comments, & Recommendation:

Summary of Contest(s) Received & Determination (if applicable):

Recommend Award: Approved by Management for Award:

State Purchasing Agent Date Director, Division of Purchasing (or designee) Date