21Q0004 BNSS Redact.pdf

Sole Source Control #

Date:

MEMORANDUM FOR SIMPLIFIED ACQUISITIONS (<$150K)

From:

To:

Technical Director, NCTAMS LANT DET CUTLER

Contracting Officer, NCTAMS LANT

Subj: USE OF OTHER THAN FULL AND OPEN COMPETITION (SOLE OR LIMITED SOURCE)

Ref: (a) NCTAMS LANT DET CUTLER Procurement Request No(s) N63038

(b) Federal Acquisition Regulation 13.106-1

The supplies or services required under this requisition are available from only one or a limited number of responsible sources, and no other type of supplies or services will satisfy the Government's need. There is a reasonable basis to conclude that the Government's minimum needs can only be satisfied by unique supplies or services available only from one or a limited number of suppliers with unique capabilities. The following justification applies.

Describe the item and/or services required:

Provide

Known Source(s) for the item or services: List the source(s) (offeror(s)/vendor(s)) who are known to be able to provide the above described item and/or services.

Check which of the following applies:

"ONLY ONE RESPONSIBLE SOURCE" (example: OEM technical representative)

"LIMITED SOURCE" (example: multiple OEM authorized technical representatives)

____ "BRAND NAME SOLE SOURCE" (example: OEM replacement part)

"BRAND NAME LIMITED SOURCE" (example: multiple OEM authorized part distributors)

1. This determination for single/limited source procurement for this requirement is based on one or more of the following. Select all that apply:

A. ______RESTRICTIVE RIGHTS. The existence of proprietary rights, limited rights in data, patent rights, copyrights or secret processes make the required item or service available from only one source.

B. EXCLUSIVE LICENSING AGREEMENTS. Due to exclusive licensing agreements and arrangements, the required repair/spare parts and/or technical representative services are only available from the

Original Equipment Manufacturer (OEM) or ONLY ONE authorized distributor or technical representative.

• Identify the OEM (i.e., Motorola; Schat Harding)

• Attach evidence of the exclusive licensing agreement.

C. ___STANDARDIZATION. Only the specified make and model of equipment/parts will satisfy the

Government's needs for additional units or replacement items, and only one source is available. (i.e., ship currently has 10 Motorola radios onboard and five more need to be purchased to bring onboard allowances up to 15). Provide the following information:

• Identify Make ___________ and Model Number __________________.

• Identify other locations/equipment/detachments that have this same Make and Model Number:

D. __FORM, FIT AND FUNCTION. The required items are direct replacement parts/components for existing equipment and must be compatible in terms of form, fit and function with existing equipment/configurations. Provide the following information:

• Identify Make ________________and Model Number________________of existing onboard equipment.

• Describe how new equipment must be compatible with existing equipment’s configurations

(i.e., piping, cabling) _________________

E. UNIQUE FEATURES. Similar products lack features that are necessary to meet the Government's minimum needs (i.e., Furuno radar vs. Raytheon radar). Provide the following information:

F. OTHER REASONS. Other reasons not identified above (i.e., statutory requirement such as harbor pilot services): __________________________________________________________.

2. Anticipated dollar value of the procurement: $ kathryn.santos Text Box kathryn.santos Text Box

I hereby certify that the above information is accurate and complete to the best of my knowledge and belief.

Technical/Requirements Certification: I certify that the facts and representations under my cognizance which are included in this justification and its supporting acquisition planning documents, except as noted herein are complete and accurate to the best of my knowledge and belief.

Requestor:

Signature Name (Printed) Date

Supv./Dept. Head/Technical Approval:

Signature Name (Printed) Date

Contract Specialist/Purchasing Agent:

Signature Name (Printed) Date

Contracting Officer:

Signature Name (Printed) Date kathryn.santos Text Box kathryn.santos Text Box kathryn.santos Text Box kathryn.santos Text Box kathryn.santos Text Box kathryn.santos Text Box

1318 Commerce Ave.

Woodlands, CA 95776 POC: Debbie Storz (503) 662-7553

CAGE: 5K166