36C77018Q0358-003.doc

Chapter VI: Other Than Full and Open Competition (OFOC) SOP

Attachment 4: Single Source Justification for SAP under $150K

JUSTIFICATION FOR SINGLE SOURCE AWARDS IAW FAR 13.106-1

(OVER MICRO-PURCHASE THRESHOLD($3.5K) BUT NOT EXCEEDING THE SAT ($150K))

IAW FAR13.104, COs must promote competition to the maximum extent practicable to obtain supplies and services from the source whose offer is the most advantageous to the Government, considering the administrative cost of the purchase. When competition is not practicable, IAW FAR13.106-1(b), COs solicit from a single source for purchases not exceeding the simplified acquisition threshold. COs may solicit from one source if the CO determines that the circumstances of the contract action deem only one source reasonably available (e.g., urgency, exclusive licensing agreements, brand-name or industrial mobilization). IAW FAR13.106-3(b)(3),COs are required to include additional statements explaining the absence of competition (see 13.106-1 for brand name purchases) if only one source is solicited and the acquisition does not exceed the simplified acquisition threshold (does not apply to an acquisition of utility services available from only one source) or supporting the award decision if other than price-related factors were considered in selecting the supplier. This template when completed can be used to document single source awards IAW FAR13.106-3(b)(3). Note: Statements such as "only known source" or "only source which can meet the required delivery date" are inadequate to support a sole source purchase.

1. ACQUISITION PLAN ACTION ID:

1A. PROJECT/TASK No.

XXXXXXXXXXXXXX

1B. ESTIMATED AMOUNT:

XXXXXXXX

2. BRIEF DESCRIPTION OF SUPPLIES OR SERVICES REQUIRED AND THE INTENDED USE:

1 GLUCOSE SENSOR ENLITE MMT-7008 CMOPID#XH509 NDC-76300000805

2 RESERVOIR,MINIMED #MMT-332A CMOPID#XZ835 NDC-76300033210

3 CARTRIDGE,ANIMAS IR 2ML 1200#100-124-01 CMOP ID#XU057 NDC-65781001246

4 UREA 40% CREAM CMOP ID#U0004

3. UNIQUE CHARACTERISTICS THAT LIMIT AVAILABILITY TO ONLY ONE SOURCE, WITH THE REASON NO OTHER SUPPLIES OR SERVICES CAN BE USED:

This specific item/part number is the only item that meets the size requirements for individual patient’s needs. There are no known acceptable generic substitutions for these items.

4. DESCRIPTION OF MARKET RESEARCH CONDUCTED AND RESULTS OR STATEMENT WHY IT WAS NOT CONDUCTED:

Market research was conducted, and there are no known acceptable generic substitutes for these items. SDVOSB are available that can provide the items required.

5. Contracting Officer's Certification: Purchase is approved in accordance with FAR13.106-1(b). I certify that the foregoing justification is accurate and complete to the best of my knowledge and belief. Note: COs are required to make a determination of price reasonableness IAW FAR 13.106-3. See the Commercial Supply and Service SOP for Price Reasonableness templates.

Signature: _Karen R. Griffin Date:____________________

Name:__________________________________

Title:___________________________________ NCO:_________________________________

OFOC SOP Revision 05

Original Date: 03/22/11

Revision 05 Date: 05/02/2016