36C77018Q0718-003.pdf

Chapter VI: Other Than Full and Open Competition (OFOC) SOP Attachment 4: Single Source Justification for SAP under $150K

OFOC SOP Revision 05 Page 1 of 2 Original Date: 03/22/11 Revision 05 Date: 05/02/2016

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:

761-18-4-014-0310

1A. PROJECT/TASK

No.

761-18-4-014-0310

1B. ESTIMATED AMOUNT:

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

XI429 - CATH,INTERMITTENT VAPRO PLUS 14F H#71144

• NDC/PART# HOLLISTER #71144

• Quantity of request: 600BX – 30ea

• Supplier: HOLLISTER

Easy-to-carry package fits easily into a pocket or backpack

Protective tip helps shield the sterile catheter from bacteria located within the initial 15 mm of the distal urethra

Protective sleeve allows the catheter to be gripped anywhere along the length of the catheter

Ready-to-use hydrophilic catheter with pure catheter hydration technology. Designed to be evenly lubricated for easy insertion

Large finger hole with tear strip helps facilitate easy opening

Smooth eyelets help ease of insertion and withdrawal

Ring cap helps keep protective tip clean and protected until use

Available in both 16" (40 cm) and 8" (20 cm) lengths

Not made with natural rubber latex, phthalates-free PVC material https://www.acquisition.gov/?q=/browse/far/13 https://www.acquisition.gov/?q=/browse/far/13 https://www.acquisition.gov/?q=/browse/far/13 https://www.acquisition.gov/?q=/browse/far/13 https://www.acquisition.gov/?q=/browse/far/13 https://www.acquisition.gov/?q=/browse/far/13

Chapter VI: Other Than Full and Open Competition (OFOC) SOP Attachment 4: Single Source Justification for SAP under $150K

OFOC SOP Revision 05 Page 2 of 2 Original Date: 03/22/11 Revision 05 Date: 05/02/2016

• The estimated Purchase Order value is for this request for this item is

3. UNIQUE CHARACTERISTICS THAT LIMIT AVAILABILITY TO ONLY ONE SOURCE, WITH THE REASON NO

OTHER SUPPLIES OR SERVICES CAN BE USED:

Products have been prescribed for patients by VA Physicians. Pharmacy employees do not have the training and/or authority to countermand physician orders. “Brand Specific” products are the same thing as “dispense as written” on a physician prescription. No NDC substitutions are permitted. In the VA, Pharmacy Benefits Management (PBM) has determined that CMOP IDs in the National Drug File (NDF) will most always identify “brand specific” products in the VA PRINT NAME. This is not always inclusive where a particular NDC has been determined to be “formulation specific” by clinical evaluation performed by the PBM or in the case where only one product in the marketplace has been identified to contain the specific ingredients to match the product code.

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

CONDUCTED:

Products were searched in the NAC and GSA catalog and none of the items were found to be on contract.

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: ______________________________ Date:____________________ Name:__________________________________ Title:___________________________________ NCO:_________________________________ https://acquisition.gov/far/current/html/Subpart%2013_1.html#wp1125466 http://vaww.pclo.infoshare.va.gov/PMWeb/Vol6Chapter5.aspx