Attachment_2_J_A.pdf

VHAPM Part 813.106 Simplified Acquisition Procedures: Soliciting from a Single Source

VHAPM Part 813.106 Page 1 of 1 Original Date: 08/30/17 Revision 01 Eff Date: 04/23/2018

DEPARTMENT OF VETERANS AFFAIRS

Justification for Single Source Awards IAW FAR 13.106-1

Acquisition Plan Action ID:___36C770-19-AP_0224___________________

1. Contracting Activity: Consolidated Mail Outpatient Pharmacy Leavenworth, KS the Department of

Veterans Affairs Network 15 Contracting Office (NCO), 3450 S. 4th St Trafficway, Leavenworth, KS 66048 is the contracting agency . Supplies will be purchased for the CMOP Leavenworth location at 5000 S. 13th St Leavenworth, KS 66048.

2. Brief Description of Supplies/ Services required and the intended use/Estimated Amount:

3. Unique characteristics that limit availability to only one source, with the reason no other supplies or services can be used: THESE MUST BE USED WITH THE INUSLIN PUMP BRAND GIVEN TO

PATIENTS. MANY VENDORS CAN SUPPLY THIS BRAND, BUT BRAND NAME MUST BE THE SAME

BRAND OF THE PUMP PATIENT HAS TO FUNCTION PROPERLY. The product is being requested to fill prescriptions where the provider specifically requested this brand for the veteran. Prescriptions are entered as DAW or Dispense as Written meaning the pharmacy is not allowed to substitute any other brand for the prescription but can only fill the prescription with the brand that was ordered by the doctor. The site is not requesting purchase from any certain vendor. Multiple vendors offer these items.

Item # Description/Part Number*

Qty

1 DEXCOM SENSOR 400

Total https://www.acquisition.gov/?q=/browse/far/13