36C77019Q0678-003.pdf

VHAPM Part 813.106 Simplified Acquisition Procedures: Soliciting from a Single Source Attachment 1: Single Source Justification for SAP under the SAT

VHAPM Part 813.106 Page 1 of 2 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 For

Over Micro-Purchase Threshold but Not Exceeding the SAT ($250K)

Acquisition Plan Action ID:________36C770-19-AP-0876______________

1. Contracting Activity: Department of Veterans Affairs, NCO-15 (for VA Leavenworth CMOP 5000 S.

13th Street Leavenworth, KS 66048-5580).

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

Line item

VA ID Description NDC CMOP Qty PKG

1 XV094 RESERVOIR,MINIME

D

#MMT-326A

10/BX

76300-0326-10 Leavenworth 2500 10 PER

BX

2 SET,MEDICATION

ADMINISTRATION,P

ARADIGM

SILHOUETTE,13 MM

CANNULA,

ADHESIVE

DRESSING,23 INCH

TUBING,DISPOSABL

E,STERILE

76300-0381-10 Leavenworth 800 10 PER

BX

3. Unique characteristics that limit availability to only one source, with the reason no other supplies or services can be used: 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. Contracting Officers has no authority to change Doctor prescription orders for name brand only.

VHAPM Part 813.106 Simplified Acquisition Procedures: Soliciting from a Single Source Attachment 1: Single Source Justification for SAP under the SAT

VHAPM Part 813.106 Page 2 of 2 Original Date: 08/30/17 Revision 01 Eff Date: 04/23/2018

4. Description of market research conducted and results or statement why it was not conducted:

The NAC website was searched and the requested ndc is not 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.

Joetta Eagle Date Contract Officer

Joetta M. Eagle 399755 Digitally signed by Joetta M. Eagle 399755 Date: 2019.08.20 08:23:56 -05'00'