60-M0016-25-CP431_Sole Source Rquest and Determination Form.pdf.PDF

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2021 Sole Source Form

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Name of Agency: Village of ChamaI.

Agency Chief Procurement Officer: Krystal Garcia

WesTech Engineering, LLCIL i

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A sole source determination is not effective until the sole source request for determination has been posted for thirty (30) calendar days without challenge, and subsequently approved in writing by the State Purchasing Agent or, for Professional Services Agreements, the Secretary of the General Services Department. The foregoing requirement is regardless of whether the sole source request for determination has been signed by the Agency and/or the Contractor.

Term of prospective contract: 2 Months Note: For terms longer than one year, Request for Policy Exemption from DFA MUST be included.

Telephone Number:

Agency Contact for this request:

Telephone Number Email Address

Name of prospective Contractor:

SHARE Vendor Number (must be active):

Address of prospective Contractor:

Contact Name, Telephone Number Email Address:

The scope of services is to completely assemble and install four Scum Skimmers at the Chama Wastewater Treatment Plant in Chama, NM.

| STATE OF NEW MEXICO

I SOLE SOURCE REQUEST AND DETERMINATION FORM

Christian Cisney, 801-290-1461 CCISNEY ©westechwater.com

3665 S West Temple Salt Lake City, UT84115 i i

575-756-2184 Krystal Garcia 575-756-2184 krystalg@villageofchama.org i.i

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Amount of prospective contract before tax: $47,151.00 Estimated tax amount (tax is subject to change): $3,700.00

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III. Agency is required to state purpose/need of purchase and thoroughly list the services (scope of work), construction or items of tangible personal property of the prospective contract (if this is an amendment request to an existing contract, include current contract number issued

' by SPD):

%25c2%25a9westechwater.com mailto:krystalg@villageofchama.org

2021. Sole Source Form

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VIII. Provide a narrative description of the agency’s due diligence in determining the basis for the procurement, including procedures used by the agency to conduct a review of available sources such as researching trade publications, industry newsletters and the internet;;

contacting similar service providers; and reviewing the State Purchasing Divisions’ Statewide Price Agreements. Include a list of businesses contacted (do not state that no other businesses were contacted), date of contact, method of contact (telephone, mail, e-mail, other), and documentation demonstrating an explanation of why those businesses could not or would not, under any circumstances, perform the contract; or an explanation of why the agency has determined that no businesses other than the prospective contractor

This agency is the manufacturer of equipment and the only one qualified to perform this service.

Provide a detailed, sufficient explanation of how the professional service, service, construction or item(s) of tangible personal property is/are unique and how this uniqueness is substantially related to the intended purpose of the contract.

Provide a detailed, sufficient explanation of the reasons, qualifications, proprietary rights or unique capabilities of the prospective contractor that makes the prospective contractor the one source capable of providing the required professional service, service, construction or item(s) of tangible personal property. (Please do not state the source is the “best” source or the “least costly” source. Those factors do not justify a “sole source.”)

There is not another company that can provide these parts for these specific clarifier units.

Provide a detailed explanation of the criteria developed and specified by the agency as necessary to perform and/or fulfill the contract and upon which the state agency reviewed available sources. (Do not use “technical jargon;” use plain English. Do not tailor the criteria simply to exclude other contractors if it is not rationally related to the purpose of the contract.)

The skimmer arms are specifically designed for these clarifiers by this manufacturer.

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VII. Explain why other similar professional services, services, construction or item(s) of tangible personal property cannot meet the intended purpose of the contract.

This is the manufacturer of the clarifier and are the only company that can provide the materials needed to replace the needed parts.

2021 Sole Source Form can perform the contract.

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Certified by:

Agency Approval by: Date:

i Cabinet Secretary/Agency or Entity Head or Designee

APPROVED: Date:

State Purchasing Agent

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If this sole source is being submitted by a governmental agency or governmental entity not under the final authority of the State Purchasing Agent, the State Purchasing Agent’s signature is not required. The signature line may be removed from this form or marked as N/A. Hard Copy Documentation for Courtesy Postings do not need to be submitted to SPD for approval i:

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Agency Chief Procurement Officer

WesTech is the engineer, manufacturer, and distributor of the required parts for these clarifiers.

Date: