A.02.12 Attachment K - SO SSJ Form.pdf

SO REQUEST NO.:

CONRACTOR: Receipt & Acceptance Acknowledged.

E-SIGNED & DATED:

A Market Survey has been conducted to determine whether other potential sources capable of satisfying the requirement exist. A list of the suppliers contacted, along with the reason why each supplier could not meet the requirement is included to justify this sole source.

Customer’s directive; Supplier is named by the funding source, inter-agency agreement or facility’s operation where the identical equipment is required for compatibility and continuity of operation or research.

Detailed description of why a sole source justification is required.

Unique expertise, background in recognized field of endeavor, the result of which may depend primarily on the individual's invention, imagination, or talent. Consultant has advanced or specialized knowledge, or expertise gained over an extensive period of time in a specialized field of experience.

Patented items or copyrighted materials, which are only available from the patent or copyright holder.

Replacement or spare parts are required from the OEM, and the OEM does not have distributors for those parts.

Maintenance or repair calls by the OEM are required for a piece of equipment, and the manufacturer does not have multiple agents to perform these services.

SERVICE ORDER SOLE SOURCE JUSTIFICATION

Subcontractor for Sole Source Justification

Please check the applicable boxes for the service order.

Item required must be identical to equipment already in use by the end user, to insure compatibility of equipment, and that item is only available from one source; same reasoning applied in the continuation of research situation.

Only one manufacturer makes the item meeting salient specifications; that manufacturer only sells direct/exclusively through one regional/national representative;

CONTRACT & TO NO.:

APPENDIX H - SERVICE ORDER SOLE SOURCE JUSTIFICATION FORM