A15-Limited Source Documentation EZ.pdf

LIMITED SOURCES DOCUMENTATION (MAR 2021)

Required for Limited Source Acquisitions Over $10,000 but not Exceeding $250,000

Acquisitions that do not allow for competition to the maximum extent practicable must be documented in accordance with Federal Acquisition Regulations (FAR) 13.106-3(b) for open market purchase orders or FAR 8.405-6(b)(2) for Federal Supply Schedule (GSA) orders. Limited source documentation is required in the following circumstances: (1) when soliciting fewer than the minimum number of sources (at least three sources) required by FAR 13.104(b), 8.405-1(c), or 8.405-2(c)(2), whichever is applicable; and (2) when using brand name only specifications.

This template may be used for the documentation described in FAR 8.405-6(b)(2)(i) or 13.106-1(b)(1). The customer shall provide the following information:

Purchase Request Number:

Estimated Amount (inclusive of options):

Delivery Date or Period of Performance:

Brand Name Only Description:

YES NO

Recurring Requirement:

YES NO

FSS Contract Number (if applicable):

Brief description of supplies or services required and the intended use:

Unique characteristics that limit availability to only one source, and any justification that no other supplies or services can be used or that urgent and compelling circumstances exist – include all critical delivery or performance dates and impact to the government if dates are not met:

Describe in detail any market research conducted. Include results and state whether any vendors expressed interest:

The Contracting Officer hereby certifies that:

A. Only one source is reasonably available;

B. An order for the supplies or services will not be placed unless the price is determined to be fair and reasonable; and C. If brand name specifications are used for the basis of this determination and the acquisition exceeds $25,000, this Limited Source

Documentation will be made available together with the solicitation and (i) posted on the Governmentwide Point of Entry (Contract Opportunities on beta.SAM.gov) in accordance with FAR 5.102(a)(6), posted on GSA eBuy in accordance with FAR 8.405-6(b)(3)(A), or posted on the NASA SEWP V Quote Request Tool pursuant to 40 U.S.C. 11302(e).

Signature and title of customer

Office Code

Telephone Number

Date

Signature and title of contract specialist

Signature of contracting officer https://www.acquisition.gov/far/part-13#FAR_13_106_3__d764e69 https://www.acquisition.gov/far/part-8#FAR_8_405_6__d477e143 https://www.acquisition.gov/far/part-13#FAR_13_104__d759e28 https://www.acquisition.gov/far/part-8#FAR_8_405_1__d472e28 https://www.acquisition.gov/far/part-8#FAR_8_405_2__d473e54 https://www.acquisition.gov/far/part-8#FAR_8_405_6__d477e143 https://www.acquisition.gov/far/part-13#FAR_13_106_1__d762e136 https://beta.sam.gov/ https://beta.sam.gov/ https://www.acquisition.gov/far/part-5#FAR_5_102__d336e68 https://www.acquisition.gov/far/part-8#FAR_8_405_6__d477e181 https://www.acquisition.gov/far/part-8#FAR_8_405_6__d477e181 https://www.sewp.nasa.gov/ http://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title40-section11302&num=0&edition=prelim