BLANK_Sole_Source_Justification_Form.pdf

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Sole Source Justification Form

Instructions:

Pursuant to the Beaverton Purchasing Code (BPC), all city procurements are required to undergo a competitive procurement process whenever practicable. An exemption to this requirement is the procurement of a good or service from a verifiable single source, or “sole source.” A sole-source purchase means that only one supplier (source) is capable of delivering the required product or service. That information is based on the requestor’s knowledge and belief and thorough research (e.g., conducting a market survey). Similar types of goods and services may exist, but only one supplier, because of expertise, and/or standardization, quality, compatibility with existing equipment, specifications, or availability, is the only source able to meet a specific need(s). If the above criteria can be met, then purchases from that source may then be exempted from a competitive purchasing process.

This Sole Source Justification Form must be completed and submitted to the Purchasing Agent for any procurement valued over $10,000 that will not be competitively bid. Requestors seeking to purchase goods or services under this exemption must seek and obtain pre-approval from the Purchasing Agent and/or Finance Director for purchases under $100,000. If the cost of the goods or services are expected to exceed $100,000, then requestors must also obtain pre-approval from the Contract Review Board and issue a public notice explaining the exemption from the procurement process.

Note: An item being a “sole brand” or a “sole manufacturer” does not automatically qualify that firm as a “sole source”.

Many manufacturers sell their products through distributors. Therefore, even if a purchase is identified as a valid “sole brand” or “sole manufacturer”, the requester should verify whether the manufacturer has multiple distributors. If the manufacturer does have multiple distributors, competition should be sought among the distributors.

1. REQUIREMENTS:

In order to qualify as a sole source good or service, at least one of the following conditions must be true: Select at least one condition applicable.

☐ The efficient utilization of existing goods requires acquiring compatible goods or services;

☐ The goods or services required to exchange software or data with other public or private agencies are available from only one source;

☐ The goods or services are for use in a pilot or experimental project; or

☐ Other findings that support the conclusion that the goods or services are only available from one source.

NAME OF STAFF MEMBER: __________________________________ DEPT: _______________________

E-MAIL: __________________________________________________ CITY EXT.: ____________________

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2. PROPOSED SUPPLIER INFORMATION:

Company Name:

Contact Person:

Address:

Phone:

E-mail:

Is the recommended company the manufacturer? ☐ Yes ☐ No Does the manufacturer sell the item(s) through distributors? ☐ Yes ☐ No

3. SOLE SOURCE in DEPTH:

Criteria for Sole Source

Licensed or Patented The supplier has a license or patent that makes them the sole provider.

One-of-a kind The commodity or service has no competitive alternatives available on the market and is available from only one supplier.

Sole Distributor The supplier is the sole distributor for the region or City.

Compatibility The commodity or service must match existing brand of equipment for compatibility and is available from only one supplier.

Replacement Part For a specific brand or existing equipment.

Warranty Sole provider of a factory authorized warranty service.

Unique Design

The commodity or service must meet physical design or quality standards and is available from only one supplier.

City Standards The commodity or service must comply with established city standards and is available from only one supplier:

1). If the justification for sole source is “Standardization” then additional supporting documentation must be provided. Please refer to BPC Chapter 50-0110.

2). Procurements of items which the City has established a standard of designating a brand name or manufacturer or by pre-approving via a testing shall be competitively bid if there is more than one supplier for the item.

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Please refer to Beaverton Purchasing Code (BPC) Chapter 50-0110 for rules on the public notice required for sole source procurements.

https://www.beavertonoregon.gov/DocumentCenter/View/72/Beaverton-Purchasing-Code-Chapter-50?bidId=

4. DESCRIPTION OF PRODUCT OR SERVICE:

a. Please identify if this a pilot program: Yes ☐ No ☐ If yes, what is the start date and end date of the pilot program? _______________________________________________________________________________

b. Description of desired good or service (including manufacturer/model, if applicable):

c. What need(s) does the city meet through this purchase?

d. If this good or service is a Pilot Program, will you be able to conduct a competitive solicitation process at the end date stated above? Yes☐ No ☐ , If ‘no,’ is marked, why?

e. How does this product uniquely meet the city’s present need(s)?

f. Would the project/program cease or fail if the city could not obtain this good or service from this particular seller?

g. How did you identify this supplier as the only source of this item or service?

https://www.beavertonoregon.gov/DocumentCenter/View/72/Beaverton-Purchasing-Code-Chapter-50?bidId=

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5. SCHEDULE:

Identify the period of time your department will be utilizing the goods or services from the Sole Source:

(i.e. 6 months, 1 year, 5 years: period of time sole source is valid)

Estimated life span of the good/length of service: ______________________

6. ESTIMATED COST: $ ______________________

CERTIFICATION STATEMENT:

By signing this form, I hereby certify the validity of the information contained above. I am confident that I understand the criteria by which the city is allowed to make a sole source procurement and I feel confident that the justification I have provided meets this criteria.

APPROVAL SIGNATURES

REQUESTOR: ____________________________________ DATE: ________________

DEPT MANAGER: ____________________________________ DATE: ________________

PURCHASING AGENT: ____________________________________ DATE: ________________

FINANCE DIRECTOR: ___________________________________ DATE: ________________