BRAND NAME JUSTIFICATION.pdf

1/19/2021 r Ventilator. Intensive Care. Adult

Brand Name Justification

Section 1: Requesting Department complete the following:

The service or material listed on is sole source, and competition is precluded for the reasons indicat!;!d below on this justification for other than full and open competition. There are no substitutes available for this material.

Restricted to the following source:

Provide original manufacturer's name {if a sole source manufacturer distributes via dealers, include dealer information as well}.

Manufacturer Details:

Name: r PHILLIPS RESPERONICS. INC.

POC: Phone Number:

Manufacturer's Dealer/Rep Details (if applicable):

Name: l First Nation Grouo. LLC OBA Jordan Res es Suoolv Comoanv

POC: f. Brent Honn Phone Number: f 480-229-5112

Description of the item/service required, estimated cost, and required delivery date:

A mobile non-invasive ventilator with humidifier attachment and probes that provides support for critical care patients with service only being required if machine malfunctions or is damaged, estimated cost $, with the requested delivery date of as soon as available.

Specific Characteristics of the material or service that limit the availability to a sole source {unique features, function of the item, etc.) Describe in detail why only this suggested source can furnish the requirements to the exclusion of other sources and the proposed contractor's unique qualifications.

Revised: 06/15 Page 1 of 4

0 0

□ Any supporting data that is the responsibility of technical or requirements personnel and which forms a basis for the justification has been certified as complete and accurate by the technical or requirements personnel (provide evidence as attachment).

List the sources, if any, that expressed, in writing, an interest in the acquisition:

0 Market research was conducted.

If no, provide a statement ot the reason market research was not conducted:

Market research was not conducted due to the manufacturer being the only one to provide new units of the particular model we are looking to acquire, the only other way to obtain units would be to purchase used units that would not likely come with the newer software we are looking for in these units.

If yes, provide a description of the market research conducted:

Provide a statement of the actions, if any, the Activity may take to remove or overcome any r arriers to competition before any subsequent acquisition for the supplies or services required:

Additional information to support the sole source justification (as needed):

Sole source justification is necessary because the need for additional units of similar model is what will give the biggest impact to providing successful patients care. It will eliminate the need for extra training to subject matter experts and will also ease the workload of the few already existing pieces of equipment that are reaching a lengthy service life.

Revised: 06/15 Page 3 of 4

Requirement approved for BRAND NAME. the suggested source is not the MFG for the requested item.