Brand_Name_Sole_Source_MCAS_Env_Dept__Smart_Sponges.pdf

JUSTIFICATION FOR SIMPLIFIED ACQUISITIONS

1. The listed on ____________________ is available from only one source and competition is precluded for reasons indicated below. There are no substitutes available.

2. This acquisition is restricted to the following source:

Manufacturer:

Manufacturer POC:

Manufacturer Phone Number:

Manufacturer Address:

Manufacturer’s Dealer/Representative:

Dealer/Representative Address:

Dealer/Representative Phone Number:

3. Description of the required, the estimated cost, and required delivery date.

4. Specific characteristics of the that limit the availability to a e.g., 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.

5. Check and fill in all that are applicable:

The material or service must be compatible in all aspects (form, fit, and function) with existing systems presently installed. Describe the equipment

Sole Source Justification for Simplified Acquisitions you have now and how the new item/service must coordinate, connect, or interface with the existing system:

A patent, copyright, or proprietary data limits competition. The proprietary data are described as follows:

These are “direct replacement” parts/components for existing equipment.

Other information to support a sole-source buy:

Sole Source Justification for Simplified Acquisitions

CERTIFICATION

I certify that statements checked and information provided above are complete and correct to the best of my knowledge. I understand that the processing of this Sole- Source Justification precludes the use of full and open competition.

[Project Officer] Date

[Contracting Officer] Date

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