D-18-BO-0004_-_LSD_Redacted.pdf

LIMITED SOURCES DOCUMENTATION (SEPT 2016)

Required for Limited Source Acquisitions Over $3,500 but not Exceeding $150,000

Acquisi'lioos !hat do nol allow for competition to the maximum extent .praclioable must be documented in accordance with Federal Acquisition Regulations (FAR} 13 106-3(b; for open market purchase orders or FAR 8A05-6m for federal Supply Schedule (GSA} orders. Limited source documentation Is required fn the following clrt:Umstaru:es: (1) whetl $Oliciting fewer than the minimum number of sources (at least three soun::es) required by FAR 13 .. 104{b). 8.405-1(<:) or 3.4C'6-2lcl{2). whichever s applicable; and (2} when using brand name only specifications.

This template may be used for the documentation described in FAR 8A05-B(b}{2}© or 13 106-1 {h)(1i. The customer shalt provide the following information:

P1.1rdiase Request Number· Estimated Amount {inclusive ofop!ioos}: Delivery Date or Period of Performance:

HQ 10/1/2017-9/ 30 / 2018

Brand Name OnlyDescriptio : Recurring Requirement: FSS Contract Number (if applicable):

0VES 181 NO Cis:!YES ONO N/ A

Blief description of supplies Of services equired and the intended use SERVICE!: TOLL SERVICE FOR NEFD. TO PAY TOLLS WHEN USING ROADS THAT REQUIRE FEES FOR

USAGE . INVESTIGATIVE. STAFF ONLY USE ON OFFICIAL GOVERNMENT DUTY

Uruque characteristics that fimit availabillty 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 cntical delivery or performance dates and impact to the government if dates are n6tmet

' ONLY VENDOR IN MA THAT RONS A.l® COLLECTS TOLLS FOR FJi..ST LANE (MASS PIKE} REGUT....ATES AND Ji..DMINISTERS PROGRAM

Describe in detail any mar!Cet research conducted. Include results and state whether any vendors expressea interest

NO MARKET RESEARCH DONE. NO OTHER VENDOR AVAILABLE'

Th~acting Officer hereby certifias that G Only ooe source is reasonably available;

B. An order for the supplies or services will not be placed unless the ptice is determined to be fair and reasonable; and

c. If brand name specifications are used for the basis of this determination and lhe acquisition exceeds $25,000, this Urrnted Source Documentabon will be made available together with the solicitation m the Govemmentwide POint of Entry (FedBizOpps} m accordance with FAR 5.102(al{6}. on GSA e-Buv.in accordance with FARS 405-6fdl, or oo 1he NASA SEWP v Quote Request Tool pursuant to 40US.C. 1i302(e).

&gnawre ~title of customer J ·~ . , £, ;,,,~'7'~ ~,/ :tJ. a .0{,JL/!.1!. y ~~ ~ I· I Stgmwre ~~ :' r-rtract :pecialist

Ffi~£tS / ' V

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