DOA-3831 STAR Piggybacking Request - E-012-22 Tasers Accessories.doc
DOC document 696 KB Posted
- Contract number
- E-012-22
- Issued by
- Wisconsin
About this file
This document is a State of Wisconsin Department of Administration STAR Piggybacking Request form (DOA-3831) that allows state agencies to utilize existing contracts established by other Wisconsin state agencies. The form involves the Wisconsin Department of Natural Resources as the originating/contracting agency (Business Unit Number 37000) with contact Leann McGowan, and references an unspecified requesting agency seeking to piggyback on an existing contract. The supplier is Taser International, Inc. (Supplier ID 0000035907) under contract number 370003-M15-C322-LE008-01.
The contract covers law enforcement equipment including black and yellow Tasers for both left and right-hand use, holsters, and miscellaneous accessories under commodity/service code 68050. The original contract was competitively bid under Request for Bid/Proposal Number E-012-22 and runs from July 24, 2014 to July 31, 2017 with two renewal options available. The form indicates this is an open contract that allows other Wisconsin state agencies to purchase the same goods and services under the same terms and conditions established by the Department of Natural Resources, subject to approval by the State Bureau of Procurement and compliance verification requirements.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| User Guide for FY17 Taser Contract.pdf | ||
| WI DNR Renewal 2016-05-18.pdf | ||
| RFB E-012-22 - WI DNR Tasers Misc. Accessories.pdf |
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Text version
State of Wisconsin
Department of Administration
DOA-3831 (r07/2016)
S. 16.71 Wis. Stats
State Bureau of Procurement
101 East Wilson Street, 6th Floor
P. O. Box 7867
Madison, WI 53707-7867
STAR Piggybacking Request Instructions: Send the completed form via e-mail to:
Section 1: Agency Requesting Piggyback
| Agency Requesting Piggyback: |
| Agency Business Unit Number: |
| Agency Contact Name: |
| Phone Number: |
| E-Mail Address: |
FORMCHECKBOX
My agency has notified the Originating/Contracting Agency identified in Section 2 below that we intend to use their contract and they have agreed.
Section 2: Originating/Contracting Agency
| Originating/Contracting Agency: |
| Agency Business Unit Number: |
| Department of Natural Resources |
| 37000 |
| Originating/Contracting Agency Contact Name: |
| Phone Number: |
| E-Mail Address: |
| Leann McGowan |
| 608-267-9534 |
| Leann.McGowan@wisconsin.gov |
Section 3: Contract Information
| Contract Number |
| Supplier Name |
| Supplier ID Number |
| 370003-M15-C322-LE008-01 |
| Taser International, Inc. |
| 0000035907 |
| Commodity/Service Codes: |
| 68050 |
| Estimated Annual Spend: |
| $ |
Is the purchase of software included in this request? If “yes”, complete Section 5 below. Yes FORMCHECKBOX No FORMCHECKBOX
N/A FORMCHECKBOX
Section 4: Eligibility Check
FORMCHECKBOX
My agency has validated the following, in compliance with the requirements of the State Procurement Manual, PRO-D-29.
FORMCHECKBOX
Contract is Open
| Contract Effective Dates: |
| 07-24-14 to 07-31-17 |
| Renewal Options: |
| 2 |
FORMCHECKBOX
Competitively Bid
| Request for Bid/Proposal Number: |
| E-012-22 |
FORMCHECKBOX
Supplier(s) is/are not on the Certification for Collection of Sales and Use Tax Ineligible Vendor Directory
FORMCHECKBOX
Supplier(s) is/are not on the Contract Compliance Ineligible Vendor Directory
Impact, if any, on any minority business enterprise, disabled veteran-owned business or work center:
FORMCHECKBOX
Contract scope matches my agency’s need.
Description of the scope of the original procurement and how it corresponds to the commodity/service to be purchased:
Black & Yellow, Left & Right hand Tasers, Holsters and Miscellaneous Accessories
State Bureau of Procurement Use Only
Request Approved:
FORMCHECKBOX
Yes FORMCHECKBOX No Date:
Approved By (Initial):
If UW, STAR Contract Number Assigned:
Section 5: Software Purchase Impact on STAR System
State agency software purchases must be compliant with the STAR Software Purchasing Policy (see PIM 17-001 and additional reference material attached therein). Please complete Section 5 for software purchases and include a technical contact that can be reached for questions related to your agency’s request.
Agency Technical Contact Name:
Phone Number:
E-Mail Address:
FORMCHECKBOX
My agency has reviewed the in-scope modules of the STAR System and we do not consider the requested software to overlap or conflict with system functionality.
FORMCHECKBOX
My agency has reviewed the in-scope modules of the STAR System and the requested software does appear to overlap or conflict, in whole or in part, with system functionality. We hereby request that approval be granted to make the purchase.
Provide a rationale for approval of the request where there appears to be a conflict or overlap with the STAR System:
This document can be made available in alternate formats to individuals with disabilities upon request.
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