E53_MISC_J_A_Final_Redacted_1.pdf

SINGLE SOURCE DETERMINATION USING

SIMPLIFIED ACQUISITION PROCEDURES (SAP) UNDER THE

SIMPLIFIED ACQUISITION THRESHOLD (SAT)

AUTHORITY: FAR 13.106-1(b)(1)

Requirement Title / Name:

Purchase Request Number:

Originating Office (Customer):

Division / Unit / Branch:

Page 1 of

1. This is a justification for other than full and open competition.

Agency:

IA Acquisition Office:

2. Description of supplies or services required to meet agency needs.

3. Identification of the single source to be solicited.

Name of Proposed Contractor:

Street Address:

City, State, Zip:

Phone:

4. Reason for authority cited. The Contracting Officer has determined the circumstances of the contract deem only one source reasonably available.

Urgency: The nature of the requirement has been deemed urgent and following competitive procedures would result in unacceptable delays.

Only One source: Highly specialized supply/service (for example technological/ specific training requirements) contractor must possess unique qualifications.

Exclusive Licensing Agreement

Other Insert reason: (could be a special statue, etc.):

5. Rationale. Provide an explanation that supports the reason cited in #4.

6. A description of efforts made to ensure that offers are solicited from as many potential sources as is practicable, including whether a notice was or will be publicized as required by Subpart 5.2 and, if not, which exception under 5.202 applies.

7. Originating Office Attestation:

I certify that the technical data which forms a basis for this justification is complete and accurate and meets the Government’s minimum needs.

8. Contracting Officer certification that the justification is accurate and complete to the best of the contracting officer’s knowledge and belief:

I hereby certify that this justification is accurate and complete to the best of my knowledge and belief.

Contracting Officer