G-TIMS_Brand Name.pdf

SOLE SOURCE / NAME BRAND JUSTIFICATION

(For Other Than Full and Open Competition)

Reference: FAR 6.303-2

Section/Unit Name: ______________________________________________________

Requestor: ____________________________ Ext: ___________________________

1. State Relevance Of Purchase To Your Mission, Purpose, Research or Study:

2. Identify Supplies Or Services To Be Approved For Sole Source/Name Brand Treatment:

3. Identify Sole Source/Name Brand Manufacturer:

Name of Mfr __________________________________________________________

Mailing Address _______________________________________________________

Phone Number ________________________________________________________

Fax Number __________________________________________________________

Web Site Address (if available) ___________________________________________

4. Identify Provider/distributor of Service/Supply (if different from item 3):

Name _______________________________________

Address _____________________________________

Phone Number ________________________________

Fax Number __________________________________

5. If the Purchase is Related To Compatibility With Existing Equipment or Services, Identify the Existing Item(s) or Services:

6. Specific efforts (including market research) made to determine the availability of another source:

7. Sole Source Considerations: (Mark Only The One That Best Qualifies. Provide details in Paragraph 9)

A. FAR 6.302-1 – Only one responsible source, and no other supplies or services will satisfy Agency requirements:

[ ] Exclusive Rights - Item under patent or copyright held by a single vendor and item possesses functions or capabilities critical to use. (Attach applicable support) [ ] Exclusive Capability - Only one vendor qualified. No other potential vendors known. (Complete Section 9) [ ] Requires specially trained personnel to accomplish task.

[ ] Possesses widely known specialized expertise to accomplish task.

[ ] Possesses unique test equipment or facilities for need or task.

[ ] Responsible for integrated system performance where warranties or results will be voided if other products or vendors are introduced.

[ ] Quality of equipment from other known vendor sources have been demonstrated to be inferior or documented to be unacceptable.

[ ] Proprietary Design - Item possesses a unique function or capability critical in the use of the item and not available from any other sources.

[ ] Replacement Equipment - The purchase is for equipment associated with use of existing equipment where compatibility is essential for integrity of results. . (Complete Paragraph 8) ] Replacement Parts - The purchase is for replacement parts needed for repair of existing equipment where compatibility with equipment from the original manufacturer is paramount. (Complete Paragraph 8)

[ ] Replacement Accessories - The purchase is for accessories sought for enhancement of existing equipment where compatibility with equipment from the original manufacturer is paramount. (Complete Paragraph 8) [ ] Technical Service - The purchase is for technical services associated with the assembly, installation or servicing of equipment of a highly technical or specialized nature.

[ ] Follow-on acquisition for the continued development, production or use of specialized equipment or services.

B. FAR 6.302-2 - Unusual and compelling Urgency [ ] The Government would be seriously injured unless the agency is permitted to limit the number of sources from which to solicit bids or proposals. (Lack of advance planning is unacceptable)

(1) Explanation of the urgency:

(2) Why only the proposed Manufacturer/Supplier can meet need:

C. FAR 6.302-3 – Industrial mobilization; engineering, developmental, or research capability;

or expert services [ ] Award to this source is required in order to maintain the facility, manufacturer, or supplier available for furnishing supplies or services in case of a national emergency or mobilization.

[ ] Award is necessary to acquire the services of an expert or neutral person for any current or anticipated litigation or dispute.

D. FAR 6.302-4 – International agreement [ ] Competition precluded by the terms of an international agreement or treaty between the U.S. and a foreign government or international organization.

E. FAR 6.302-5 – Authorized or required by statute (or regulation) ] Statute (or regulation) expressly authorizes or requires that the acquisition be made from a specified source or through another agency. (Cite the statute or regulation in Paragraph 9 and provide supporting documentation.)

F. FAR 6.302-6 – National Security [ ] Disclosure of the unit’s needs would compromise national security, unless the unit is permitted to limit the number of sources from which to solicit bids or proposals.

G. FAR 6.302-7 – Public Interest [ ] Full and open competition need not be provided for when the Agency Head determines that it is not in the public interest in the particular acquisition concerned.

8. Replacement Equipment, Parts Or Accessories - (Mark One That Qualifies)

A. [ ] The item is manufactured or produced by the supplier and the supplier solely distributes (sells) direct to the customer.

B. [ ] The item is produced by the manufacturer, but not sold direct to the customer by the manufacturer, and the manufacturer solely distributes the item through a single supplier in the world, United States, or identified market area.

Note: If item is available from more than one supplier, the item can be treated as proprietary, but must be solicited from multiple sources of supply.

9. Narrative Justification - (Please Be Precise In Your Explanation)

10. I hereby certify the information provided herein to be accurate and complete to the best of my knowledge.

I understand any false or misleading information may be considered a violation under Federal Acquisition Regulations and subject to legal action.

Signature _________________________________________ Date: ___________________

Title: __________________________________________

Section Manager: ___________________________________ Date: ___________________ (Signature)

Typed Name: ______________________________________

FOR CONTRACTING USE ONLY:

It is the Contracting Officer’s determination that the anticipated cost to the Government will be fair and reasonable.

The Contracting Officer certifies that the justification is accurate and complete to the best of the Contracting Officer’s knowledge and belief.

Approved: __________________________________ Date: _______________________

Equipment must be purchased IAW Program Management Office specification as this is the only equipment tested and proven to support G/TIMS.

Clear Form: