JA_GSL Solutions_KO signed_Redacted.pdf

GSL Solutions AutoNotify Control No:

Version February 2017

Nature: New Requirement Follow-on Requirement

Contract Vehicle: Purchase Order Number _______________________________ Blanket Purchase Agreement (BPA) Number _______________ Order/BPA# _______ against FSS Contract #_____ _________ Order #___________ against Multiple Award IDIQ Contract Name or #______________

Order #_______ against a single award IDC Contract

Modification # _______ to existing PO/TO/DO/Call Order

Pricing/Contract Type: Fixed Price Time & Materials/Labor Hours Cost Reimbursable Hybrid

Funds: Operations & Maintenance, Army (OMA) Other Funds: DHP

FY: 21

Name of Proposed Contractor(s) and Address:

GSL Solutions 2414 SE 125Th Ave Vancouver WA 98683-3841

Brand Name Buy: Yes No

Version February 2017

Period of Performance:

Base Year FY21 POP 1 OCT 20 - 30 SEP 21

Unlimited text/voice messages Main Pharamcy, Jennifer Moreno Clinic, Westover, Community/PX Refill, Schertz Pharmacy.

Option 1 FY22 POP 1 OCT 21 - 30 SEP 22

Unlimited text/voice messages Main Pharamcy, Jennifer Moreno Clinic, Westover, Community/PX Refill, Schertz Pharmacy.

Option 2 FY23 POP 1 OCT 22 - 30 SEP 23

Unlimited text/voice messages Main Pharamcy, Jennifer Moreno Clinic, Westover, Community/PX Refill, Schertz Pharmacy.

Option 3 FY24 POP 1 OCT 23 - 30 SEP 24

Unlimited text/voice messages Main Pharamcy, Jennifer Moreno Clinic, Westover, Community/PX Refill, Schertz Pharmacy.

Option 4 FY25 POP 1 OCT 24 - 30 SEP 25

Unlimited text/voice messages Main Pharamcy, Jennifer Moreno Clinic, Westover, Community/PX Refill, Schertz Pharmacy.

Total Value: $45,000.00

Version February 2017

FAR 13.106-1(b)(1): For purchases not exceeding the simplified acquisition threshold (SAT), only one source reasonably available, urgency, exclusive licensing agreements, brand name, or industrial mobilization.

For FAR Part 13 actions, the public display and synopsis requirements of FAR 5.101 and FAR 5.203 do not apply due to the threshold, apply and will be followed, or do not apply due to an exception at

5.202 ______________________.

Requirement to post justification in accordance with FAR 8.405-6(b)(3), FAR 13.105(c), or FAR 16.505(a)(4)(iii)(A)

Action is NOT a brand name restriction and is under $250K, no posting required Action is a brand name restriction, under $25K, no posting required Action is a brand name restriction, over $25K. It will be redacted and posted with the solicitation.

Action is a brand name restriction over $25K but will not be posted due to exception:

FAR 6.305(f) FAR 8.405-6(b)(3)(iii)(A) FAR 8.405-6(b)(3)(iii)(B) FAR 8.405-6(b)(3)(iii)(C) FAR 16.505(a)(4)(iii(C)

I certify that the supporting data under my cognizance which are included in the justification are accurate and complete to the best of my knowledge and belief.

Typed Name:

Version February 2017

Date: 2/26/2020 Title: Budget Analyst/COR

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Signature:

I hereby determine that the anticipated cost or price to the Government for this contract action will be fair and reasonable based upon

I certify that this justification is accurate and complete to the best of my knowledge and belief, and that completing this purchase as a sole source is in the best interest of the Government. Additionally, I approve this justification to limit competition subject to the availability of funds and provided that the services or supplies herein described have otherwise been authorized for acquisition.

Typed Name:

Date:

Title:

Signature:

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