LC Request_2300 Armed Forces Vision Tester.signed.pdf

JANUARY 13, 2021 NEBRASKA ARMY NATIONAL GUARD 1 of 2JANUARY 13, 2021 NEBRASKA ARMY NATIONAL GUARD 1 of 2

Justification for Other than Full and Open Competition MPT - $25K Instructions

CONTROL NUMBER

21-004

DATE

June 29, 2021

1a. CONTRACTING ACTIVITY b. REQUIRING ACTIVITY c. POC W91243 - NE USPF&O NE Medical Readiness Detachment SSG Travis Garrett

2a. NATURE OF ACTION Brand Name Request

b. CONTRACT ACTION New Contract

c. CONTRACT TYPE Firm Fixed Price

d. FUND TYPE O&M, Army

3a. ESTIMATED TOTAL PRICE OF REQUEST (including options, if any) b. IF APPLICABLE, ESTIMATED PRICE OF SUPPLIES/SERVICES $24,500.00

4a. NAME OF REQUIREMENT Requestor Stated: Optec 2300 Armed Forces Vision Tester

b. DESCRIPTION OF SUPPLIES/SERVICES REQUIRED TO MEET THE AGENCY'S NEED Requestor Stated: Need Optec 2300 Vision Tester IOT conduct all required vision screening tests per AR 40-501, AR 40-502 and Aeromedical APL

c. DESCRIBE THE EFFORTS TO FIND AS MANY POTENTIAL SOURCES AS POSSIBLE.

Requestor Stated: Found the manufacturer, Stereo Optics, online as the only location that had the equipment on hand.

d. HAVE ANY SOURCES EXPRESSED INTEREST IN WRITING? ?

Requestor Stated: no

5. AUTHORITY CITED

10 U.S.C. 2304(c)(1) or 41 U.S.C. 3304(a)(1) as implemented in FAR 6.302-1 Only One Responsible Source and No Other Supplies or Services Will

Satisfy Agency Requirements

6. POSTING REQUIREMENTS

None Required

7a. AUTHORITY

b. PROVIDE DETAILS OF PROCUREMENT AUTHORITY ?

Requestor Stated: AR 40-501, AR 40-502, Aeromedical APL

c. DESCRIBE HOW THIS ACTION REQUIRES THE USE OF THE AUTHORITY CITED ?

Requestor Stated: This piece of equipment is the standard vision test machine used throughout the military and

8a. COMPETITION

b. DESCRIBE THE EXTENT OF EFFECTIVE COMPETITION ANTICIPATED FOR THIS ACQUISITION ?

Contracting's Response: Soliciting on SAM.gov should provide global attention to the requirement.

c. DESCRIBE ACTIONS TAKEN, OR TO BE TAKEN, TO INCREASE COMPETITION BEFORE ANY SUBSEQUENT ACQUISITION ?

Contracting's Response: An RFI was put on GSA E-buy with no responses. The requirement will be synopsized on SAM.gov as a Brand name only rqmt.

d. DESCRIBE THE EXTENT AND THE RESULTS OF MARKET RESEARCH (FAR 10) CONDUCTED TO IDENTIFY QUALIFIED SOURCES ?

Contracting's Response: An RFI was put on GSA E-buy with no responses.

9. HAS THIS BEEN PREVIOUSLY PROCURED?

Yes, details are below. No.✔

JANUARY 13, 2021 NEBRASKA ARMY NATIONAL GUARD 2 of 2

10a. REQUIRING ACTIVITY CERTIFICATION

b. TECHNICAL AND REQUIREMENTS I certify that the supporting data included in the justification is accurate and complete to the best of my knowledge and belief.

DATE NAME

March 02, 2021 SFC Nick Reis

SIGNATURE

11a. APPROVAL

b. CONTRACTING OFFICER Fair and Reasonable Cost Determination:

I hereby determine that the anticipated cost to the government for this contract action will be Fair and Reasonable.

Certification: I certify that this Justification is accurate and complete to the best of my knowledge and belief.

(This certification shall be made by the contracting Officer who will sign the contract resulting from this Justification and Approval.)

DATE NAME

June 29, 2021 CARRIE L HANCOCK

SIGNATURE

For Official Use Only

JANUARY 13, 2021

NEBRASKA ARMY NATIONAL GUARD

of

LIMITED COMPETITION REQUEST

NEBRASKA NATIONAL GUARD

Contracting Office Joint Forces Headquarters Suite 2200 Instructions: 1. Do not touch "FOR CONTRACTING USE ONLY!". 2. Complete all fields in the form. Fields will expand if necessary. 3. Sign and save the form. 4. DO NOT TOUCH "FOR CONTRACTING USE ONLY!".

1a. REQUIRING ACTIVITY

b. POC

c. DATE

d. REQUEST TYPE

e. FUND TYPE Brand Name - a contract for the purchase of supplies or services that is entered into or proposed to be entered into by an agency after soliciting and negotiating with only one source.

Sole Source - a purchase description that calls for a particular brand-name product, or a feature of a product that is peculiar to one manufacturer, and which does not permit the offer or delivery of an equal.

Unusual and Compelling Urgency - a condition that will lead to serious injury if a procurement is not undertaken immediately. However, 10 USC 2304(f)(5)(A) and 41 USC 3304(d)(5)(A)(i) preclude the use of this exception to full and open competition if the urgency is created by lack of acquisition planning or concerns over the amount of funds available for the procurement.

2a. ESTIMATED TOTAL REQUEST PRICE (including options, if any)

b. ESTIMATED PRICE OF SUPPLIES/SERVICES (if only a portion of Total Price) 3a. NAME OF REQUIREMENT

DESCRIPTION OF SUPPLIES/SERVICES

b. DESCRIPTION OF SUPPLIES or SERVICES REQUIRED TO MEET THE AGENCY'S NEED.

c. DESCRIBE THE EFFORTS TO FIND AS MANY POTENTIAL SOURCES AS POSSIBLE.

d. HAVE ANY SOURCES EXPRESSED INTEREST IN WRITING?

SOURCE LIST (Provide Names, Phone Numbers, Email Address, etc.)

4a. AUTHORITY CITED Identify any statutory authority or internal regulation that supports your request.

b. REASON AUTHORITY CITED State explanation describing circumstances preventing full and open competition and describe what harm will come to the Government if this action is not taken.

5. HAS THIS BEEN PREVIOUSLY PROCURED?

b. CONTRACT NUMBER

c. DATE

d. COMPETITIVE STATUS

e. AUTHORITY PREVIOUSLY CITED (if OTF&O)

f. SUMMARY OF "ACTIONS TO INCREASE COMPETITION" AND EXPLANATION OF THE RESULTS.

g. IF PREVIOUSLY USED "FULL AND OPEN COMPETITION" EXPLAIN WHAT CHANGED CAUSING THIS TO NOW HAVE LIMITED SOURCES.

h. PROVIDE AN EXPLANATION OF ANY UNUSUAL PATTERNS THAT MAY BE REVEALED BY THE HISTORY, e.g., SEVERAL CONSECUTIVE, URGENT BUYS.

i. IF A JUSTIFICATION WAS PREPARED TO SUPPORT THE PROCUREMENT MADE BEFORE THIS ONE, BRIEFLY DESCRIBE THE CIRCUMSTANCES JUSTIFYING THE PROCUREMENT AND WHETHER THERE HAVE BEEN ANY SIGNIFICANT CHANGES.

j. PROVIDE ANY OTHER FACTS NECESSARY TO JUSTIFY LIMITING COMPETITION THAT WERE NOT PREVIOUSLY STATED.

Justification for Other than Full and Open Competition MPT - $25K Justification for Other than Full and Open Competition $25K - SAT Justification for Other than Full and Open Competition SAT - $700K Justification for Other than Full and Open Competition MPT - SAT Justification for Other than Full and Open Competition SAT - $700K Memorandum for Record - Limiting Competition MPT - $25K Memorandum for Record - Limiting Competition $25K - SAT Memorandum for Record - Limiting Competition MPT - SAT Limited Source Justification SAT - $700K Memorandum for Record - Absence of Competition MPT - $25K Memorandum for Record - Absence of Competition $25K - SAT Justification for Other than Full and Open Competition SAT - $700K Justification for an Exception to Fair Opportunity MPT - $30K Justification for an Exception to Fair Opportunity $30K - SAT Justification for an Exception to Fair Opportunity SAT - $700K Justification for an Exception to Fair Opportunity MPT - SAT Justification for an Exception to Fair Opportunity SAT - $700K Grey fields are customer input.

Underlined fields are form generated.

Blue fields are for contracting input.

CONTROL NUMBER

DATE

1a. CONTRACTING ACTIVITY

b. REQUIRING ACTIVITY

c. POC 2a. NATURE OF ACTION Brand Name Request Only One Responsible Source Request Brand Name Request Only One Source Request Only One Awardee is Capable Request

b. CONTRACT ACTION

c. CONTRACT TYPE

d. FUND TYPE 3a. ESTIMATED TOTAL PRICE OF REQUEST (including options, if any)

b. IF APPLICABLE, ESTIMATED PRICE OF SUPPLIES/SERVICES 4a. NAME OF REQUIREMENT Requestor Stated:

Contracting's Response:

Provide additional response?

b. DESCRIPTION OF SUPPLIES/SERVICES REQUIRED TO MEET THE AGENCY'S NEED Requestor Stated:

Contracting's Response:

Provide additional response?

c. DESCRIBE THE EFFORTS TO FIND AS MANY POTENTIAL SOURCES AS POSSIBLE.

Requestor Stated:

Provide additional response?

Contracting's Response:

d. HAVE ANY SOURCES EXPRESSED INTEREST IN WRITING?

Requestor Stated:

Contracting's Response:

Provide additional response?

Provide instructions.

5. AUTHORITY CITED

10 U.S.C. 2304(c)(1) or 41 U.S.C. 3304(a)(1) as implemented in FAR 6.302-1 Only One Responsible Source and No Other Supplies or Services Will Satisfy Agency Requirements FAR 8.405-6(b) FAR 8.405-6(a)(1)(i)(B) FAR 13.106-1(b)(1) 41 U.S.C. 1901 or 41 U.S.C. 1903 as implemented in FAR 13.501(a) Simplified Procedures for Certain Commercial Items - Sole source acquisitions FAR 16.505(a)(4)(iii) FAR 16.505(b)(2)(i)(B)

6. POSTING REQUIREMENTS

None Required Include justification with solicitation (FAR 6.302-1(c)(1)(ii)(C)) RFI or sources sought notice (DFARS 206.303-2). Post the justification within 14 days after contract award on FBO for a minimum of 30 days (FAR 6.305).

Include MFR with solicitation (FAR 13.106-1(b)(3)) Make publicly available the justification with the solicitation (FAR 13.501(a)(1)(iv)) MFR isn't posted but RFQ shall be synopsize IAW FAR 5.101 & 5.203 if greater than $15K to a public place for at least 10 days MFR isn't posted but RFQ shall be synopsize IAW FAR 5.101 & 5.203 Post the justification within 14 days after contract award on FBO for a minimum of 30 days (or if unusual and compelling urgency 30 days after contract award for a minimum of 30 days) (FAR 13.501(a)(1)(iii)) Documentation of basis for restricting to brand name shall be posted along with the RFQ to e-Buy (FAR 8.405-6(b)(3)(i)(A)) Limited Source Justification shall be posted along with the RFQ to e-Buy (FAR 8.405-6(b)(3)(i)(B)) Shall post a notice and the Limited Source Justification within 14 days after placing an order or establishing a BPA on FBO (GPE) for a minimum of 30 days (FAR 8.405-6(a)(2)(i)) Shall post a notice and the justification within 14 days after placing an order on FBO (GPE) for a minimum of 30 days (FAR 16.505(b)(2)(ii)(D)) Post justification and supporting documentation on FBO or provide the justification and supporting documentation along with solicitation to all contract awardees (FAR 16.505(a)(4)(iii)) 7a. AUTHORITY

b. PROVIDE DETAILS OF PROCUREMENT AUTHORITY Requestor Stated:

Contracting's Response:

Provide additional response?

Identify any statute or internal regulation that supports your request.

c. DESCRIBE HOW THIS ACTION REQUIRES THE USE OF THE AUTHORITY CITED Requestor Stated:

Contracting's Response:

Provide additional response?

Provide instructions.

8a. COMPETITION

b. DESCRIBE THE EXTENT OF EFFECTIVE COMPETITION ANTICIPATED FOR THIS ACQUISITION Contracting's Response:

Provide instructions.

c. DESCRIBE ACTIONS TAKEN, OR TO BE TAKEN, TO INCREASE COMPETITION BEFORE ANY SUBSEQUENT ACQUISITION Contracting's Response:

Provide instructions.

d. DESCRIBE THE EXTENT AND THE RESULTS OF MARKET RESEARCH (FAR 10) CONDUCTED TO IDENTIFY QUALIFIED SOURCES Contracting's Response:

Provide instructions.

9. HAS THIS BEEN PREVIOUSLY PROCURED?

d. CONTRACT NUMBER

e. DATE

f. COMPETITIVE STATUS

g. AUTHORITY PREVIOUSLY CITED (if OTF&O)

h. SUMMARY OF "ACTIONS TO INCREASE COMPETITION" AND EXPLANATION OF THE RESULTS.

i. IF PREVIOUSLY USED "FULL AND OPEN COMPETITION" EXPLAIN WHAT CHANGED CAUSING THIS TO NOW HAVE LIMITED SOURCES.

i. PROVIDE AN EXPLANATION OF ANY UNUSUAL PATTERNS THAT MAY BE REVEALED BY THE HISTORY, e.g., SEVERAL CONSECUTIVE, URGENT BUYS.

j. IF A JUSTIFICATION WAS PREPARED TO SUPPORT THE PROCUREMENT MADE BEFORE THIS ONE, BRIEFLY DESCRIBE THE CIRCUMSTANCES JUSTIFYING THE PROCUREMENT AND WHETHER THERE HAVE BEEN ANY SIGNIFICANT CHANGES.

k. PROVIDE ANY OTHER FACTS NECESSARY TO JUSTIFY LIMITING COMPETITION THAT WERE NOT PREVIOUSLY STATED.

10a. REQUIRING ACTIVITY CERTIFICATION

b. TECHNICAL AND REQUIREMENTS I certify that the supporting data included in the justification is accurate and complete to the best of my knowledge and belief.

DATE

NAME

SIGNATURE

c. CONTRACT SPECIALIST APPROVAL NEEDED?

c. CONTRACT SPECIALIST APPROVAL I certify that the supporting data included in the justification is accurate and complete to the best of my knowledge and belief.

DATE

NAME

SIGNATURE

11a. APPROVAL

b. CONTRACTING OFFICER Fair and Reasonable Cost Determination:

I hereby determine that the anticipated cost to the government for this contract action will be Fair and Reasonable.

Certification: I certify that this Justification is accurate and complete to the best of my knowledge and belief.

(This certification shall be made by the contracting Officer who will sign the contract resulting from this Justification and Approval.)

DATE

NAME

SIGNATURE

b. LEGAL

REVIEW DETAILS

DATE

NAME

SIGNATURE

c. SUPERVISORY CONTRACT SPECIALIST I certify that this Justification is accurate and complete to the best of my knowledge and belief.

DATE

NAME

SIGNATURE

CONTRACTING USE ONLY!

1. WHICH FAR PART ARE YOU USING?

2. NATURE OF REQUEST?

2. NATURE OF REQUEST?

2. NATURE OF REQUEST?

2. NATURE OF REQUEST?

3. PRICE ESTIMATE FOR PORTION THAT IS OTF&O COMPETITION?

3. PRICE ESTIMATE FOR PORTION THAT IS OTF&O COMPETITION?

3. PRICE ESTIMATE FOR PORTION THAT IS OTF&O COMPETITION?

3. PRICE ESTIMATE FOR PORTION THAT IS OTF&O COMPETITION?

3. PRICE ESTIMATE FOR PORTION THAT IS OTF&O COMPETITION?

3. PRICE ESTIMATE FOR PORTION THAT IS OTF&O COMPETITION?

3. PRICE ESTIMATE FOR PORTION THAT IS OTF&O COMPETITION?

3. PRICE ESTIMATE FOR PORTION THAT IS OTF&O COMPETITION?

11.0.0.20130303.1.892433.887364