Sole_Source_15-Q-0021.pdf

Contracts Department Form No. 45SAP (Rev 12/13)

SOLE SOURCE JUSTIFICATION FOR RE'QUIRE:MICN1'\(S) OVER $2,500.00

AND UNDER $150,000.00 (Simplified Ac11uislition)

From: (Department).~D""2"'4'-----....,-- To: 02 Contracts Department

Ref: (a) Requisition #_1cc3:..:0c::O..c.4=-83::..:5:..:9c::9 ____ _

Contractor: __ T-'-"ekt=ro"'n"'i"'x"""ln"'c"-. -----------

Items: RSA. repairs and calibrations. Est. Cost:

Required Delivery Date: 30 Sept 2015

Procurement To Be Conducted (check one of the following):

__ By Bankcard Holder Under $25,000 Letter of Agreement (LOA) A. nthnriJv ,.X_ By A2 Contracts Department (Note: Only Contracts Department Per·sont*el have GSA Schedule

Ordering Authority)

I. In accordance with reference (a) the following is submitted.

repair the unit.

The above information must be certified as to the accuracy of the facts and re!>re,lentationtscontained in the request.

VSUPINST 4200.85C Chapter 5, Paragraph 5 (e)}

Technical Representative

"Source Selection Information-See FAR 2 .. 1 and 3.104."