N421582178C027 sole source justification signed.pdf

JUSTIFICATION FOR SOLE SOURCE ACQUISITION

NNSY 4255/6 (Rev 10/88)

NOTE: This form is to be used to request a Sole Source Acquisition in accordance with Title 10 USC section 2304, CICA - Public Law 98-369, FAR 6 and 13.106, and other implementing Acquisition Regulations. Contracting without providing for full and open competition shall not be justified on the basis of (1) lack of advanced planning or (2) concerns related to the amount of funds available (expiring funds), FAR 6.301(c). Statements such as "only known source" or "only known source which can meet the required delivery date" are inadequate and insufficient to support a Sole Source purchase, SUPAR 13.106(b)(2)(ii)..

It is requested that the following JML(s)/NML(s) be restricted to the following manufacturer(s):

JML(s)/NML(s): 2178C027, 042 043 Name and Div:: RB Allen City and State: No. Hampton, NH

Competition is precluded for the following reason(s):

1. Only one responsible source and no other supplies or services will satisfy agency requirements. (FAR 6.302-1).

X a. Request is for unique supplies or services available from only one source or only one supplier with unique Capabilities. (FAR 6.302-1(b)(1)) For example: 1) An accessory or addition to existing equipment.

2) Replacement parts or components of equipment for which technical data is not available or adequate. 3) Must not be used for standard commercial products.

Provide the following:

What makes this material or service unique? Be Specific!

C275 has been working with RB Allen to develop a system that meets are specific needs. Specific system software has been developed for this system that only RB Allen can provide and the associated equipment has been tailored to meet our requirements.

Make and model of equipment that parts, components, accessories, or additions are for.

Make: N/A Model N/A

N/A b. Manufacturer has possession of limited rights data, patent rights, copyrights, secret processes, license, etc. making the suppliers or services available from only one source. (FAR 6.302-1(b)(2)).

Provide the following:

Legal document number Title:

Expiration:

N/A c. Equipment or parts have been adopted as Standard Items of Supply in accordance with the DOD Standardization Program (DOD 4120.3). DFAR 6.302-1(cc) (70)) Provide documentation for standardization.

Any additional justification/documentation should be attached to this form.

I certify that the statements given above are applicable and true.

Jeff Bailey, Electrical Engineering Technician 757-396-5144 06-30-2022 Originators signature, title and code. Phone Date

CONCUR DO NOT CONCUR

Contracting Officer Signature, and code Phone Date