Polleverywhere-SoleSourceJustification_REDACTED.pdf

SOLE SOURCE JUSTIFICATION FOR

ACQUISITIONS WITHIN THE SIMPLIFIED ACQUISITION THRESHOLD ($250K)

1. In accordance with Federal Acquisition Regulation 13.106-1(b)(1), I hereby determine that is available from only one source, and competition is precluded for the reasons indicated below. There are no substitutes available.

2. This acquisition is restricted to the following source:

Company:

Address:

Point of Contact:

Telephone:

Email:

3. Description of Supply/Service:

4. Estimated Total Value:

5. Check and fill in all that are applicable:

The material or service must be compatible in all aspects (form, fit, and function) with the systems presently installed.

A patent, copyright, proprietary data, or licensing agreement limits competition. The proprietary data are described as follows:

These are "direct replacement" parts/components for existing equipment.

Other information to support a sole-source buy:

CERTIFICATION

I certify that statements checked, and information provided above are complete and correct to the best of my knowledge. In accordance with FAR 13.106-1(b)(1). The facts of this acquisition preclude the use of full and open competition.

Submitted by:

Name:

Title: Date:

Approved by:

Name:

Title: Date: