QFLOW Approved JA.PDF

For All Actions At or Below the Simplified Acquisition Threshold Use for FAR Part 8, FAR Subpart 13.1, or FAR Part 16, Including Brand Name

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Memorandum for Record – Limiting Competition at or below the Simplified Acquisition Threshold

1. Contracting Activity: 411th Contracting Support Brigade, USAG Humphreys, Korea

2. Description of Action:

Nature: New Requirement Follow-on Requirement

Contract Vehicle: Purchase Order Number _ 0011678057____ 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: ________

FY: ________

Name of Proposed Contractor(s) and Address:

__ ACF Technologies _______________________ __64 Peachtree Rd #201 _____________________ __ Asheville, NC 28803_______________________

Brand Name Buy: Yes No

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3. Description of Services or Supplies:

ACF Technologies, Inc. - Estimated Bill of Materials (EBOM)

Date:

ACF Reference Number Customer Email Address Site / Project

23-Jun-21 SJC06232021a

BDAACH - Clinic Expansion

Estimate Valid for 120 days - This Hardware Only estimate does not include installation services.

Enterprise Software with Support and Maintenance ACF Hardware, New Purchase - NOTE: Includes OCONUS Shipping and 12 Months Warranty Item Product

Code Product Description Unit of

Measure Quantity

OHI

Kiosk

SEWH-ITD-

Freestanding Kiosk w ith Pre-Imaged PC, Printer, Barcode Reader and Optical Scanner

Media Player

SEWH-PKG-

Media Player Kit/Rack w ith Dual Port HDMI over CAT 6 Distribution

Enabler

PC

SEWH-MED-

Replacement Enabler PC for Kiosk or Media Player (Pre- imaged, includes brackets and Device Manager Softw are)

ACF Implementation, Development and Configuration - Onsite Services Include CONUS Travel

Item Product Code Product Description Unit of Measure Quantity

Develope r

SEWS-SCS-

Technical Scripting, Customization and Development Services

Project Manage ment

SEWS-SCS-

Project Management, Site Support

Onsite Tech

SEWS-SCS-

Onsite Technical and Installation Services

CUSTOMER ESTIMATE - SEWP w/ Admin Fees

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For Actions without Options:

Delivery Date: 60 days after receipt of order Total Value: $ ___

4. Authority:

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.

Or

FAR 8.405-6(a)(1)(i)(B) and 8.405-6(b)(1)Brand Name FAR 8.405-6(a)(1)(i)(A) Urgency FAR 8.405-6(a)(1)(i)(B) Only One Source is Capable FAR 8.405-6(a)(1)(i)(C) Logical Follow-on

Or

FAR 16.505(b)(2)(i)(B) Only One Awardee is Capable FAR 16.505(a)(4) Brand Name FAR 16.505(b)(2)(i)(A) Urgency FAR 16.505(b)(2)(i)(C) Logical Follow-on FAR 16.505(b)(2)(i)(D) Minimum Guarantee

5. Reasons for Authority Cited:

This purchase of ticketing kiosks for satellite clinics are to be added to a ticket system already in use at the main hospital. These ticketing kiosks need to be compatible with a pre-existing system. The pre-existing system has been approved for use at our health care facilities for patient tracking.

6. Publicizing Contract Actions: 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 ______________________. (Fill in exception).

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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 $150K, 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)

7. Market Research: The extensive market research was conducted by the requiring activity for this requirement via GSA & CHESS. The results of market research indicated only ACF Technologies is available and is provide of capability for this requirement at commercial market places.

8. Other Facts: This is an addition of additional hardware for a pre-existing system needing support in order to perform the installation from the same pre-existing system vendor.

9. Technical/Requirements Certification: 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.

Submitted By:

Position Title :

Email address:

Date:

10. Contracting Officer Certification/Approval: I certify that this justification is accurate and complete to the best of my knowledge and belief.

Typed Name:

Position Title:

Email address: