Redacted Sole Source W340.pdf
PDF 395 KB Posted
- Attached to
- BUS ASSEMBLY Federal contract opportunity
- Solicitation number
- SPMYM225Q0936
About this file
This is a sole source justification form (TRIREFFAC 4491/3) template used by DLA Maritime Puget Sound to document and certify when competition must be restricted to a single source or brand name. The blank form requires details about the manufacturer including name, CAGE code, POC information, and dealer/representative information if applicable. It includes sections to explain the specific characteristics limiting availability to a sole source, compatibility requirements with existing systems, patent/copyright restrictions, and other supporting information for the sole source determination.
The related solicitation (SPMYM225Q0936) is for a Bus Assembly issued by DLA Land and Maritime. Quotes must be submitted via SAM.gov with requirements including NIST SP 800-171 compliance assessment (unless item is COTS), signed documentation, CAGE code, tax liability representations, FOB destination to Bremerton, WA, lead time, manufacturer details, and country of origin. Quotes should be submitted via email to Armando.saya@dla.mil.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| SPMYM225Q0936 BUSS ASSEMBLY.pdf | ||
| Redacted Sole Source W339.pdf |
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Text version
Ref: TRIREFFACINST 4491.1
TRIREFFAC 4491/3 (Rev. 11-2020)
The Service or material listed on __________________________ is the sole source and competition must be restricted to one Document Number source, or only one brand name for reasons indicated below. There are no substitutes available for this material.
Restricted to the following source or brand name. Provide the original manufacturer s name.
NOTE: If a sole source manufacturer distributes via dealers, also provide dealer information.
Manufacturer: _________________________________________ Cage: _____________________________________
Manufacturer POC Name & Phone Number: _____________________________________________________________
MFR Address: _____________________________________________________________________________________
Manufacturer s Dealer/Rep: ______________________________ Cage: _____________________________________
Dealer/Rep Address, Phone Number: ___________________________________________________________________
Specific characteristics of the material or service that limit the availability to a soul source or particular brand name (unique features, function, of the item, etc.). Describe in detail why only this suggested source can furnish the requirements to the exclusion or other sources:
_______ _______ The requested material or service represents the minimum requirements of the Government.
Yes No
CHECK & FILL IN ALL APPLICABLE BLANKS BELOW
_______ _______ The material/service must be compatible in all aspects (form, fit, and function) with the
Yes No existing systems presently installed. Describe the equipment you have now and how the new item/service must coordinate, connect, or interfere with the existing system:
_______ _______ A patent, copyright, or proprietary data limits competition. The proprietary data is:
Yes No
_______ _______ These are direct replacements parts/components for existing brand name equipment.
Yes No
_______ _______ Other information to support a sole-source buy:
Yes No
I certify that statements checked, and information provided about, are complete and correct to the best of my knowledge and do not contain classified information. I understand the processing of this sole-source justification precludes the use of full and open competition.
Signature Title Date
Contracting Officer:
Signature Date
DLA Maritime Puget Sound Justification for Sole-Source
File details come from the government source that posted it. Updated .