Request Form to Division of Purchasing (DOP).pdf

Request Form to Division of Purchasing (DOP)

Name:*

E-mail:*

Phone:*

Agency Name*

Property being Purchased:*

Submission Date

Fiscal Year

IDAPA 38.05.01.045 provides that sole source purchase shall be used only if a requirement is reasonably available from a single supplier.

Type of Request*

Name of Requested Vendor*

Desired Term (in years):*

Anticipated Total Cost (for full desired term):*

Do you anticipate the need for renewals?*

Property*

Justification*

Sole Source Authorization

Kirk Anderson kirk.anderson@itd.idaho.gov

Format phone number as (555)555-5555

(208)334-8084

Idaho Transportation Department

LTR788 Dual Platform Scale

10/5/2023

New Renew (Agency wishes to extend an existing sole source authorization) Amend (Check this box to request a change to the goods/services, term, or other conditions of the SSA) Both Renew and Amend

New

Intercomp Company

187,056.00$

Yes No

Describe the property you are seeking:

LTR788™ Dual Wheel Load Scale created to directly measure tire weights in a dual tire configuration and compare to tire ratings on the sidewall.

Check all that apply:

Sole source provider of a licensed or patented good or service Sole manufacturer AND distributor Sole provider of factory-authorized/warranty service Sole provider of items that are compatible with existing equipment, systems, programs, etc.

Other https://adminrules.idaho.gov/rules/current/38/380501.pdf

Business Need*

Description*

Alternatives*

Requestor was asked to upload a letter from the requested manufacturer/supplier

Requestor was asked to upload any additional documents/information that could help support the sole source request

File Upload

Agency Certification*

Signature

Approval

The following conditions apply to this authorization:

SSA Number*

DOP Signature*

Describe the Agency’s business need for the requested property:

These scales will allow the Ports of Entry (POE) to individually measure both the inside and outside tires throughout the state and will also be used to train ITD districts and the public. ITD wants to purchase six (6) scales at a cost of $6,495 each. If the pilot program is a success, there is a potential of purchasing 18 more.

Currently the inside tire is much harder to inspect, these scales will help the POE to quickly identify inspection issues that are not easily found. If a truck does not pass inspection at a POE site, they are not allowed back on the road until the tire/problem is fixed which is a critical safety issue to the traveling public. The tire repairs and/or replacements are completed by third-party companies contracted by the trucking companies themselves. These scales are expected to save companies money by reducing both downtime and additional costs if the tires fail while on the road; increase safety because tires are fixed at the port before they cause blowouts, put obstacles on the road, accidents, etc.; and opens up economic opportunity for cost savings for commercial drivers/companies.

Describe what makes the identified property unique. Why is it the only property that could meet your business need?

The LTR788™ Dual Wheel Load Scale is the only scale available on the market that has two separate pads to provide two separate tire weights on a single scale.

Describe the research you conducted to identify other potential property/sources. What potential alternatives did you find and why will they not meet the Agency’s business needs?

Internet search no equivalent found.

Sole Source_LTR788.pdf 169.65KB

LTR788 Data Sheet Pending NTEP.pdf 559.06KB

By submitting this form, I certify that the information provided above is true and accurate to the best of my knowledge, supports the requirement for a sole source procurement, and is in the best interest of the State:

Approver

Administrator intends to approve (pending legal notice and appeal period).

This SSA is only an authorization; a contract must be executed as detailed herein.

The Agency is authorized to issue a contract for an amount up to the anticipated total cost identified above.

DOP will issue and administer a contract pursuant to this SSA.

The Agency is responsible for requesting renewals and amendments to this SSA as appropriate.

The Agency must submit an SSA Business/Financial Analysis with it’s next request to renew the SSA.

Any agreement resulting from this SSA must be in writing, must comply with Idaho laws and policies, and must comply with best practices in contracting to the greatest extent practical. It is recommended that the Agency consult with its legal counsel.

Other:

Sign

DOP Printed Name*

Title*

Date*

Notes