Request Form to Division of Purchasing (DOP).pdf
PDF 143 KB Posted
- Solicitation number
- 131
- Issued by
- Ada County, Idaho
About this file
This document is a Request Form to the Idaho Division of Purchasing (DOP) for a Sole Source Authorization (SSA) by the Idaho Department of Health and Welfare (DHW) to procure a Substance Use Disorder Board Certification System from the Idaho Board of Alcohol/Drug Counselor Certification, Inc. (IBADCC). The DHW is seeking a one-year contract with the possibility of renewals to provide this system, which is estimated to cost $74,880 over the full desired term. The DHW has determined that IBADCC is the sole provider of the required certification services, as they are the only state-recognized credentialing body for these services.
The pricing and funding details are not explicitly stated in the document, but the DHW has provided a budget and financial analysis to support the sole source request. There are no set-asides mentioned, and the incumbent provider appears to be IBADCC. The procurement is being initiated to meet the agency's business needs as outlined in the attached documentation, and the funding source is not specified.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| RFQ Event #100 Administration Document.docx | DOCX document | |
| RFQ Event 61 Administrative Document.docx | DOCX document | |
| Standard-Terms-and-Conditions_May-2021 (6).pdf | ||
| Insurance Requirements 2023.pdf | ||
| IBADCC Budget 8.29.23.docx | DOCX document | |
| Standard-Terms-and-Conditions_May-2021.pdf | ||
| Signature+Page.pdf | ||
| solicitation_instructions+Jan+2017.pdf | ||
| IBADCC_Sole Source Letter 9.18.23.pdf | ||
| Exhibit A - Bid Schedule.xlsx | XLSX spreadsheet | |
| IBADCC One Time Exemption Request.docx | DOCX document |
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Text version
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*
Business Need*
Description*
Sole Source Authorization
Kristin Perry kristin.perry@dhw.idaho.gov
Format phone number as (555)555-5555
(208)334-5603
Department of Health and Welfare
Substance Use Disorder Board Certification System
9/22/2023
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
Idaho Board of Alcohol/Drug Counselor Certification, Inc.
74,880.00$
Yes No
Describe the property you are seeking:
See attached documentation
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
Describe the Agency’s business need for the requested property:
See attached documentation
Describe what makes the identified property unique. Why is it the only property that could meet your business need?
See attached documentation https://adminrules.idaho.gov/rules/current/38/380501.pdf
Alternatives*
Requestor was asked to upload a detailed justification
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*
DOP Printed Name*
Title*
Date*
Notes
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?
Per IDAPA, Chapter 16.07.17 this vendor is the sole state credentialing body recognized to provide all services required.
IBADCC_Sole Source Letter 9.18.23.pdf 173.45KB
IBADCC Budget 8.29.23.docx 91.04KB
IBADCC One Time Exemption Request.docx 99.5KB
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
File details come from the government source that posted it. Updated .