Single_Source_Ceritificate_-Manhole_Risers_-_American_Highway_Products.pdf
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- Solicitation number
- 26-X-00539
- Issued by
- Hillsborough County, Florida
About this file
This is a Single Source Certificate of Conditions and Circumstances submitted by the City of Tampa's Mobility Department to justify a non-competitive procurement for pivoted turnbuckle steel expandable manhole risers. The City has standardized its manhole risers to the turnbuckle steel expandable type to achieve full circumferential engagement of manhole covers, thereby reducing hazardous cover displacements and ensuring continuity in equipment maintenance and training requirements. American Highway Products, Ltd. is identified as the sole authorized dealer for this equipment, which the City currently owns and requires replacement parts and service for. No specific quantities, response dates, site visits, or bidder conferences are detailed in this certificate.
The estimated annual expenditure for this single source procurement is $75,000.00, funded from the Local Options Gas Tax account 10200.234500.552010. The justification for single sourcing emphasizes that only replacement parts manufactured by American Highway Products will provide satisfactory repair for the pivoted turnbuckle manhole risers. The procurement requires approval from the Purchasing Department contingent upon review for compliance with purchasing policies and procedures, legal sufficiency, and applicable insurance requirements. Documentation and quotations from the vendor are attached to support this single source request.
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Text version
SINGLE SOURCE
CERTIFICATE OF CONDITIONS AND CIRCUMSTANCES
Instructions: The purpose of this form is to certify conditions and circumstances for the purchase of goods and services under the single source exception to the competitive bid process. This request is to be executed by the Department Director and submitted to the Purchasing Department for consideration and approval/disapproval.
Item or Services Required:
Name of Company considered Single Source:
Conditions and special circumstances for the Single Source. Please be specific:
Requesting Department Director’s Signature Date of Request
Requisition Number Buyer Name
Purchasing Department Action:
Date
Signature Please note: Approval of any Requisition or Proposal related to this Single Source Request is contingent on review for compliance with Purchasing Policies/Procedures, Legal Sufficiency, and Insurance Requirements (if applicable).
Quotation/Documentation attached
Original to Purchasing
Copy to Mayor’s Office by Requesting Department
| Item or Service Required: Pivoted Turnbuckle Steel Expandable Manhole Risers |
| Name of Company: American Highway Products, Ltd. |
| Conditions & Special Circumstances: American Highway Products, Ltd. is the only authorized dealer for this equipment. The City of Tampa owns the equipment which requires replacement parts and service. Only replacement parts manufactured by American Highway Products will allow for satisfactory repair for the pivoted turnbuckle manhole risers. The City has standardized manhole risers to the turnbuckle steel expandable type to obtain full circumferential engagement of the manhole cover reducing hazardous cover displacements and for continuity of equipment, maintenance and training requirements. Estimated Annual Expenditure is $75,000.00 from Local Options Gas Tax. Account: 10200.234500.552010 |
| Department Director Signature: |
| Date of Request: |
| Requisition Number: |
| Buyer Name: |
| Purchasing Dept Action: |
| Check Box11: Yes |
| Check Box12: Yes |
| Check Box13: Off |
| Buyer Signature: |
| Buyer Sig Date: |
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