Specified_or_Sole_Source_Selection_Form_-_Fillable.pdf
PDF 1 MB Posted
- Solicitation number
- RFP 2026-038
- Issued by
- Alachua County, Graceville City, Florida
About this file
This is a Specified or Sole Source Selection Form used by Gainesville Regional Utilities (GRU), a multi-disciplinary utility provider serving the Gainesville area in Alachua County and Graceville City, Florida. The form is a template document designed to justify the selection of either a sole source or specified source vendor for procurement purposes. The form provides checkbox options for three sole source justifications: replacement parts available only from the original equipment manufacturer (OEM), services requiring copyrighted drawings or specifications available only from the OEM or authorized distributor, or unique goods or services covered under an active U.S. patent or copyright. For specified source selections, the form requires detailed written justification. The document includes signature lines for the requestor, department head, and executive team approval, establishing a hierarchical review and authorization process before proceeding with non-competitive procurement methods.
The form itself contains no pricing information, set-asides, incumbent vendor details, or funding requirements, as it serves solely as a procedural mechanism for documenting and justifying non-competitive source selections within GRU's procurement framework. Supporting documentation such as explanation letters from manufacturers or patent/trademark/copyright information must be provided to substantiate the claimed sole source or specified source justifications. This form is part of GRU's internal procurement controls and compliance procedures, working in conjunction with the organization's broader procurement policies and the efficiency review engagement referenced in the related RFP, which addresses accounts payable and procurement division operations.
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Text version
Rev. 21 Aug 2024
GAINESVILLE REGIONAL UTILITIES
SPECIFIED OR SOLE SOURCE SELECTION
PROJECT NAME: Date:
CHECK ONLY ONE METHOD OF SOURCE SELECTION
SOLE SOURCE:
This is the sole source provider because:
Replacement parts only available from the original equipment manufacturer (OEM)
(Example: Provide explanation letter from the manufacturer)
Services will require copyrighted drawings or specification documents only available from the OEM or authorized OEM service center or distributor.
(Example: Provide explanation letter from the manufacturer)
A unique good or service covered under an active U.S. patent or copyright.
(Example: Provide explanation letter from the manufacturer that includes but is not limited to Patent/Trademark and/or Copyright Number)
SPECIFIED SOURCE:
JUSTIFICATION FOR SPECIFIED SOURCE (REQUIRED):
Requestor Name: Title:
Signature:
Department Head Signature
Executive Team Signature
Fillable Form
| PROJECT NAME: |
| Date: |
| CHECK ONLY ONE METHOD OF SOURCE SELECTION: |
| This is the sole source provider because: |
| undefined: |
| undefined_2: |
| undefined_3: |
| JUSTIFICATION FOR SPECIFIED SOURCE REQUIRED 1: |
| JUSTIFICATION FOR SPECIFIED SOURCE REQUIRED 2: |
| JUSTIFICATION FOR SPECIFIED SOURCE REQUIRED 3: |
| Requestor Name: |
| Title: |
| Check Box1: Off |
| Check Box2: Off |
| Check Box3: Off |
| Check Box4: Off |
| Check Box5: Off |
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