Specified_or_Sole_Source_Selection_Form_-_Fillable.pdf
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- Attached to
- Surplus
- Solicitation number
- Request-2025-025
- Issued by
- Alachua County, Graceville City, Florida
About this file
This document is a Specified or Sole Source Selection form from Gainesville Regional Utilities (GRU), dated 21 August 2024. The form provides a structured method for selecting a vendor through either a sole source or specified source procurement process. The sole source options include scenarios such as obtaining replacement parts exclusively from an original equipment manufacturer (OEM), requiring copyrighted drawings or specifications only available from an OEM or authorized service center, or procuring a unique good or service covered under an active U.S. patent or copyright.
The form requires detailed documentation and multiple levels of organizational approval, including signatures from the requestor, department head, and executive team. For sole source selections, the requester must provide an explanatory letter from the manufacturer substantiating the reason for the single-source procurement. While no specific project details are filled in on this sample form, it represents a standardized internal procurement template designed to ensure transparency and justify non-competitive vendor selection processes within Gainesville Regional Utilities' procurement framework.
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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 |
File details come from the government source that posted it. Updated .