Specified_or_Sole_Source_Selection_Form_-_Fillable.pdf

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ANNUAL PROVISION OF POLYETHYLENE GAS PIPE
Solicitation number
ITB 2026-107
Issued by
Alachua County, Graceville City, Florida

About this file

This is a Specified or Sole Source Selection Form for Gainesville Regional Utilities (GRU) in Florida related to an annual contract for polyethylene gas pipe procurement. The form is a fillable document used to justify the selection method for procurement decisions. The related contract opportunity indicates that GRU is soliciting polyethylene gas pipe in accordance with a Scope of Work and Technical Specifications. The objective of the contract is to form an alliance that generates efficiencies in the supply chain while reducing total cost of ownership through cooperative efforts between GRU, the successful supplier, and their respective manufacturers.

The Specified or Sole Source Selection Form provides three primary justification options for non-competitive procurement: sole source selection when replacement parts are available only from the original equipment manufacturer (OEM), when services require copyrighted drawings or specifications available only from the OEM or authorized distributors, or when goods or services are covered under active U.S. patents or copyrights. The form requires requestor information, department head approval, and executive team signature. The document serves as the formal justification mechanism for GRU's procurement decision and requires supporting documentation such as manufacturer explanation letters when applicable, including patent, trademark, or copyright numbers as relevant to the selected source.

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Other files

File Type Posted
ANNUAL_PROVISION_OF_POLYETHYLENE_GAS_PIPE.pdf PDF
P-28.05.pdf PDF
Contract_Sample_Document.pdf PDF
P-28.00.pdf PDF

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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 .