Specified_or_Sole_Source_Selection_Form_-_Fillable.pdf
PDF 1 MB Posted
- Attached to
- 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 | ||
| P-28.05.pdf | ||
| Contract_Sample_Document.pdf | ||
| P-28.00.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 .