Specified_or_Sole_Source_Selection_Form_-_Fillable.pdf

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Attached to
Annual Provision of Three-Phase Pad Mounted Transformers
Solicitation number
ITB 2026-089
Issued by
Alachua County, Graceville City, Florida

About this file

This is a Specified or Sole Source Selection Form from Gainesville Regional Utilities (GRU), a Florida-based government entity, used to justify the procurement method for the annual provision of three-phase pad-mounted transformers. The form provides a structured framework for determining whether a procurement should be classified as a sole source or specified source acquisition. Sole source justifications are permitted when replacement parts are available only from the original equipment manufacturer, when services require copyrighted drawings or specifications exclusively available from the OEM or authorized distributor, or when the good or service is covered under an active U.S. patent or copyright. The form requires detailed documentation supporting the selected procurement method and must be signed by the requestor, department head, and executive team prior to proceeding with the acquisition.

The form itself contains no specific pricing terms, contract duration, renewal options, set-asides, or funding information. It functions solely as an internal approval document that establishes the procurement justification before GRU moves forward with acquiring the three-phase pad-mounted transformers. Requestors must provide supporting documentation such as explanation letters from manufacturers when claiming sole source status based on OEM exclusivity or patent/copyright protections.

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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 .