SOLE SOURCE 00304001.pdf

JUSTIFICATION FOR SOLE SOURCE (SAP <$150k) Ref: FAR 13.106 and NAVSUP 4200.BSD Chapter 5 Para. 2.b. (5)

The service or material listed on (Document number) 00:10-1�1 is sole source and competition must be restricted to one source, or to only one brand name for reasons indicated below. There are no substitutes available for this material.

Restricted to the following source or brand name. Provide originai manufacturer's name.

(If a sole source manufacturer distributes via dealers, ALSO provide dealer information.)

Manufacturer: _�_ ... _,a_CorJJ<r ____ ,......�-�---------------------------- Manufacturer POC !i Phone Nr • JeromyGo•tn\tr1cu, .... ,_M•••;.,1e .. , JeromyGoftth .. Gl(oma• .. m.PM•t: •IW.2438181

Mfr. Address ll:10bkieJi1&A,..,ueB1oomat1d.CT06002

Manufacturers Dealer/Rep_w_A_..,-______________________ _ Dealer/Rep Address/Phone Number�w�A ___________________

X Description of the item or service required, the estimated cost, and required delivery date.

Rod End l!effl>(I, Se1Hub,...1ed. M""' Thread per �matdo Pao Number (KSRl 5lnDV). 0.U."'"f dale oJ Uy 1 It. 2020 IO """""'"' 1dlewle.

_x_Specific characteristics of the material or service that limit the availability to a sole source or particular brand name (unique features, function of the item, etc.).

Describe in detail wh� only this suggested source can furnish the requirements to the exclusion of other sources.

C11ar1ctensbc1 of mattn1I at• parK&mlt.a part nurtMf KSR1S2n0V ,>tr EN OM 103&30 Du• to 1h41 M1!1td �forttllbon on EH DM 103830. t11e1e It. no matlnll i'l!olffllbCln on U\a t>d, t11lrac1, Hit� knw, and rod end.

lVOOM103830 l!Mldffn �ffllla Cotporaaon 111!le �prOYtd ....... ola"l'J)ly. Tht Klroc1 COlllng on lllntburingo lo propritllrt and...,., bl ........ dby .... , ...,.,._ .. _

�The requested material or service represents the minimum requirements of the government

CHECK & FILL IN ALL APPLICABLE BLANKS BELOW

x The material/service must be compatible in all aspects (form, fit and function) with existing systems presently installed. Justi Describe the equipment you have now and how the new item/service must coordinate, connect, or interface with the existing system.

The tod end bea;,g t1Hm la be thtaaded and carwiec.ted IO an er.laBng rHch rod. There needt lo bt • •�erical bal baantg \Mth ■ 1e{f �_,g Wier ta fl c:an ca,111ue lo partorm lta Uldion even aft• bfflQ a"""""11ed In tetwlt., Lutfy. Ille tod end b•lritt� ... ,rtmly n.- IO bt ,_, enough IO wlll"""d 111• beet t'"!'"'ed to DI>"" and cloae • ti Inch tw and llactup Vain.

_X_A patent, copyright, or proprietary data limits competition. The proprietary data is:

l'A1en ollltr .....,hlcueo aaen-c,e 10 p,ov!dHlmilal bearings. Ille proprietary coobng Kama tic pr..tdeo __,., be ltJ;illcaled.

__ These are "direct replacements" parts/components for existing brand name equipment.

__ Other information to support a sole-source buy:

I CERTIFY THAT STATEMENTS CHECKED, AND INFORMATION PROVIDED ABOVE, ARE COMPLETE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND DO NOT CONTAIN CLASSIFIED INFORMATION. I UNDERSTAND THAT THE PROCESSING OF THIS SOLE-SOURCE JUSTIFICATION PRECLUDES THE USE OF FULL AND OPEN

COMPETITION.

Signatur

TiUe

Activity _________________ _

Date

Contracting Officer Signature// L:j;ISA LO(;SLc:,?:;;{!. Date _______ _

FISCPS 4200/180 (Rev. 10/1/10)

02/12/2020