SPOFOR_1.PDF

Page 1 of 2 SPO Form 104 Standard Work (Rev 08-22)

Owner State Procurement Office, Compliance Unit

Form Number SPO Form 104 - Off-Contract Procurement Authorization Version Revised 08-22

Process Standard Work / Instructions for completion and submittal of the SPO 104 form. The form is available on the SPO website: For Agencies > Resources > Standard Forms and Documents.

Form Completion Process

No. Action Action Detail / Key Points

Sections I through III to be completed by the requesting State Governmental Unit:

SECTION I - State Governmental Unit Request

1 State Governmental Unit Name of the requesting State Governmental Unit (SGU; agency, board, or commission)

2 Requestor Name of the requestor 3 Email Email of the requestor 4 Title Job title of the requestor 5 Telephone Telephone number of the requestor

SECTION II - Background 6 Service(s)/Material(s) Description of service(s)/material(s) or Contract title (eProcurement Label)

Provide the number(s) of the mandatory state contract(s) that is/are not meeting the State Governmental Unit need

Provide the number(s) of the mandatory state contract that is/are subject of the Off-Contract request

8 Suggested Supplier Name and Address Name of supplier and address

9 Off-Contract Procurement Select applicable option:

‐ Authorization request ‐ Authorization modification request

10 Requesting Term Specify contract term or extension period, as applicable 11 Estimated Cost Forecasted expenditures for the duration of the term or extension period

SECTION III - Justification

12 Rationale The state contract(s) designated as mandatory pursuant to A.A.C. R2-7-A301(B) does not/do not meet the need

Provide details of the procurement need, reason for the off-contract request, and how the proposed procurement is advantageous to the State

Detail information regarding the State Governmental Unit use of the material(s) or service(s); which mandatory state contracts were explored; the limitations which led to the off-contract request; and how the State would benefit from the procurement

Page 2 of 2 SPO Form 104 Standard Work (Rev 08-22)

Select the procurement method or process that will be used to award the off-contract

Select applicable option:

- Competitive solicitation (RFQ, IFB, RFP)

- Purchase order (under $10,000; A.A.C. R2-7-D301(3); A.A.C. R2-7-D304)

- Competition impracticable (A.A.C. R2-7-E303)

- Not practicable to quote (A.A.C. R2-7-D301(4))

- Sole source (A.A.C. R2-7-E301)

Describe the procurement process, efforts to locate other sources, and determination that the price is fair and reasonable

Detail strategy for the proposed procurement, considered competition, reason for selecting specific supplier, and negotiations strategy.

16 Signature * Signature of the authorized requestor. An authorized requester must have Delegation or SubDelegation authority. If you do not have this authority please send this to your procurement officer for signature

17 Date of Request Select the date of request from the drop-down calendar

Requestor: Upon completion of Sections I - III, send this signed form to the Contract Owner listed in the eProcurement system for their review and signature

Contract Owner's contact information is listed within the eProcurement system (APP Contracts > Contacts > Internal team)

SECTION IV - Contract Owner Review

19 Comments, conditions, and restrictions (as applicable)

Contract Owner to review the request and confirm whether the procurement need may not be met through the mandatory state contract.

Note(s):

- Contract Owner shall retain a copy of the request and if possible, include the procurement need in the scope of work when the mandatory state contract is resolicited

- Contract Owner shall upload the signed approval version of this form in the eProcurement system.

20 Print Name Printed name of the Contract Owner 21 Title Job title of the Contract Owner 22 Signature Signature of the Contract Owner 23 Date of Review Select the date of review from the drop-down calendar

24 Contract Owner: Upon completion of Section IV, send this signed form to SPOCompliance@azdoa.gov and cc Requestor for processing

SECTION V - Approval

25 Determination

Select the applicable option:

- Request Authorized Pursuant to to A.A.C. R2-7-A301(B)

- Request Authorized with Conditions/Restrictions

- Request Returned for Additional Information

- Request Denied

26 Approved Expiration Date Specify date or term of expiration

27 Comments, conditions, or restrictions (as applicable) Complete as needed

28 Print Name Printed name of the approver 29 Title Job title of the approver 30 Signature Signature of the approving authority 31 Date of Approval Select the date of approval from the drop-down calendar

STATE GOVERNMENTAL UNIT NOTICE: This is an official written determination in response to a procurement authorization request.

A copy of the form shall be maintained by the State Governmental Unit and the State Procurement Office.

Upon completion, Requestor shall forward the signed form to the Contract Owner.

Contract Owner shall upload the signed approval version of this form in the eProcurement system.

Page 1 of 6 SPO Form 104 ‐ Off‐Contract Procurement Authorization (Rev 08-22)

Procurement Determination:

Off-Contract Procurement Authorization A.A.C. R2-7-A301(B)

SECTIONS I THROUGH III MUST BE COMPLETED BY THE REQUESTOR

USE ADDITIONAL PAGE AS NECESSARY

SECTION I - State Governmental Unit Request

1. State Governmental Unit

2. Requestor 3. Email

4. Title 5. Telephone

Page 2 of 6 SPO Form 104 ‐ Off‐Contract Procurement Authorization (Rev 08-22)

SECTION II - Background

6. Service(s)/Material(s)

7. Provide the number(s) of the mandatory state contract(s) that is/are not meeting the State Governmental Unit need

8. Suggested Supplier Name and Address

9. Off-Contract Procurement

10. Requesting Term 11. Estimated Cost

Page 3 of 6 SPO Form 104 ‐ Off‐Contract Procurement Authorization (Rev 08-22)

SECTION III - Justification

12. Rationale

13. Provide details of the procurement need, reason for the off-contract request, and how the proposed procurement is advantageous to the State

14. Select the procurement method or process that will be used to award the off-contract

Page 4 of 6 SPO Form 104 ‐ Off‐Contract Procurement Authorization (Rev 08-22)

15. Describe the procurement process, efforts to locate other sources, and determination that the price is fair and reasonable

16. Signature * 17. Date of Request

*Please note that only someone with a Delegated Procurement Authority or SubDelegated Procurement Authority is considered authorized for this signature

18. Requestor: Upon completion of Sections I - III, send this signed form to the Contract Owner listed in the eProcurement system for their review and signature

In accordance with the Procurement Rules, the Arizona Uniform Terms and Conditions must be made a part of all Contracts. If you will be required to sign a software licensing agreement or sign any other agreement containing terms and conditions, these will need additional review to ensure that the terms and conditions do not invalidate the Arizona Uniform Terms and Conditions. Approval of this request does not allow for agencies to exceed their dollar acquisition amount of delegated authority.

Page 5 of 6 SPO Form 104 ‐ Off‐Contract Procurement Authorization (Rev 08-22)

TO BE COMPLETED BY THE CONTRACT OWNER

SECTION IV - Contract Owner Review

19. Comments, conditions, and restrictions (as applicable)

20. Print Name 21. Title

22. Signature 23. Date of Review

24. Contract Owner: Upon completion of Section IV, send this signed form to SPOCompliance@azdoa.gov and cc Requestor for processing

Page 6 of 6 SPO Form 104 ‐ Off‐Contract Procurement Authorization (Rev 08-22)

TO BE COMPLETED BY PROCUREMENT AUTHORITY

SECTION V - Approval

25. Determination

26. Approved Expiration Date

27. Comments, conditions, or restrictions (as applicable)

28. Print Name 29. Title

30. Signature 31. Date of Approval

STATE GOVERNMENTAL UNIT NOTICE: This is an official written determination in response to a procurement authorization request.

A copy of the form shall be maintained by the State Governmental Unit and the State Procurement Office.

Upon completion, Requestor shall forward the signed form to the Contract Owner.

Contract Owner shall upload the signed approval version of this form in the eProcurement system.

- 2401 W Bell Rd, Phoenix, AZ 85023 CTR65141 Bell Ford

- 1988 S Hwy 92, Sierra Vista, 85635 AZ CTR066066 Cochise Tires & Automotive LLC

- 3400 s tomahawk rd Apache junction, AZ 85119 CTR065142 Robert Horne Ford

- 3101 Armour ave Kingman, AZ 86401 CTR065017 Great West Tire

- PO BOX 728, WELLTON, 85356 AZ CTR065204 PETES BODY SHOP INC

- 3139 W Meadowlark Ln, Benson, 85602 AZ CTR064988 RAPID TOWING & RECOVERY

- 965 s 4th Ave Yuma, AZ 85364 CTR065359 Ed Whitehead Tire Pros DBA Active Tire

- 2161 US HWY 70, THATCHER, 85552 AZ CTR064951 DPS 6-25 Horne Freedom Ford

- 1118 w rt66 Flagstaff, AZ 86001 CTR064084 DPS 6-25 Flagstaff Chevy

- 2828 AZ-260, Overgaard, AZ 85933 CTR064357 DPS 6-25 AUTOMOTIVE CARE CENTER LLC

- 1208 AZ-260, cottonwood, 86326 AZ CTR072982 DPS 6-25 OGDEN ENTERPRISES

- 22900 WEST OLD HWY 66, SELIGMAN, 86337 AZ CTR072981 DPS 6-25 POPE ENTERPRISE

- 698 W HILLSIDE AVE, PRESCOTT, 86301-1910 AZ CTR072979 DPS 6-25 Jims Alignment

- 1240 Iron Springs rd Prescott, AZ 86301 CTR069332 DPS 6-25 Heath Auto Service- Prescott

- 1201 S HWY 80, BENSON, 85602-6300 AZ CTR072980 BENSON AUTOBODY INC

- 775 E 32ND ST, YUMA, 85365 AZ CTR058754 Chapman Chevy

- 5418 NW Grand ave Glendale, AZ 85301 CTR050365 Sands Chevrolet

- 1864 S WOODLANDS VILLAGE BLVD, FLAGSTAFF, 86001 AZ CTR050361 University Auto Repair

For a variety of reasons (documented below), DPS is requesting the ability to go off-contract:

1. Many of these suppliers are located in remote areas where options are not available. In order to fill this gap and ensure that contracts are in place through out the State to continue to service DPS and other SW agencies fleet vehicles, requesting this approval to go off contract to move forward with creating contracts with the previous DPS SW suppliers. DPS Procurement met with DPS Fleet to ensure we did not overlap ADOT statewide suppliers with DPS off-contract request suppliers (w/ the exception of 2 suppliers - see below).

2. DPS is requesting approval for Bell Ford and Sands Chevrolet. DPS is different than many agencies as we purchase our own vehicles (vs. leasing from ADOT). Both of these suppliers are key partners as it relates to our annual fleet purchase requirements. In addition, both suppliers also play a significant role in the post-purchase vehicle upfit process. And as anticiapted because of the significant relationship, we also use these two suppliers for vehicle light duty maintenance... and we are requesting permission to include in this eventual CI (to support the continuation of the important partnership).

3. Lastly, in addition to geographic coverage and key partnership (for two suppliers)... the suppliers we are recommending provide an increased level of service to our on-duty and off-duty Troopers. The service providers have accommodated privacy for the Troopers in the way of secluded waiting areas... allowing our officers to maintain confidencitality and perform their duties.