SSJF Part 1 23VS103002 Horizontech.pdf

Sole Source Justification Form

Bulletin Reference Number �=====================================�

Requesting Agency/University jL.s_e _cr_e_ta_ ry_o_f _S _ta_t _e ____________ ___, Sole Source Justification Form - Part I

Section I - General Information

Department/Bureau/Section: Ljv_e_h _ic_le _se_ rv_ic_e _s _D_e _p _a _rt _m_ e_n_t ____________________________, Need Identified Date: !January 25, 2024 I Supply/Service Need By Date: !January 25, 2024

Project Title: Data Entry of Forms and Documents 23VS103002/Admendment

Vendor: IHorizontech Inc adding "scrapped" documents to services at the same cost as Title/Provide a description of the supplies or services required: Registration processing and to ensure coverage for the contract invoices

Value: I ....E_ st_ im_ a _te_d ______ .... l Value of Initial Term, this Change Order or Amendment: 1 ....$ 625,715_________ __, Will this Sole Source amend a Professional or Artistic Services contract? D Yes i:gj No

*Sole Source may not be used for amendments for Professional or Artistic Services if the amendment would increase the value by more than 5% of the initial award or extend the term by more than 60 days.

Type: New Sole Economically Feasible Source

Section II - Proposed Term

[gj One-Time Purchase D Term Contract Section Ill - Funding Source

Select the type of funding to be used (Check all that apply): i:gi State Appropriate Funds D Federal Funds D Other (Explain):

Section IV - Sole Source Justification

This purchase is economically only available from a single source primarily because it is:

Operational needs procure as a replacement a flow for transition and migration of files and data

Are there secondary justification(s) for this sole source? D Yes l:gj No

(lf"Other" explain in one sentence)

Version 7.01 Page 1 of 5

24-350SOS-VEHSE-B-42283

IFB

Renewal

Renewal

X

Dave Littrell dlittrell@ilsos.gov

3/20/24

217-782-3091

Sole Source Justification Form

Bulletin Reference Number

Requesting Agency/University ...

ls_e _cr_e _ta_ ry_o_f_S_ta_t_e ____________ ___, Sole Source Justification Form - Part II

Section I - General Information

Project Title

Vendor

Initial Date of Procurement Bulletin Posting

Was a Sole Source hearing held per 30 ILCS 500/20-25?

D Yes - Complete Section II and Ill below (Section II will only be visible when this option is selected)

D No - Section II not required, go to Section Ill below Section Ill - CPO Approval and Signature Required

D Based on my review, I authorize the Agency/University to proceed in accordance with the published Notice referenced above.

D Based upon my review, I authorize the Agency/University to proceed with the following Changes.

□ Based on my review, the Agency/University is not authorized to proceed with this sole source as presented and my recommendation is that it be cancelled.

D Other

CPO Signature CPO Phone

Printed Name Date

CPO E-mail

Version 7.01 Page 5 of 5

Katherine Tople ktople@ilsos.gov

Horizontech, Inc.

Data entry of title and registration documents 23Vs103002 Amendment

3/20/24