Sole Source Request Form printable pdf download

Sole Source Request Form

MMRF Sole Source Justification Checklist

PURPOSE:

Procurement Regulations, in accordance with MMRF policy, require that material,

equipment, supplies and services be procured via competitive means. However,

MMRF may elect to waive the competitive process and approve sole source

procurement in certain instances, provided the requester can adequately justify

its use.

MMRF’s decision on the reasonability of sole source procurement will be based

on the requester’s investigation, evaluation and documentation of alternate

sources of supply and documentation that rejection of similar products is based

solely on their failure to meet specific and necessary specifications. In cases

where an alternate supplier for a similar product cannot be identified, the

requester must document that a good faith effort has been made to seek other

sources.

A list of the unique technical specifications required of the product and the

potential companies contacted in the search for alternate sources is also

necessary.

The decision whether the MMRF can employ sole source contractors will be

made by MMRF Purchasing and the MMRF Chief Operating Officer upon review

of materials provided by the requesting department.

INSTRUCTIONS:

The attached form with one or more categories completed must be forwarded to

Purchasing when sole source approval is requested for services, equipment and

supplies exceeding $3,000.

Purchases from funding agency approved sub/contract vendors (i.e. Contracts

for Key Personnel at collaborating institutions or other named collaborators or

vendors) are exempted from sole source justification and bidding (evaluation of

those contractors will be made during the proposal preparation process).

Please complete all categories and sections that apply.

Provide full explanation, complete descriptions, and/or list all relevant reasons

where space has been provided. Sole Source Justification forms lacking

sufficient detail cannot be approved.

Sign and date the form.

Improperly completed or unsigned forms may be returned.

Version Date: December 24, 2015

Sole Source Request Form