File:  DJE-E - Business Services Department

Summit School District

Single/Sole Source Justification

(Note:  Return this original to Business Services with the purchase requisition)

Date:  ____________________

(For use on Single/Sole Source Acquisitions of $5,000 and greater)

  Sole Source

Is a good or service that is ONLY available from one (1) source (vendor, manufacturer, etc.)

  Single Source

Is a good or service that is available from numerous sources, but is required from one single source provider on a non-competitive basis.

Check one or more of the following non-competitive acquisition justifications (See definitions page 2 below)

______ Customer Direction                                ______ Consulting Services

______ Engineering Direction                            ______ Source Controlled Drawing

______ Proprietary Items                                    ______ Environmental Direction

______ Only Qualified Supplier                          ______ Time Limitations

______ Spare Items                                            ______ State Bid

______ Economic Considerations                    ______ Follow-On

                                                                                ______ Other Cost Factors (i.e., standardization)

Non-Competitive Acquisition Justifications

Customer Direction:  A specific paragraph must be referenced from governmental agency (grant, prime contract, follow-on) that identifies the requirement as non-competitive.

Engineering Direction:  When the product is identified on Engineering drawing or specification; such as, "No substitutes or equivalents will be accepted".

Proprietary Items:  A particular item may be protected by a patent, pr trade secrets may prevent soliciting alternate sources.  Either a patent number or the proprietary nature of the information is required.

Only Supplier Qualified:  Used when reliability and maintainability of the system would be degraded unless a specific, proven, and reliable supplier is used.

Spare Items:  When replacement parts from alternate suppliers are not interchangeable with original part and repair tools (equipment incompatibility).

Consulting Services:  When the nature of the acquisition is considered to be in the interest of good business management.

Time Limitations:  Indicate that product delivery will affect program delivery.  It must be verified by specific need dates and program schedules.

Economic Considerations:

A.)  Any order less than $5,000 (if the estimated price is fair and reasonable)

B.)  Previously tested product for a similar application that makes it economically unfeasible to test additional products.

C.)  Follow-on orders, to the same suppliers, eliminate costs incurred by using a different supplier.

D.)  Cost factors, including:  standardization costs, engineering costs, maintenance costs, retooling, re-invention costs.

1).  Description of items or service:

______________________________________________________________________________

2).  Supplier  ______________________ Phone ____________ Estimated Price ______________

3).  Description of unique features of the desired materials or services that must meet minimum requirements:

______________________________________________________________________________

______________________________________________________________________________

4).  Description of other items or services that were considered and why they were rejected:

______________________________________________________________________________

______________________________________________________________________________

5).  The above requirement is non-competitive for the following reason(s):

______________________________________________________________________________

______________________________________________________________________________

The School/Department agrees that there is no real or potential Conflict of Interest in recommending this product and/or service as a Sole/Single source procurement.  (Refer to Summit School District Policy DJG - Vendor Relations) The final determination of sole/single source will be made by the Business Services Department and the procurement submitted to the appropriate authority as defined in Board Policy DJE for approvals.

Prepared by: 

NAME _______________________________ TITLE _______________ DATE ___________

Reviewed and approved by:

NAME _______________________________ TITLE _______________ DATE ___________