Sole Source

CSU BAKERSFIELD SOLE SOURCE / BRAND APPROVAL

REQUISITION NUMBER: DATE:

Please fill in the following information. Click above link for instructions and definitions. (Attach a separate page if room is not sufficient.)

This is a request for (please check one):       SOLE SOURCE        SOLE BRAND

1. What are the unique performance features of the product or brand requested that are not available in any other product or brand? (For services: What are the unique qualifications this vendor possesses?) Identify specific, measurable factors/qualifications.

2. Why are the unique features/qualifications required?

3. What other brands/services were evaluated, rejected and why? Provide brand name, model, vendor name and contact, date contacted and prices quoted. A minimum of three suppliers must be surveyed and the results noted below.

4. To match or "intermember" is not normally an acceptable justification for sole brand. If you determine this is a factor which should be considered, the quantity, manufacturer, brand, model, State property ID number of the existing equipment, and necessity for "interfacing" must be provided below.

CERTIFICATION: I am aware of the State requirements for competitive bidding and the established criteria for justification for sole source/sole brand purchasing. As an approved department representative, I have gathered the required technical information and have made a concerted effort to review comparable/equal equipment. This effort is documented in this justification. I hereby certify as to the validity of the information and feel confident that this justification for sole source/sole brand procurement meets the State's criteria and withstand an audit by the State Auditor General, or a vendor protest.
The following procedures have been followed to justify this purchase:

Unique performance factors have been specified.
Statement as to why they were required.
Other products have been evaluated, and reasons for rejection stated.

Please complete #1 and #2 below and forward to Purchasing with your requisition.

1. REQUESTOR:

DEPARTMENT:

2.____________________________________________
    Signature (Division Executive or Designee)

__________________
Date

3.____________________________________________
    Procurement & Support Services Director __________________
Date

4.____________________________________________
    Vice President, Business and Administrative Services ($25,000 and over)
__________________
Date

1. REQUESTOR:	DEPARTMENT:
2.____________________________________________ Signature (Division Executive or Designee)	__________________ Date
3.____________________________________________ Procurement & Support Services Director	__________________ Date
4.____________________________________________ Vice President, Business and Administrative Services ($25,000 and over)	__________________ Date