2013/05/15 Council Agenda Packet

4 REQUEST FOR SOLE SOURCE To: Purchasing Office From: o /-3-% / IA() Name of Department Head Dept./Division Subject: Sole Source Request for the Purchase Of: -.1/4.--v- -`ca6.4-sA%^^ �- REQUESTED SUPPLIER: a REQUISITION NUMBER: miLi`l S r COST ESTIMA 1'b: E OO c)O Sole source purchases are defined as clearly and legitimately limited to a single supplier. Sole source purchases are normally not allowed except when based upon strong technological grounds such as operational compatibility with existing equipment and related parts or upon a clearly unique and cost effective feature requirement. The use of sole source purchases shall be limited only to those specific instances which are totally justified to satisfy compatibility or technical performance needs. STATEMENT OF NEED: My department's recommendation for sole source is based upon an objective review of the product/service required and appears to be in the best interest of the City. I know of no conflict of interest on my part or personal involvement in any way with this request. No gratuities,favors or compromising action have taken place. Neither has my personal familiarity with particular brands, types of equipment, materials or firms been a deciding influence on my request to sole source this purchase when there are other known suppliers to exist. Refer to the attached sole source iustification as prepared by our department, to the attached review of available products/services and to my completed Purchase Requisition. Requestor Department Hea*-- f I Appro ed ❑Rejected / yltt3 Signantp of Requestor Date Signature of Dep He.. Date • If Purchase is$10,000 or more: If Purchase is$50,000 or more: Purchasing Manager Attorney Approved ❑Rejected U .. .ved U ' ected igna r- of Purchasing Manager Date Si••: e of City Attorney e s:/#common/forms/sole 15