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3 <br /> gir <br /> REQUEST FOR SOLE SOURCE <br /> To: Purchasing Office <br /> From: Tom Thetford / Public Works/Utilities <br /> Name of Department Head Dept./Division <br /> Subject: Sole Source Request for the Purchase Of: Mahr, 1/4"Automatic <br /> Mechanical Bar Screen(Quantity 1) <br /> REQUES 1'ED SUPPLIER: Treatment Equipment Company,14400 Bel-Red Road#101-C,Bellevue,WA Q <br /> REQUISITION NUMBER: 13 0,01- COST ESTIMAII.: $199,732.78 <br /> Sole source purchases are defined as clearly and legitimately limited to a single supplier. Sole source <br /> purchases are normally not allowed except when based upon strong technological grounds such as <br /> operational compatibility with existing equipment and related parts or upon a clearly unique and cost <br /> effective feature requirement. The use of sole source purchases shall be limited only to those specific <br /> instances which are totally justified to satisfy compatibility or technical performance needs. <br /> STATEMENT OF NEED: <br /> My department's recommendation for sole source is based upon an objective review of the product/service <br /> required and appears to be in the best interest of the City. I know of no conflict of interest on my part or <br /> personal involvement in any way with this request. No gratuities,favors or compromising action have taken <br /> place. Neither has my personal familiarity with particular brands, types of equipment, materials or firms <br /> been a deciding influence on my request to sole source this purchase when there are other known suppliers to <br /> exist. <br /> Refer to the attached sole source justification as prepared by our department, to the attached review of <br /> available products/services and to my completed Purchase Requisition. <br /> Requestor: Peter Berger/John McClellan Department Head: Tom Thetford <br /> . ®Approved ❑Rejected <br /> "0 <br /> ..:, 4 /40_____ ,,__ / 2J .* , <br /> Si of Requestor Signature o ep %/t.Head Date <br /> If Purchase is$10,000 or more: If Purchase is$50,000 or more: <br /> Purchasing Manager City Attorney <br /> it Approved ❑Rejectedproved El Rejected <br /> ( <br /> rz,,„,, <br /> s'L'vc' <br /> :rof Purchasing Manager Date Si tore of City Attorney Date <br /> i <br /> s:!#common/forms/sole <br /> 8 <br />