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staff experience and research on valve actuator reliability and performance. List any other facts supporting the use of a non-competitive process. Is this a one-time procurement? *If an on-going sole source procurement is required, include or X No* Ill Yes attach an estimate that shows total annualized expenditure for each year. PRICE REASONABLENESS(Cheek all that apply and attach back-up documentatiott I determined that the price is fair and reasonable because: ❑ I compared the proposed price to prices I previously paid for the same or similar goods and/or services. See PO# . Specify price: ❑ I compared the proposed price to current published catalog, price lists, or market prices as documented in the attachments and the proposed price is similar or less. Attach relevant documentation. ❑ I compared the proposed price to rough yardsticks, such as dollars per pound, per horsepower,or other units of measure and did not discover significant inconsistencies that warrant additional pricing inquiry. ❑ Based on my knowledge of the market, my experience of prior similar proposals, or knowledge imparted by technical experts. ❑ The price is set by law or regulations. ❑ Market research reveals that same or similar goods or services are available for a similar price. ❑ Other: ❑ Back-up documentation is attached. Explanation of above-checked justification: STATEMENT OF NEED AND CERTIFICATION: 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 of Everett. 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. I hereby certify that t is Ctstification for sole source procurement is accurate and complete to the best of my knowlectgeapd belie . A10.4 ( !ay 2C (1 Signature (Requt..tor) Date / ir ` 1f Title: C._ C' ? IIs 4 t� �.�'.' %C .,.._..__ Printed Name: s eee))) t r t DEPARTMENT DIRECTOR Based upo the abov , I authorize the sole source acquisition of the goods or servicescspecified. r.?— IIII- ' 1 Signatu Date Printed Name: INFORMATION TECHNOLOGY—For any technology purchases including software Based upon the above, I authorize the sole source acquisition of the goods or services specified. Signature Date Page 2 of 3 Revised 3/14/2018