Sole Source Form

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SOLE SOURCE FORM Date: Description of Purchase: Sole Source Vendor, Address, Telephone Number, Fax Number, Contact Name: Please check section as appropriate: Research and analysis has determined that equipment or service is available from only one vendor or manufacturer and is the only product that will meet our center’s needs. Item specifically required by grant or contract provisions. Utility, fixed rent, or government/state/municipal/agency mandated services. Emergency repair services or parts replacement. Compatibility with existing university systems or equipment is required. Other. Please explain: Department Name: Department Approval: University Purchasing solesource Rev. 5/99

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