Sole Source Justification Form (Word)

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Procurement and Contract Services (PaCS) Oregon State University, 644 SW 13th St, Corvallis, Oregon 97333-4238 T 541-737-4261 | F 541-737-2170 | http://pacs.oregonstate.edu/ Sole Source Request Form Pursuant to OAR 580-062-0020 (8) a sole source is a process where the Institutional President, the Chancellor or designee has made a Written determination that due to special needs or qualifications, only a Single Seller is reasonably available to provide such personal or professional services or goods or services. Sole source procurements will be avoided except when no reasonably available alternative source exists. Sole sources must be advertised by procurement and contract services for 7 days prior to ordering. For sole source purchases over $5000, a Sole Source Request Form is required. Please submit this form along with your Departmental Requisition to Procurement and Contract Services. DEPARTMENT: REQUESTOR: PROPOSED VENDOR: GOOD(S) OR SERVICE(S): Please answer the following with as much detail as possible (attach any additional materials or information): 1. What are the unique specifications of these good(s) or service(s) which make it imperative to your success? 2. Could you change your unique specifications, while getting the same performance or results, to make it available from multiple sources? 3. Explain how you determined that this is the only vendor. 4. If your proposed vendor went out of business how would it affect your success? 5. Other Comments: Procurement and Contract Services Internal Use Only This sole source was advertised on the OUS website from: to: Pursuant to OAR 580-062-0020(8), Procurement and Contract Services has found that due to special needs or qualifications only a single seller is available to provide these goods. PaCS Procurement Analyst Date Revised 10/08

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