California Department of Aging Equipment Justification Form Instructions: Please answer the questions below; the responses must coincide with the budget.
AAA Name and Number:
AAA Procurement Contact:
Budget Version:
Question Response
Please describe the item or items
to be purchased.
Select the procurement method(s)
used to select vendor (i.e., price
quotes, competitive bids, auction
site). Check all that apply.
☐ Price Quotes
Competitive bids
Auction
Other (Describe):
☐
☐
☐
Where will the equipment be
located? Site name:
County:
Please select the AAA program
the equipment will be funded by.
If more than one, please select
other and list all applicable
programs.
Program:
Other:
Please give a detailed justification
why the equipment is needed, and
how it will be used to benefit the
program.
The year the last time this item
was purchased and the quantity.
Will the equipment be used solely
by the specified AAA Program(s)
from which the purchase will be
funded?
☐ Yes ☐ No
If requesting a vehicle, provide a
list of the existing fleet vehicles,
and the reason the existing fleet
cannot meet ongoing program
needs.
STATE OF CALIFORNIA
DEPARTMENT OF AGING
EQUIPMENT JUSTIFICATION FORM
CDA 7037 (REV 03/2022)