Attachment 2
Sole Source Justification Form
Complete and submit this form to the Purchasing Division when requesting exception to the competitive procurement process.
Sole source procurement refers to those purchases where there is only one supplier that can provide the product/service to the City. Please be as thorough and detailed with explanations to assist in the evaluation process .
Date:
Department: Division:
Name: Title:
Requisition No:
Vendor Name: Vendor ID:
Item Description/
Scope of Work:
1. Why is the acquisition restricted to this good/service/supplier? (Explain why the acquisition cannot be competitively bid, and Include consequences that would occur from not contracting with this supplier.)
2. How was the price offered determined to be fair and reasonable? Explain what the basis was for comparison and include cost analyses as applicable. (Compare to vendor’s previous or current offer to the City or to another agency/company, market research – or any other method of comparison that will substantiate fair and reasonable pricing in the absence of competition).
Attach back-up documentation for reference.
Single Source Justification Form
3. Describe any cost savings realized or costs avoided by acquiring the goods/services from this supplier. Include consequences that would occur from not contracting with this supplier.
Certification of Responsibility:
I am aware of the City of Riverside requirements for competitive bidding and the established criteria for justification of single source purchasing. As an authorized Department representative, I have gathered the required technical information and have made a concentrated effort to review comparable/equal vendors or equipment. I hereby certify the validity of the information and feel confident this justification of single source meets the City’s criteria and would withstand audit or vendor protest.
Signature Date
Department Head Date
Purchasing Manager (Up to $50,000)
Over $50,000 - Must be submitted for City
Council Approval with Purchasing Manager
concurrence.
Date