Sole Source Request Form

City of Roswell Justification for Other Than Full and Open Competition Form

Purchasing Department

Please ensure that the relevant Department Director agrees with the justification for Sole Source prior to submittal.

In accordance with City of Roswell policy, any requisition totaling $2,500 or more that has not been competitively bid/quoted, must be accompanied by a sole source/single source and brand justification form. All transactions are subject to review and audit.

A sole source/single source/brand justification cannot be based on price. City of Roswell requires price consideration be evaluated via competitive bid/quote only. The purchase must be based on the requestor’s research and evaluation of the requested product/services and its availability (or lack of availability) from multiple sources/brands. The sole source/single source/brand justification form must be completed and signed by the requesting department head.

Approximately five business days are required to evaluate and process a sole source/single source/brand request. Please consider this when submitting a request, and allow sufficient time prior to deadlines (quote expiration, grant expiration, etc.)

The City of Roswell is committed to active and open competition in the purchase of supplies, equipment and services. The final determination as to whether such an exception request is valid will be made by the Finance Director and rest on the existence of a valid supportable requirement which is adequately documented. The following are definitions to exceptions that may be considered:

Sole Source Procurement Definition: Sole source procurement refers to those purchases where only one supplier that provides the product. Usually these are unique products that you cannot find anywhere but only thru one supplier/manufacturer/distributor. If the manufacturer of an item that would be a sole brand request limits competition in the area to one distributor, that distributor would be the sole source.

Single Source Procurement Definition: Single source purchasing refers to purchases from one selected supplier, even though there are other suppliers that provide the product or service. There are other companies to choose from, but for strategic and possibly cost reasons the City decides to use only a specific supplier.

Sole Brand Purchase Definition: Sole Brand Purchase occurs when MULTIPLE vendors may provide the same product but a specific brand is needed. An example of appropriate use of sole brand is when specific piece of equipment is needed to match existing equipment or hardware.

Requestor Name*

First NameLast Name

Requestor Email*

example@example.com

Department Director Email*

example@example.com

Department*

Type of Request*

Sole SourceSingle SourceSole Brand / Product

Short Description of Product or Services to be supplied*

Short but full description of what the product or service is.

Is this request based on a distributor claim of an exclusive agreement with the manufacturer or claim of patent?*

YesNo

Claim of exclusivity or patent.*

Browse Files

Exclusive Distributor or claim of patent letter.

Cost (total or first year if there will be ongoing costs)*

Estimated Annual (Maintenance) Costs (if any)

NOTE: This is an order of magnitude question - not an exact question. Use projected annual cost.

Justification / Business Case*

Why do we need a sole source? Can other companies provide functional equivalent goods or services?

Short Description of Exclusive Capabilities*

Short Description of Proposed Source/Brand unique capabilities and/or personnel to perform this work; and why this is the only source/brand/service available that can meet your functional requirements.

Requested Sole/Single Source Supplier (Company Name)*

Company Contact Name*

Company Contact Email*

Company Contact Phone*

Other Companies contacted to confirm the sole / single source and why they cannot provide what we need, or why it is in the best interest of the City to not buy from that source.*

If no other companies were contacted to justify the sole source, state that here.

Other Sole / Single Source Justification Documentation / Manufacturers Letter

Upload a File

If your Sole / Single Source justification requires complex reasoning or extensive technical descriptions please upload the document here. Also upload emails sent to request quotes from companies that did not respond or research indicating limited market if applicable.

Sole Source Conflict of Interest Statement - please select any that apply.*

Department has no Conflict of Interest in recommending this supplier.Department has a previous relationship with the supplier/rep. explained below.

Explanation of Potential Conflict of Interest*

General Notes

Please make any general notes regarding the request here.