THE UNIVERSITY OF WEST FLORIDA
EXEMPTION FROM COMPETITION AFFIDAVIT
Req. #:
Vendor Name:
Vendor Address:
Vendor FAX:
Vendor Email:
Over $99,999.99, Approval by Over $499,999.99, Approval by
VP for Div of Finance and Admin. Provost
Requestor's Signature Title Date
Dept. Head/Chair/Dean's Signature Title Date
Buyer's Signature Title Date
Procurement Director's Signature Title Date
Betsy Bowers Date George Ellenberg Date
PURCHASES COSTING $75,000 + Failure to timely file a protest or failure to timely deliver the required bond or other security in accordance with Board
of Governors (BOG) Reg. 18.002 and 18.003 shall constitute a waiver of protest proceedings.
Date & Time Decision Posted: _______________________ Date & Time Decision Removed:____________________
Rev 09/01/2018
Date:
FOP: Amount:
Vendor Contact:
Vendor Phone:
Department Contact: Department Contact Phone:
Sponsored Research Exemption
PART I JUSTIFICATION: (Check All That Apply)
Updating Outdated Equipment W/New Version
Continuing Ed/Fees Collected
Emergency
Infrastructure Connectivity
Compatibility
Unique Technical Requirements
Please provide detailed answers to the following questions:
1. What is unique about this service/commodity to classify it as exempt from competition? Attach sheet if needed.
2. Why is this uniqueness needed? Attach sheet if needed.
3. Explain the reasons for all the above choices that were checked. Attach sheet if needed.
PART II APPROVAL: I/We, the undersigned, certify the above to be true and correct to the best of my/our knowledge and belief. I/we as
UWF employee(s) taking part in the development of the affidavit, attest that I/we am/are independent of, and have no conflict of interest
in, the entities to which this non-competitive award is made.
PART III
Comments:
