3
Revised 09/11/18 AH
CHECKLIST FOR DEPARTMENT
☐ Sole S
our
ce Justification Form
Completed
☐ Department Documentation/Memo
☐ Vendor Memo
☐ W-9 (required for new vendors)
☐ Index number provided for Advertising cost
(required only for purchases $25,000 or more)
☐ All documentation sent to Purchasing
Department for review
--------------------------------
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For Purchasing Department’s Use Only
CHECKLIST FOR PURCHASING
Purchase Requisition Number: __________________________
Date Received: ___________________
Documentation
☐ Departme
nt Docum
e
ntation/Memo Received
☐ Vendor Memo Received
Suspended/Debarred Vendors
If a company is listed as a Suspended/Debarred Vendor, we cannot proceed with this sole source procurement.
If the vendor is not listed, print screens for the file.
☐ Federal: www.sam.gov Date Checked: ___________________
☐ Missouri: http://oa.mo.gov/purchasing-materials-management Date Checked: ___________________
Advertising
The University must advertise sole source procurements in at least two (2) daily newspapers when the
estimated expenditure is $25,000 or more within a 12-month period.
☐ Posted on Purchasing Website ($
10,000 or more) Date Posted: _________________________
☐ Newspaper Advertisements Required ($25,000 or more) Date Ads Published: ___________________
Date Purchase Orde
r can be Processed:
Five (5) days after posted/pu
blished date
_________________________________
Inquiries
☐ No Inquiries Received
☐ Inquiry(s) Received
Date Received: _______________
Name and Contact Information of Requestor(s):
____
_________________________________________________
_____________________________________________________
____
_________________________________________________