Single/SoleSourceJustificationForm
Use for all purchases of $5000 or more when low bidder has not been selected
Refertothebidsandquotationspolicyat:
http://www.case.edu/bizpolicies/procure
Brief Description of %ULHI'HVFULSWLRQRIPurchase:
SelectedVendor:_________________________________________
Checkboxesasappropriate:
(SECTION I) SOURCE JUSTIFICATION
PART A
Award to SINGLE SOURCE (Check one)
Reorderbasedonpreviousbidoranalysis(withinoneyear).Sendcopyofprevious
quote.Supplypreviouspurchaseordernumber_____________PODate_________.
Repairservicesorpartsunavailablefromanyothersourceexceptoriginalequipment
manufacturerortheirdesignatedservicingdealer.
Compatibilityofequipmentorsuppliesrequired.Listequipmentwithwhichpurchase
willbeused:Model#___________SerialNumber___________.
Upgradetoexistingsoftware.Availableonlyfromtheproducerofthissoftwarewho
sellsondirectbasisonly.
Usedordemonstrationequipmentavailableatalower-than-newcost.(Providecopyof
quoteshowingusedvs.newpricing.)
Other. (Explain in Section III)
PART B
Award to SOLE SOURCE (Check box below)
Onlyknownsourceintheworld.(Explain technical or other reasons why similar or like items
are not available for cost/price analysis in Section III.)