HomeMy WebLinkAbout- - Hazardous Materials Disclosure PSA Att.2 - 6/19/2012JUSTIFICATION FOR SOLE SOURCE REQUEST
Date: May XX, 2012 Dept./Div.: Fire / Prevention Phone: 714-754-5155
Contact: Steve Bunting, Interim Deputy Fire Chief
Description of Equip. /Service Req.: Haz Mat Coordinator/Consultant
Recommended Vendor: Michelle Rudaitis
Address: 2112 Colina del Arco Iris, San Clemente, CA 92673 Phone: 714-244-6183
1. Check reason for sole source request:
❑ Sole Source: No other items are known to exist which perform the same function.
❑ Proprietary: The item is held under exclusive title, trademark or copyright by a private person or
company; a proprietary distributorship would also apply.
❑ Standardization: The City requires the item(s) to standardize parts, design, quality, etc. (explain in
more detail below)
2. Is the product or service available from other sources?
❑ Yes
® No
If YES, list name of vendors:
If NO, explain why the product/service is available from only one source:
This consultant has worked on this program for Costa Mesa since 1998 and provides additional services to the
department including vacation and other leave coverage for the fire prevention staff as well as assistance
with work overflow.
3. Can your requirements be modified so that competitive products or services may be used?
❑ Yes
❑ No Please explain:
Requirements are mandated under state laws.
4. How does the recommended vendor's prices or fees compare to the general market?
State Law allows the administering agency to charge fees adequate to administer the program; thus, making
them self-funded.
Dept./ Div. Head's Signature:
Purchasing Supervisor's Signature:
Purchasing Officer's Signature:
Sole Source Vendor form - online
Date:
Date:
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