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DEPARTMENT OF NATURAL RESOURCES <br />SOLE SOURCE PURCHASE REQUEST <br />Submit Form to: <br />COMMODITIES (PSA, PJA)/ PRINTING -> King Weith (303) 291-7313 fax (303) 291-7107 <br />PCA, PEA, PIA, PKA PJA (Services & Contracts)-+ Maggie Van Cleef (303) 866-4188/fax (303) 866-5575 <br />PAA, PDA, PHA, PBA (Services & Contracts) --> Jim Sharp (303) 866-2532/fax (303) 866-5575 <br />For Purchase Orders: attach this completed form to your purchase request. <br />For Contracts: submit this form for prior approval be ore contract negotiations. <br />*************************************************************************************************** <br />Requesting Division: Colorado Water Conservation Board Contact: Rick Brown/Steve Shull <br />Phone # 866-3514 or 866-3998 Date: September 23, 2003 <br />Describe supply or service to be purchased: <br />The Contract is for administrative support to the Governance Committee and the Execurive Director for the Platte River <br />Endangered Species Partnership (PRESP). The PRESP is a joint effort between the states of Colorado, Nebraska, and Wyoming <br />and the United States Departrnent of Interior. The goal of the PRESP is to develop a long term endangered species program that if <br />agreed to would provide for endangered species compliance for water development projects in each state. <br />Delivery Date: OR Start Date Services Originally procured July 1, 1999 End Date: Extend to Julv 31, 2005 <br />APPROXIMATE COST: $ 700.000 for Colorado's Contribution <br />Recommended Vendor: (Name, Address, Phone, and Contact Person) <br />Nebraska Community Foundation Inc., 317 South 12th Street, Suite 200, Lincoln, NE 68508 <br />(402) 323-7332 <br />Jeffrey Yost <br />SOLE SOURCE STATUS IS DETERMINED AS FOLLOWS: (List all vendors/contractors contacted and describe criteria used <br />to deternune sole source status of the one recommended. ATTACH ADDITIONAL PAGES IF MORE SPACE IS NEEDED) <br />Nebraska Community Foundarion was idenrified as a funding enrity that could make payments on behalf of the 4 parties <br />participating in the PRESP. Since the parties all have specified dollar contriburion requirements (see Contract C153878 for details) <br />it is essential that a single entity distribute the funds according to the agreement. Because the other three entities (Nebraska, <br />Wyoming and the Departrnent of Interior) have agreements with Nebraska Community Foundation, they are the Sole Vendor <br />available to provide the required services. <br />Does the purchase represent a real or potential conflict of interest? ? Yes X No <br />Is this purchase for the services of an architect, engineer, landscape architect, surveyor or indushial hygienist? <br />? Yes X No <br />If this is a service purchase, has the Executive Director approved a Personal Services Purchase Authorization? <br />? Yes ? No <br />REQUESTED BY: <br />Print Name <br />Signature: <br />Date: <br />RECOMMENDED BY: <br />APPROVED BY: <br />State Purchasing Director or Representarive <br />Date: