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<br />." <br /> <br />,I <br />, <br /> <br />J <br /> <br />/ <br /> <br />i' <br /> <br />COLORADO DEPARTMENT OF TRANSPORTATION PROCUREMENT MANUAL <br /> <br />SOLE SOURCE PURCHASE REQUEST <br /> <br />Sole Source Procurement is an option if a purchase requirement is reasonably available only from <br />a single vendor or if it otherwise qualifies under Code of Colorado Regulations, lCCR10l-9 (see <br />next page for the text of this rule). <br /> <br />AITACH THIS COMPLETED FORM TO YOUR PURCHASE REQUISITION WHEN <br />SUBMITTING A REQUEST FOR SOLE SOURCE PURCHASE BY PURCHASE ORDER. <br /> <br />IF THE PURCHASE IS TO BE MADE BY AN AGENCY CONTRACT, SUBMIT THIS FORM FOR <br />PRIOR APPROVAL BEFORE CONTRACT NEGOTIATIONS. <br /> <br />REQUESTING PARTY: <br /> <br />PHONE # <br /> <br />DATE <br /> <br />DESCRIBE SUPPL Y(S)/SERVICE(S) TO BE PURCHASED: <br /> <br />START DATE: <br /> <br />END DATE: <br /> <br />APPROXIMATE COST: $ <br /> <br />RECOMMENDED VENDOR/CONTRACTOR: (Name, Address, Phone, and Contact Person) <br /> <br />SOLE SOURCE STATUS IS DETERMINED AS FOLLOWS: (List all vendors/contractors <br />contacted and describe criteria used to determine sole source status of the one recommended. <br />AITACH ADDITIONAL PAGES IF MORE SPACE IS NEEDED) <br /> <br />REQUESTED BY: <br /> <br />APPROVED BY: <br /> <br />Print name: <br /> <br />State Purchasing Director <br />or Representative <br /> <br />Authorized <br />Signature: <br /> <br />Date: <br /> <br />Date: <br /> <br />coar Procurement Manual - Sept. '95 <br /> <br />45 <br /> <br />0233 <br />