65--583-15-4-943-4034-SORIN-HEART VALVE

JUSTIFICATION FOR SINGLE SOURCE AWARDS IAW FAR 13.106-1 (OVER MICRO-PURCHASE THRESHOLD($3K) BUT NOT EXCEEDING THE SAT ($150K)) IAW FAR13.104, COs must promote competition to the maximum extent practicable to obtain supplies and services from the source whose offer is the most advantageous to the Government, considering the administrative cost of the purchase. When competition is not practicable, IAW FAR13.106-1(b), COs solicit from a single source for purchases not exceeding the simplified acquisition threshold. COs may solicit from one source if the CO determines that the circumstances of the contract action deem only one source reasonably available (e.g., urgency, exclusive licensing agreements, brand-name or industrial mobilization). IAW FAR13.106-3(b)(3),COs are required to include additional statements explaining the absence of competition (see 13.106-1 for brand name purchases) if only one source is solicited and the acquisition does not exceed the simplified acquisition threshold (does not apply to an acquisition of utility services available from only one source) or supporting the award decision if other than price-related factors were considered in selecting the supplier. This template when completed can be used to document single source awards IAW FAR13.106-3(b)(3). Note: Statements such as "only known source" or "only source which can meet the required delivery date" are inadequate to support a sole source purchase. 1. PURCHASE REQUEST OR REQUISITION NUMBER: 583-15-4-943-4034 1A. PROJECT/TASK NUMBER N/A 1B. ESTIMATED AMOUNT: $10,164.00 2. BRIEF DESCRIPTION OF SUPPLIES OR SERVICES REQUIRED AND THE INTENDED USE: Prosthetic Heart Valves - 1 EA 33MM, 1 EA 27MM Sorin Group USA Inc., 14401 West 65th Way, Arvada, CO 80004. 3. UNIQUE CHARACTERISTICS THAT LIMIT AVAILABILITY TO ONLY ONE SOURCE, WITH THE REASON NO OTHER SUPPLIES OR SERVICES CAN BE USED: Emergency order - The prescribed item represents a compelling urgency in order to ensure the patient's physical well-being. The item described will be purchased from the Vendor identified because they are able to meet the Veteran's immediate need. Failure to meet the immediate need may result in physically injury to the patient, medical liability to the agency, and would adversely impact the mission and objectives of the VHA. 4. REASON THAT SUGGESTED SOURCE IS THE ONLY SOURCE, WHICH CAN PROVIDE THE SUPPLIES OR SERVICES: Surgically implanted products are specified by the clinical team to meet the unique and comprehensive needs of each Veteran with an identified medical indication. The specific product described above has been determined by the clinical team to be the best product to treat the Veteran patient's medical condition and functional limitations. Substituting an implant with other than that specifically prescribed is beyond the role, competency and professional functions of the Contract Specialist and would be detrimental to the treatment of the Veteran patient. Full and open competition for the above described implant negates the clinician's subject matter expertise as related to the medical treatment for the individual Veteran. In this case the by-name device(s) is/are the specific prescription and method of treatment for the Veteran-patient. 5. DESCRIPTION OF MARKET RESEARCH CONDUCTED AND RESULTS OR STATEMENT WHY IT WAS NOT CONDUCTED: Market research was not conducted due to the urgent nature of the request. 6. Contracting Officer's Certification: Purchase is approved in accordance with FAR13.106-1(b). I certify that the foregoing justification is accurate and complete to the best of my knowledge and belief. Signature: ______________________________ Date:____________________ Name:__________________________________ Title:___________________________________ Facility:_________________________________