ࡱ> JLI[ !(bjbjmm 0DbbU$ $ ~~~~~8L$T%f:( .7K $$$$$$$$&p)$~  $~~%(((*~~$($((w!!@"2(>F!$$%0T%!,"*:"*!!"*~!WZ@(4%WWW$$jWWWT%"*WWWWWWWWW$ D: SINGLE FEASIBLE SOURCE (SFS) APPROVAL REQUEST WORKSHEET TO: ______Commodities Section Manager Gary Eggen ( HYPERLINK "mailto:gary.eggen@oa.mo.gov" gary.eggen@oa.mo.gov); Phone: 573-751-2497; Fax: 573-526-9816 OA-Div of Purchasing, Rm 630, Truman Bldg., Jefferson City, Missouri ______Information Technology (IT) Section Manager Brent Dixon (brent.dixon@oa.mo.gov); Phone: 573-751-4903; Fax: 573-526-9816 OA-Div of Purchasing, Rm 630, Truman Bldg., Jefferson City, Missouri ______Services Section Manager Laura Ortmeyer ( HYPERLINK "mailto:laura.ortmeyer@oa.mo.gov" laura.ortmeyer@oa.mo.gov); Phone: 573-751-4579; Fax: 573-526-9816 OA-Div of Purchasing, Rm 630, Truman Bldg., Jefferson City, Missouri FROM: _________________________________ (Department name) _________________________________ (Department contact name, email address, phone) _________________________________ _________________________________ (Department agency address) RE: SFS Approval Request DATE: _________________________ DESCRIPTION: Please specify the exact product/service your department needs: _________________________________________ __________________________________________________________________________________________ Is this a one-time acquisition or an ongoing need to acquire this product/service? _________________________ If ongoing, please specify the period for which the SFS is being requested (e.g. July 1, 20XX through June 30, 20XX):_____________________________________________________________________________________ Contractor name and vendor number: ______________________________________________________________ Estimated annual amount of the SFS request: $_______________ JUSTIFICATION: In the space provided below or on an attached page, please explain how the product/service described above satisfies one or more of the following SFS criteria (section 34.044, RSMo): a. Supplies are proprietary and only available from the manufacturer or a single distributor; or b. Based on past procurement experience, it is determined that only one distributor services the region in which the supplies are needed; or c. Supplies are available at a discount from a single distributor for a limited period of time. ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ REMINDERS: 1) Sections 285.525 285.550, RSMo,: Section 285.530, RSMo, pertains, in part, to all state contracts for services over $5,000. It does not apply to solicitations for commodities only or to solicitations that include services in which the resulting contract will have no cost to the state (even though there may be value to the contractor). If a solicitation is for services and commodities, section 285.530, RSMo, applies if the services portion of the solicitation is over $5,000. Section 285.530, RSMo, may not pertain to some purchases that will be paid using exempt object codes. It is advised that each agency speak with its General Counsel if it has any questions as to the applicability of section 285.530, RSMo. Any SFS procurement that includes services over $5,000 must require the potential contractor to certify their current business status by completing Box A, Box B, or Box C of the BUSINESS ENTITY CERTIFICATION, ENROLLMENT DOCUMENTATION, AND AFFIDAVIT OF WORK AUTHORIZATION EXHIBIT. Reference Sections 285.525 to 285.550, RSMo, Guidelines located at  HYPERLINK "http://oa.mo.gov/purchasing/agency-information/section-285525-%E2%80%93-285550-rsmo-employment-unauthorized-aliens-and" http://oa.mo.gov/purchasing/agency-information/section-285525-%E2%80%93-285550-rsmo-employment-unauthorized-aliens-and for additional instructions regarding SFS procurements. NOTE: Section 285.530, RSMo, does not apply to procurements in which an agency contracts with a Missouri state agency or federal governmental entity. Section 285.530, RSMo, does pertain to procurements in which an agency contracts with a Missouri school, a Missouri university, an out of state agency, an out of state school, an out of state university, all political subdivisions, an instate vendor, or an out of state vendor. 2) Section 34.040.7, RSMo,: Verify if the vendor is in compliance with section 34.040.7, RSMo. Reference Section 34.040.7, RSMo, Vendor Compliance-Single Feasible Source Guidelines located at  HYPERLINK "http://oapurch.state.mo.us/compliance.shtm" http://oapurch.state.mo.us/compliance.shtm. NOTE: Agencies are not required to verify if Missouri state agencies and federal governmental entities are compliant with section 34.040.7, RSMo. Agencies are required to verify if the following entities are compliant with section 34.040.7, RSMo,: Missouri schools, Missouri universities, out of state agencies, out of state schools, out of state universities, all political subdivisions, instate vendors, out of state vendors, and foreign vendors. 3) Federal Funds: If SFS procurement will include federal funds, verify against the System for Award Management (SAM) ( HYPERLINK  HYPERLINK "https://www.sam.gov/portal/public/SAM/" https://www.sam.gov), provided by the General Services Administration (GSA), to ensure the vendor is not on the list of individuals, entities, and contractors excluded from Federal procurement and sales programs, non-procurement programs and financial and non-financial benefits. If the vendor is found on the list, the SFS procurement cannot be processed. 4) Secretary of State Business Registration: Verify whether the vendor is registered with the Secretary of State at  HYPERLINK "https://bsd.sos.mo.gov/BusinessEntity/BESearch.aspx?SearchType=0" https://bsd.sos.mo.gov/BusinessEntity/BESearch.aspx?SearchType=0. If the vendor is registered with the Secretary of State, document the vendors registration by including a copy of the screen print(s) of the applicable Secretary of State search results screen in the Departments procurement files. If the vendor is not registered with the Secretary of State, contact the vendor using the Secretary of State Business Registration E-Mail provided in Appendix H of the Procurement Manual located at  HYPERLINK "http://oapurch.state.mo.us/procurementsources.shtm" http://oapurch.state.mo.us/procurementsources.shtm or similar e-mail. If the vendors response to the e-mail states they are not required to register per a specific exemption stated in per  HYPERLINK "http://www.moga.mo.gov/statutes/C300-399/3510000572.HTM" section 351.572, RSMo, place the Secretary of State Business Registration E-mail and the vendors response in the Departments procurement files. If the vendors response does not indicate that they are exempt from registering with the Secretary of State due to one of the specific exemptions contained in section 351.572, RSMo, an award cannot be made to the vendor. However, Departments are encouraged to consult with their Department legal counsel to confirm validity of registration exemptions. Document the vendors ineligibility for award and places the documentation along with the Secretary of State Business Registration E-Mail and the vendors response in the Departments procurement files. 5) Purchasing Suspension/Debarment List: Verify whether the vendor is found on the Purchasing Suspension/Debarment List located on the Purchasing Vendor Information tab at  HYPERLINK "http://oa.mo.gov/purchasing/vendor-information" http://oa.mo.gov/purchasing/vendor-information. If the vendor is found on the list, an award cannot be made to the vendor. Documentation of the search results may include a screen print(s) of the Purchasing Suspension/Debarment List.     MO 300-1872 (Revised 09/08/2017) Page  PAGE 1 of  NUMPAGES 3 9=CO_kl  % @ A Q      A B P Ŵ͞{͞og_UhtD40JCJaJh CJaJhtD4CJaJheNhz5CJaJh^h5CJaJhh5>*CJaJh5CJaJhzCJaJjhNp0JCJUaJhIh20JCJaJhNpjhNpUh2CJaJh^hz5CJaJhz5CJaJhz5CJaJh 4 hz5CJaJ89=_  Q   [  gd 4 ^gdJh^gd7t 0^`0gd^gd2 0^`0gd7tgd $a$gd 4 P Z [ \ n r , 6 : D L % > ?   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