Fillable Fy2014 Gpc Purchase Request printable pdf download

FY2014 GPC PURCHASE REQUEST < $3,000

Agencies must comply with all regulatory and statutory rules which include FAR Part 8, Required Sources of Supplies and Services regardless

of dollar value. According to the order of precedence outlined in FAR Part 8, DoD agencies must first seek to fulfill requirements through Ability

One/JWOD, then from existing Government pre-priced contracts or Blanket Purchase Agreements whenever possible. Open market

commercial sources should only be used as the last available option for fulfilling DoD requirements (see note in “Required Government

Sources Reviewed” section below).

ALL FIELDS ON THIS FORM ARE REQUIRED TO BE FILLED IN.

PR NUMBER

REQUESTOR

DISTRICT/SCHOOL OR OFFICE

DATE REQUESTED

REQUIRED GOVERNMENT SOURCES REVIEWED

NOTE: Before selecting from the options below, you must conduct market research to determine if Ability One/JWOD has an item that is “essentially the

same” (ETS) as the item you require; if they do, you MUST purchase the Ability One item or obtain a waiver from them. If Ability One does NOT have an ETS

item, then your next source option would be vendors with pre-priced contracts or BPAs with the Government (e.g. GSA contracted vendors). Open Market or local

commercial vendors should only be used as a last resort, and only after adequate market research has been conducted to determine what you need is not

available from Ability One or other contracted vendors, or that pricing from a commercial vendor is actually less than GSA pricing.

OPEN MARKET

ABILITY ONE/JWOD

GSA

PRE-PRICED CONTRACTS/BPAs

Not offered/available

CHOOSE FROM LIST

REASON

Waiver attached

!! REMEMBER: SHIPPING ON ALL ORDERS MUST BE FOB DESTINATION !!

SOURCE ROTATION FAR Subpart 13.202 (a)(1) mandates; micro-purchases shall be “equitably distributed” among

all qualified suppliers to the greatest extent practicable.

PURCHASE DOCUMENTATION

VENDOR NAME

ITEM PART NO. & DESCRIPTION

QTY

UNIT PRICE

TOTAL AMOUNT

500.00

VENDOR POC

TELEPHONE NUMBER

CONTRACT OR BPA NUMBER

DATE OF QUOTE

CARRIED OVER FROM CONTINUATION SHEET

SUBTOTAL

500.00

SHIPPING, HANDLING, ETC.

NOTE: Please ensure you keep hard copies of all

supporting documents pertaining to your purchase

DISCOUNT OFFERED (E.G. AAFES DISCOUNT)

(quote, invoice, receipts. etc.)

500.00

FOREIGN CURR TOTAL @ DAILY RATE

Enter foreign currency exchange rate (Daily Rate) above. The form will convert the pricing to the $US equivalent for estimate of final cost.

Budget Rate Amount: [Leave blank if prices are in US Dollar]. This

determines the amount deducted from your Purchase Log.

Select Currency:

US (Dollar)

$500.00

THE PRICE QUOTE BY VENDOR #1 IS CONSIDERED REASONABLE BASED ON:

ADEQUATE VENDOR PRICE COMPARISON

COMPARISON TO PRICES PREVIOUSLY FOUND REASONABLE (ONLY IF $3,000 OR LESS)

ACCOUNTING CLASSIFICATION:

AMOUNT:

$500.00

APPROVING OFFICIAL CERTIFICATION: Except as noted, approval is granted to purchase the item(s) listed above using the Governmentwide Commercial Purchase card. I certify that the supplies and services

listed below and in the list are properly chargeable to the following allotments, the available balances of which are sufficient to cover the cost thereof, and funds have been committed.

DATE

APPROVING OFFICIAL:

SIGNATURE:

APPROVED:

DATE

CARDHOLDER:

SIGNATURE:

ORDERED:

DATE

REQUESTOR RECEIVING SIGNATURE:

RECEIVED:

IF THE AMOUNT OF THIS PURCHASE IS MORE THAN $3,000.00, USE DoDEA GPC 8052-1.