Form Pr-025 - Single/sole Source Justification And/or Waiver Of Competitive Bidding Page 2
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3Office of Sponsored Programs; 1960 Kenny Road; Columbus, OH 43210
Single/Sole Source Justification and/or Waiver of Competitive Bidding
Part 2A: Summary of Quotations Obtained
Indicate the items you wish to purchase and their prices by vendor. Attach price quotations from each vendor contacted. If you have
quotations from more than two vendors, or more than three items, please complete additional copies of this page, or attach a spreadsheet
with this information.
List all vendors who were contacted but did not
provide a price quotation.
Name of vendor selected
Conflict of Interest: In selecting the vendor, the Principal Investigator (PI) certifies that, to the best of his/her knowledge, neither the
principals, directors, owners, employees, nor business associates (including respective family members) of the vendor selected are
employees of The Ohio State University and/or any agency of the State of Ohio. Such vendors are restricted from contracting with the Office
of Sponsored Programs per OMB Circular A-110 and Section 2921.42 of the Ohio Revised Code.
Part 2B: Supporting Justification and Documentation
Please attach the specifications you provided to the vendors.
Please attach the price quotations included in your summary above (Part 2A).
Part 3: Justification for Vendor Selection
Check one of the following and attach justification.
Competitive price quotations were obtained, and the lowest bidder was selected.
Competitive price quotations were obtained, but the lowest bidder was not selected.
Please attach a memorandum with justification to support your decision to reject each of the lower bids (than the one
selected). Your decision must be based upon scientific, technical, and/or economic reasons.
Competitive price quotations were not obtained, and a single/sole source procurement is requested. The goods or services required
to satisfy the university’s needs are only available from one supplier. Provide the following:
1. A memorandum of explanation to support your request to designate a particular vendor and/or a specific product for
a single/sole source purchase.
2. The price quotation from the vendor you selected and the vendor's published price list highlighting all items listed on the
price quotation. If the vendor does not have a published price list, provide a letter from the vendor certifying that the
quoted price is equal to or less than that given to the vendor's most favored customers or other
government agencies.
3. For custom products or services where the price is not derived from a published price list, you must attach the price
quotation and a cost analysis from the vendor you selected. See Part 4.
Page 2 of 3 - form continues on page 3
PR-025 (Revised 07/10)
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