ࡱ> 9;8] Ubjbj 4&!b!b Vl l 84,`k!.|~D4x  $"O%!!4%!j  `&q6  ;!0k!&4H&&!!|k!&l B : CUSTOMER REQUEST FOR A BRAND/VENDOR SPECIFIC WAIVER OF COMPETITION CASE OF REQUISITION NUMBER: R__________ Please check the appropriate justification(s) below for a waiver of competition, pursuant to the North Carolina Administrative Code (01 NCAC 05B.1401). _____ Where performance or price competition is not available. _____ Where a needed product or service is available from only one source of supply. _____ Where emergency action is indicated. _____ Where competition has been solicited but no satisfactory offers are received. _____ Where standardization or compatibility is the overriding consideration. _____ Where a donation predicates the source of supply. _____ Where personal or particular professional services are required. _____ Where a particular medical product or service, or prosthetic appliance is needed. _____ Where a product or service is needed for the blind or severely disabled and there are overriding considerations for its use. _____ Where additional products or services are needed to complete an ongoing job or task. _____ Where products are bought for over the counter resale. _____ Where a particular product or service is desired for educational, training, experimental, developmental or research work. _____ Where equipment is already installed, connected and in service, and it is determined advantageous to purchase it. _____ Where items are subject to rapid price fluctuation or immediate acceptance. _____ Where there is evidence of resale, price maintenance or other control of prices, lawful or unlawful, or collusion on the part of companies, which thwarts normal competitive procedures. _____ Where the amount of the purchase is too small to justify soliciting competition or where a purchase is being made and a satisfactory price is available from a previous contract. _____ Where the requirement is for an authorized cooperative project with another governmental unit(s) or a charitable non-profit organization(s). _____ Where a used item(s) is available on short notice and subject to prior sale. Customers Statement (please elaborate on your justification(s) designated above by giving specific details): PLEASE SEE ATTACHED LETTER OF EXPLANATION. Customers Certification: I certify that this requested procurement does not violate the Universitys policy on Avoiding Vendor Conflicts of Interest.  HYPERLINK "http://www.wcu.edu/academics/research/Research-Compliance/conflicts-of-interest/index.asp" http://www.wcu.edu/academics/research/Research-Compliance/conflicts-of-interest/index.asp Customers Signature: Date: ______________ *** Purchasing Agent's Certification: I certify that the above statement describes a condition for which the North Carolina Administrative Code allows for a Waiver of Competition. Therefore, in reliance on the accuracy of the Customers Statement and the Customers Certification above, this request for waiver is approved. Purchasing Agent's Signature: Date: ______________ Purchasing Director Review and Approval required for all Purchase Requests over $25,000: Purchasing Director Signature: ________________________________________________Date: _____________     {00011887.DOC 3} Waiver of Competition form (02/11) {00011887.DOC 3} klmw    3 5 D E F K L M E F h n F G W X c wpp h-C6CJh-Ch}JO6CJh-Ch-C6CJh-ChM6CJ hM5CJha6hM5>*CJ h}JO6CJ hG$6CJhm<hM6CJ hM6CJhFmwhM6CJhFmwhMCJ h-CCJ h}CJhFmwh}CJ hFmwhMCJOJQJ^JaJ*Ckl  F  l F ( h e B3 & Fgd} & F gd-C & FgdMgdMgd}gdM$a$gdO^c d e q '.34<>GH^bct|~ṯwndh+EhF5CJhl/5>*CJh+EhF5>*CJhG$hFCJ h-C5CJ hOj5CJ hF5CJ hM5CJ h c5CJhFmwhM5CJhG$hOjCJ hM6CJ hV|"6CJ h}6CJh}h}6CJhFmwh}6CJh-ChM6CJh-Ch}6CJ'34./bc>?gdA  @&^gdG$gdFgdFgd-CBgjkw,-./78DLabcs¹Ȯrh^UhFhMCJhFhM5CJhFhD$5CJh c>*CJOJQJ^JaJh cCJOJQJ^JaJhMCJOJQJ^JaJ hFmwhMCJOJQJ^JaJh)hV"0JCJhhV"CJ hV"CJjhV"CJU hFCJ h-CCJh-Ch-CCJ h-C5CJhG$hFCJhFmwhMCJs!(=>?R 8:?AQ¸}y}y}y}ymfbYYbmh{LhACJhA h1hAh chAmHnHuh}jh}UhG$h*CJhFmwh*CJ h3PDCJ h*CJ h-+CJ hACJhAhACJhAhA5CJ h-+5CJ hFCJhFmwh cCJ h c>*CJ h cCJhFh cCJhFhMCJh ch cCJ"  ?@ARSTUgdF QRSTUhG$h*CJh}hA h1hA21h:p[]/ =!"#$% s02 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@_HmH nH sH tH <`< $BNormalCJ_HmH sH tH Z@Z $B Heading 1$<@&5CJ KH OJQJ\^JaJ DA D Default Paragraph FontRiR  Table Normal4 l4a (k (No List >O> $B fax info body ^4 @4 $B0Footer  !44 $BHeader  !6U`!6 F Hyperlink >*B*phH2H G$ Balloon TextCJOJQJ^JaJN/AN G$Balloon Text CharCJOJQJ^JaJ2/Q2 l/0 Footer CharCJFV aF FollowedHyperlink >*B*phOrPK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭Vc:E3v@P~Ds |w< U & CCUXc sQU 3U j , U X@ @H 0(  0(  B S  ? 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D L a b s   = > V ad1 hh^h`.ad1AV:%R= [ f eB+p(I[]Ng1 wf cpA! < ^ V"V|"D$G$ %,z%-+l/0k1G1{1r3d49.6;p;AA$B7B+Cg0C3PD .EF&FGIOtJ"eK{L}JOlOUsV'"X\i]O^bWbg},h|hibpq2rut GuFym&|>&}Q}$U[t.-CR?xr`9Tr$j`H%}@MjL"9I Ja"n^ =% 3`}!0P"&0HK{cm#s nyV.iwK$ 7*@: 1j[##XM$Oj(9?3l}88iu y:.!K8> @U @UnknownG.[x Times New Roman5Symbol3. .Cx Arial5. .[`)TahomaA$BCambria Math"1hcaca7 F  !24  3qHP ?$B2!xx )Form Sole Source Request (00011887-3).DOC00011887.DOC 3UNC Tamrick Mull Oh+'0$ <H h t  ,Form Sole Source Request (00011887-3).DOC00011887.DOC 3UNC Normal.dotmTamrick Mull2Microsoft Office Word@@%9@R@R  ՜.+,D՜.+,Hx  *[Compatibility Mode]UNCt  *Form Sole Source Request (00011887-3).DOC Titled8 _PID_HLINKS MAIL_MSG_ID1RESPONSE_SENDER_NAMEEMAIL_OWNER_ADDRESSAZhttp://www.wcu.edu/academics/research/Research-Compliance/conflicts-of-interest/index.aspHABAAVOAfoSrQoyzz6fa9BpasAVmADvvd/YrvCVWDfgUN8W5zBqj4CVeMITXV7iuzLLez(gAAAdya76B99d4hLGUR1rQ+8TxTv0GGEPdix@4AAA9mrMv1QjWAsvhmqwat+nhG6Jvk3YmK6PzOJfLbuG6oJyX1JEAjx+YQ==  !"#$%&')*+,-./1234567:Root Entry F&q<1Table&WordDocument4&SummaryInformation((DocumentSummaryInformation80CompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q