Sole Source Purchase Justification Form
Submit your justification for a sole source purchase to initiate the approval process.
Requester Full Name
*
First Name
Last Name
Department/Unit
*
Email Address
*
example@example.com
Date of Request
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Title of Purchase Request
*
Description of Product or Service Needed
*
Vendor Name
*
Vendor Contact Information
*
Estimated Cost (USD)
*
Reason for Sole Source Justification
*
Only known source
Compatibility with existing equipment
Unique features or specifications
Urgent need that cannot be met by other suppliers
Other (please specify)
Describe why alternative vendors or products are not suitable
*
Describe the impact if this purchase is delayed or not approved
*
Alternative Vendors Considered (if any)
Supervisor/Approver Name
*
First Name
Last Name
Supervisor/Approver Email
*
example@example.com
Signature of Requester
*
Submit Justification
Submit Justification
Should be Empty: