Commonwealth of Pennsylvania
Notice of Forthcoming Procurements

This form is to be submitted at the beginning of the process, for all procurements which will exceed the dollar thresholds as established in The Procurement Handbook, Part I, Chapter 7- Thresholds and Delegations.
         Status: Reserved  
Requesting Agency Information
Date:   5/19/2013
Agency:*
Bureau:*
Agency Contact Person:*
Contact Tel#:*
Format : ###-###-####
Contact Email:*
Confirm Email:*
Project Manager:*
Project Title:*



Description of Project*





Attach Project Charter or SOW (if available) 		* For IT-Services and IT Materials, please choose IT

Documents naming conventions should not contain special characters (i.e. -, (), &, etc).
Existing Contract Method of Procurement:*




Existing Contract Information:
Contract Number: *
Current Supplier: *
Contract Expires: *
Contract Spend: * Enter numeric values, No symbols

Note: If not in SRM Procurement, please attach copy of Contract
 


Documents naming conventions should not contain special characters (i.e. -, (), &, etc).
Please complete sections below
Anticipated Solicitation Posting Date
Anticipated Term of Contract/ Renewals
Original Term: year(s)
Number of Renewals: ea year(s) Enter decimal for months
Anticipated Method of Procurement*
Don't know which one to choose?


If IFB not checked for proposed method of contract, have you determined that the use of competitive sealed bidding is not practicable or advantageous?*
 Issuing Office
We are requesting
lead this procurement.
Estimated $ Amount

Per Contract Term Per Contract Term with Optional Years
Funding
Does this procurement involve IT?*
Does this procurement impact Article 43 employer / employees / union matters?"*
Please provide names of other individuals that would be required to attend a meeting in reviewing your upcoming procurement:
Name:   Email:



Please provide information on other potential suppliers that may be able to provide this service:
 Supplier Name


Please complete the following information in accordance with The Procurement Handbook: Part 1, Chapter 4, Contract Use, need and authorization:

When needed services are not available from within the Commonwealth, a contract can normally be justified if the following questions can be answered affirmatively and documented.
Are the services needed to satisfy a specific program or departmental objective?*
Can the results of a contract be anticipated?*
Will the anticipated results justify estimated costs of the contract?*
If a similar effort was previously undertaken, have the results of the prior effort been evaluated to determine why it was not successful and why the effort is to be duplicated either partially or wholly?*
Are knowledgeable agency personnel available to monitor a contractor's progress to ensure compliance with contract provisions? If the contract involves a system design, are agency personnel available to work with the contractor to ensure a smooth transition and understanding when the contractor transfers the complete design to the Commonwealth?*
Have all Commonwealth personnel policies and practices been considered and adhered to, assuring that the needed services should not be provided by an employee and the contract will not involve an employee/ employer/ relationship or violate labor relations?*
Approving Authority (Agency Head or Deputy reviewing and approving this request)
Name: Email: Date:
If you wish to receive a copy of any future emails associated with this request, including approval/disapproval please provide your e-mail address below and you will receive a copy in addition to the Agency Contact Person listed above.

Please note: Comptroller’s Office and BSBO will always receive a copy of the approval/disapproval email and need not be listed in this area.

The printed names on this form shall constitute the signature of these individuals and approval for the Agency request. Agencies must ensure that these individuals review the completed form and give their consent to apply their printed name on this form. No handwritten signatures shall be required in order for the form to be considered "signed" by these individuals.

E-mail:


By clicking this button, the form will be submitted to DGS/OIT depending upon the category selected.