This section captures essential metadata about the requesting department and the proposed vendor. Accurate completion ensures proper routing, budget allocation, and compliance tracking. All fields marked mandatory must be completed to prevent processing delays.
Requester Full Name
Requester Official Title
Requester Department or Business Unit
Requester Official Email Address
Requester Direct Contact Number
Department Budget Code or Cost Center Identifier
Department Head or Budget Approver Name
Brief Description of Department's Core Function
Proposed Vendor Legal and Operational Details
Vendor Legal Entity Name
Vendor Registration or Tax Identification Number
Vendor Registered Address
Vendor Primary Contact Person
Vendor Contact Email
Vendor Contact Phone
Vendor Corporate Website URL
Vendor Enterprise Size Classification
Large Enterprise (1000+ employees)
Mid-Market (100-999 employees)
Small Business (10-99 employees)
Startup (<10 employees)
Non-Profit Organization
Government Entity
Academic Institution
Vendor Diversity and Inclusion Certifications (select all that apply)
Minority-Owned Business
Women-Owned Business
Veteran-Owned Business
Disabled-Owned Business
LGBTQ+-Owned Business
Indigenous-Owned Business
No Diversity Certifications
Is this vendor an existing approved supplier with prior contract history?
Previous Contract or Purchase Order Number
Explain why a new vendor is being proposed despite sole-source restrictions for first-time suppliers
Total Proposed Contract Value (in USD)
Proposed Contract Duration (in months)
Requested Contract Start Date
Primary Service Category
Information Technology & Software
Professional & Consulting Services
Facilities & Real Estate
Logistics & Supply Chain
Manufacturing & Engineering
Research & Development
Marketing & Communications
Human Resources
Financial Services
Legal & Compliance
Other
Criticality Level of This Service to Business Operations
Mission-Critical (business would halt)
Business-Critical (severe revenue impact)
Operational (significant efficiency loss)
Standard (routine operational need)
This section requires detailed technical justification for bypassing competitive bidding. Provide evidence-based rationale demonstrating why this vendor is the only viable source. Vague or insufficient justification will result in automatic rejection. Attach supporting documentation where indicated.
Detailed Technical Description of Required Service or Solution
Upload Technical Specifications Document or Statement of Work (SOW)
Primary Reason Competitive Bidding Is Not Feasible
Proprietary Technology or Intellectual Property
Unique Technical Expertise or Rare Capabilities
Urgent Time Constraint Due to Emergency or Business Critical Event
Interoperability with Existing Critical Infrastructure
Regulatory or Compliance Mandate
Single Source Availability in Market
Other (requires detailed explanation)
Describe the proprietary technology or IP protection (patents, trade secrets) that prevents alternative solutions
Detail the unique qualifications, certifications, or rare expertise that only this vendor possesses
Explain the emergency or critical event creating time constraint and why advance planning was not possible
Describe the existing infrastructure complexity and why integration requires sole-source vendor
Reference the specific regulation, standard, or authority mandating this specific vendor
Provide evidence of market research demonstrating no alternative suppliers exist
Provide comprehensive alternative justification with supporting evidence
Describe Comprehensive Market Research Efforts Conducted to Identify Alternative Vendors
Alternative Vendors Evaluated (if any)
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Upload Market Research Documentation, RFI Responses, or Industry Reports
Did you consult with independent industry experts or third-party advisors?
Expert Consultation Details
Expert Name | Organization | Consultation Date | Key Findings Summary | ||
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Quantified Business Impact if This Sole-Source Request Is Not Approved
Time Sensitivity Classification
Immediate (less than 7 days)
Urgent (7-30 days)
High Priority (1-3 months)
Moderate Priority (3-6 months)
Planned (6+ months)
This section requires rigorous financial analysis to demonstrate that the proposed sole-source pricing is fair, reasonable, and represents value for money. Provide quantitative evidence and comparative benchmarks. Incomplete cost justification will trigger enhanced scrutiny.
Total Proposed Contract Value (in USD)
Detailed Cost Breakdown with Benchmarking
Cost Category | Amount (USD) | Percentage of Total (%) | Benchmark Source or Justification | Reasonableness Rating (1=Concerning, 5=Excellent) | ||
|---|---|---|---|---|---|---|
A | B | C | D | E | ||
1 | Direct Labor & Expertise | $350,000.00 | 46.7 | Bureau of Labor Statistics - IT Security Specialists | ||
2 | Specialized Software Licenses | $150,000.00 | 20 | Vendor-published price list - no variance | ||
3 | Project Management & Overhead | $100,000.00 | 13.3 | Industry standard 15% overhead rate | ||
4 | Travel & Expenses | $75,000.00 | 10 | Estimated 50 trips @ $1500 average | ||
5 | Contingency Reserve | $75,000.00 | 10 | Standard 10% risk contingency | ||
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Pricing Model Structure
Fixed Price (lump sum)
Time & Materials (hourly/daily rates)
Unit-Based Pricing (per transaction/device)
Hybrid Model (combination)
Cost-Plus (cost + fixed fee)
Value-Based Pricing
Has this vendor provided similar services at different pricing in the past 24 months?
Historical Pricing Comparison
Previous Contract ID | Previous Contract Value | Contract Date | Price Change (%) | Change Justification | ||
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Have you conducted formal market rate benchmarking for this service category?
Summarize Benchmarking Sources, Rate Ranges, and Variance Analysis
⚠️ WARNING: Lack of benchmarking will require enhanced CFO review and may delay approval by 10 business days.
Has a formal should-cost analysis been performed by finance or cost engineering?
Upload Should-Cost Analysis Document
Has a value analysis been conducted to assess cost-benefit beyond price?
Summarize Value Drivers: quality, speed, risk reduction, innovation, strategic alignment
Has Total Cost of Ownership (TCO) been calculated for a 3-year period?
3-Year TCO Estimate (USD)
Price Reasonableness Determination
Highly Reasonable (significant evidence)
Reasonable (adequate benchmarking)
Fair (some concerns but acceptable)
Concerning (requires CFO justification)
Unreasonable (likely to be rejected)
Negotiation Summary: Key Concessions, Discounts, or Value-Adds Secured
Identified Cost Risk Factors (select all that apply)
Foreign currency exchange volatility
Specialized labor shortage
Raw material scarcity
Regulatory or tariff changes
Technology obsolescence
Vendor financial instability
Scope creep potential
No significant risk factors
Cost Contingency Reserve Percentage Included
Payment Terms Structure
Net 30 days
Net 60 days
Net 90 days
Upfront payment
Milestone-based payments
Quarterly payments
Annual payments
Other
Does contract include Most Favored Customer (MFC) pricing clause?
✅ MFC clause provides price protection if vendor offers lower rates to other customers during contract term.
⚠️ Absence of MFC clause increases price risk. Consider negotiating inclusion.
Complete this rigorous risk assessment to evaluate vendor security posture, operational resilience, and compliance status. Any identified high-risk areas must include mitigation plans. This assessment is mandatory for sole-source approvals.
Financial Stability Assessment (based on latest audited financials)
Excellent (strong balance sheet, profitable)
Good (stable, minor concerns)
Fair (some financial stress)
Poor (significant concerns)
Unknown (no financial data available)
Describe Financial Risk Mitigation Plan
Describe Financial Risk Mitigation Plan
Explain why proceeding without financial data is justified and required risk mitigations
Upload Vendor Financial Statements or Credit Report
Operational Resilience Rating (consider redundancy, staffing, disaster recovery)
Has vendor's Business Continuity Plan (BCP) been reviewed?
Upload BCP Review Summary
Plan for BCP review and risk acceptance justification
Cybersecurity and Data Protection Certifications (select all verified)
ISO 27001 Certified
SOC 2 Type II Audited
NIST Cybersecurity Framework
PCI DSS Compliant
GDPR Compliant
HIPAA Compliant
No Certifications Verified
Describe Cybersecurity Risk Assessment and Compensating Controls
Is a formal Data Processing Agreement (DPA) required for this engagement?
DPA Status
DPA fully executed
DPA in final negotiation
DPA not yet initiated
Expected DPA Execution Date
Justification for proceeding without DPA and risk mitigation
Insurance Coverage Verification
Insurance Type | Coverage Amount (USD) | Policy Expiry Date | Certificate Verified | ||
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A | B | C | D | ||
1 | General Liability | $2,000,000.00 | 12/31/2025 | ||
2 | Professional Indemnity | $5,000,000.00 | 12/31/2025 | ||
3 | Cyber Liability | $10,000,000.00 | 12/31/2025 | ||
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Regulatory Compliance Status
Fully Compliant (all requirements met)
Partially Compliant (minor gaps with remediation plan)
Non-Compliant (significant gaps)
Not Applicable (no regulatory requirements)
Describe Compliance Gaps and Remediation Timeline
Justification for Proceeding Despite Non-Compliance and Risk Mitigation Strategy
Ethical Standards and Sustainability Certifications
SA8000 Social Accountability
B Corporation Certified
Fair Trade Certified
UN Global Compact Signatory
No Ethical Certifications Verified
Has a Geopolitical Risk Assessment been conducted for this vendor?
Summarize Geopolitical Risk Factors and Mitigation Strategy
Dependency Risk Level (impact if vendor fails)
Low (easily replaceable)
Medium (moderate disruption)
High (significant business impact)
Critical (business continuity threat)
Dependency Risk Mitigation Plan
Critical Dependency Risk Mitigation and Exit Strategy
Will the vendor use subcontractors for delivery?
List subcontractors and due diligence performed
Are performance guarantees or penalty clauses included?
Describe Guarantee Structure and Remedy Provisions
Has a formal Risk Register been developed for this engagement?
Overall Risk Rating Recommendation
Low Risk (proceed with standard monitoring)
Medium Risk (proceed with enhanced oversight)
High Risk (proceed with executive risk acceptance)
Critical Risk (recommend against sole-source)
This section requires formal executive authorization. All preceding sections must be fully completed before submission for approval. Approval authorities must independently verify key claims and assumptions. False attestations may result in disciplinary action.
SECTION A: Head of Procurement Review and Recommendation
Head of Procurement Name
Procurement Review Date and Time
Procurement Approval Recommendation
Recommend Approval (compliant and justified)
Recommend Approval with Conditions (minor issues)
Recommend Rejection (insufficient justification)
Escalate to CFO for Decision (significant concerns)
Escalate to Procurement Committee (high value/high risk)
Procurement Conditions or Stipulations (if applicable)
I, as Head of Procurement, have independently verified the technical rationale and market non-availability claims
I confirm that all mandatory documentation has been provided and is satisfactory
I acknowledge the risks associated with sole-source procurement and accept them on behalf of the organization
Head of Procurement Digital Signature
SECTION B: Chief Financial Officer Financial Risk Assessment and Approval
Chief Financial Officer Name
CFO Review Date and Time
CFO Financial Risk Assessment
Financial Risk Acceptable (within budget and risk appetite)
Financial Risk Moderate (requires enhanced monitoring)
Financial Risk High (requires Board notification)
Financial Risk Unacceptable (recommend rejection)
Is budget availability confirmed and approved for this expenditure?
Budget Approval Plan and Timeline
I certify that the pricing represents value for money and is fair and reasonable based on market conditions
I confirm that cost benchmarking and should-cost analysis are adequate for the expenditure level
Chief Financial Officer Digital Signature
SECTION C: Escalation Path (if required)
If escalation is required, route to
Chief Executive Officer (CEO)
Board of Directors
Procurement Committee
Executive Risk Committee
Not Applicable (no escalation needed)
Reason for Escalation
SECTION D: Final Authorization and Implementation
Final Decision Authority
Head of Procurement (delegated authority)
Chief Financial Officer (standard approval)
Escalated Authority (CEO/Board)
Rejected - Do Not Proceed
Approved Implementation Start Date (if approved)
Is a post-award audit or review required?
Post-Award Audit Scope and Timing
I acknowledge that sole-source procurement requires enhanced transparency and may be subject to internal audit review
To configure an element, select it on the form.