**Attachment D**

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  **HHS Template and Instructions for a\
  General Services Administration Federal Supply Schedule\
  Limited Source Justification**

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**Completion Instructions:** HHS has established a standard template for
preparation of a Limited Source Justification (LSJ). For Federal Supply
Schedule (FSS) acquisitions over the Simplified Acquisition threshold,
Operating Divisions (OPDIVs) shall prepare the template in accordance
with these completion instructions. ([NOTE]{.underline}: *The Project
Officer (PO) has responsibility for completing all of the information
items included in the template, with any necessary assistance from the
cognizant Contracting Officer (CO) and Contract Specialist (CS) \--
especially for Items 3.(b), 4., 5., 6., and 8.(b) listed below.*

The instructions for preparing an LSJ are specified in "red" and should
be deleted prior to processing the document for review and approval.
Also, do not include the completion instructions in the completed
document.

A completed LSJ must contain all of the applicable bolded headings in
the order specified. Place the required information directly next to, or
under, the applicable heading. If a heading does not apply to a specific
LSJ, indicate "not applicable" (N/A) next to it. Reference and attach
any additional information necessary to support the LSJ.

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  **Limited Source Justification**

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*"Source Selection Information -- see FAR 2.101 and 3.104"*

1.  **Identification of the agency and contracting activity.** Provide
    the following information:

    a.  **Federal agency and contracting activity.** **HHS.** Enter the
        OPDIV name after "HHS."

    b.  **Sponsoring organization.** Specify the name of the OPDIV's
        major subcomponent organization (such as Institute, Center,
        Office, or Division) and lower-tier organization, if applicable,
        that is sponsoring the proposed acquisition.

    c.  **Project Officer information.** Provide the following
        information:

        -   **Project Officer name.**

        -   **Mailing address.**

        -   **E-mail address.**

        -   **Telephone number.**

2.  **Nature and/or description of the action being approved.** Provide
    the following information:

    a.  **Acquisition purpose and objectives.** State the nature,
        purpose, and objective(s) of the acquisition and the overall
        program of which it is a part. Identify the authorizing program
        legislation, as applicable.

    b.  **Project background.** Specify any project background that is
        important to understanding the acquisition and the need it will
        satisfy. If the project is a continuation or renewal of an
        ongoing order, provide the current order number and
        indicate: (i) the name of the incumbent or predecessor
        contractor; (ii) the period of performance; (iii) total dollar
        amount obligated to date; and (iv) whether the initial and any
        subsequent awards were competed and, for any sole source or
        limited source awards, the basis for the approved LSJ.

3.  **Description of the supplies or services required to meet the
    agency's needs (including the estimated value).** Provide the
    following information:

    a.  **Project title.** Enter the project title as it will appear in
        the solicitation and resultant order.

    b.  **Project description.** Provide a brief (i.e., half-page or
        less) narrative description of the project. ([NOTE]{.underline}:
        A Statement of Work (SOW), if applicable, may be referenced and
        attached in lieu of providing a project description. The term
        SOW, as used throughout this document, includes "Specification,"
        "Statement of Objectives" (SOO), and "Performance Work Statement
        (PWS)."

> Provide the following information:

-   **Requirement type.** Check the appropriate box:

> Support services (non-research & development)
>
> Supplies/equipment
>
> Information technology (IT)
>
> Other (specify): \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

-   **Type of action.** Check the appropriate box:

> New requirement
>
> Follow-on
>
> Other (specify): \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

-   **Proposed contract/order type.** Check all that apply:

> Firm-fixed-price
>
> Time and materials
>
> Indefinite delivery (specify whether indefinite quantity,
>
> definite quantity, or requirements): \_\_\_\_\_\_\_\_\_\_\_
>
> Other (specify): \_\_\_\_\_\_\_\_\_\_\_

-   **Acquisition identification number.** Specify the requisition
    number, proposed solicitation number, or other acquisition
    identification number, if applicable.

> **c. Total estimated dollar value and performance/delivery period.**
> Specify the total estimated dollar value of the acquisition, inclusive
> of options, and the total performance/delivery period.
>
> **4. Identification of the justification rationale \[see 8.405-6(a)
> and (b)\] and, if applicable, a demonstration of the proposed
> contractor's unique qualifications to provide the required supply or
> service.**
>
> **a. Acquisition authority.** Check the applicable block below based
> on the acquisition circumstance.
>
> **This acquisition is conducted under the authority of the Multiple
> Award Schedule Program. Consideration of schedule contractors will be
> restricted to fewer than the number required by Federal Acquisition
> Regulation (FAR) 8.405-6(a)(1)** \[see FAR 8.401, 8.405-1, 8.405-2,
> 8.405-6(b), and 8.405-6(g)(1)\] **(i.e., fewer than three FSS
> contractors).**
>
> **This acquisition is conducted under the authority of the Multiple
> Award Schedule Program. Consideration of schedule contractors will be
> restricted only to the item peculiar to one manufacturer as provided
> in** **FAR 8.405-6(a)(2)** \[see FAR 8.401 and 8.405-6(g)(1)\]**.**
>
> **b. Demonstration of the proposed contractor(s) unique qualifications
> to provide the required supply or service.** Provide the following
> information, as applicable:

-   **Name and address of the proposed contractor(s).** Enter\
    (i) the name and address of the proposed sole source contractor
    or (ii) the names and addresses of the contractors to which the
    order will be restricted.

-   **Nature of the acquisition and proposed contractor(s) unique
    qualifications.** Describe fully why only the designated supply or
    service will meet the sponsoring organization's needs and the
    contractor's unique qualifications to provide the requirement.

> **5. Determination by the ordering activity Contracting Officer that
> the order represents the best value consistent with FAR 8.404(d).**
> Provide a statement, based on the specific circumstances of the
> acquisition proposed, that reflects the steps the CO will take
> (including documentation) regarding the price of the order prior to
> its award.
>
> Since (a) GSA has already determined the prices of the supplies and
> services under FSS contracts, including rates for services offered at
> fixed hourly rates, to be fair and reasonable; and (b) by placing an
> order against a schedule contract using the procedures in FAR 8.405,
> the ordering activity CO has concluded that the order represents the
> best value (see FAR 2.101) and results in the lowest overall cost
> alternative, the determination shall cite:
>
> \(i\) whether any additional discounts will be sought before placing
> an order (see FAR 8.405-4);
>
> \(ii\) the type of pricing information, if any, that will be obtained
> from the schedule contractor(s) in relation to seeking additional
> discounts; and
>
> \(iii\) the extent of the price evaluation anticipated in order to
> determine that the total price is reasonable -- see FAR 8.405-2(d).
>
> **6. Description of the market research conducted among schedule
> holders and the results, or a statement of the reasons market research
> was not conducted.** List any FSS contractors, other than the
> source(s) named in item 4.b. above, that were contacted and the
> results of that communication or other market research performed among
> schedule contract holders. If other FSS contractors were not contacted
> or other FSS market research was not conducted, provide an
> explanation.
>
> Explain the efforts to be taken to ensure that offers are solicited
> from as many potential FSS contractors as possible.
> \[[NOTE]{.underline}: When a proposed FSS order exceeding the
> simplified acquisition threshold contains a brand-name specification,
> FAR 8.405-6(d) and (d)(2) require that, unless exempted by paragraph
> (e), the CO post the Request for Quotation to e-Buy
> ([http://www.ebuy.gsa.gov]{.underline}) along with a justification as
> required by FAR 8.405-6(g).\]
>
> **7. Any other facts supporting the justification.** Cite any other
> factors not mentioned earlier in the justification as to why the
> requirement cannot be competed. Also, if applicable:
>
> \(a\) when the new work is a logical follow-on to an original FSS
> order\
> \[see FAR 8.405-6(b)(2)\], indicate whether there would be (i)
> unacceptable delays in fulfilling the agency's requirements and/or
> (ii) duplication of cost by award to another organization and, if so,
> provide an estimate of the cost duplication and how it was derived;
>
> \(b\) if the justification is based on an urgent and compelling need
> (see FAR 8.405-6(b)(3), indicate (using data, estimated cost, or other
> rationale) the extent and nature of the harm that the sponsoring
> organization would incur and/or the unacceptable delays that would
> occur. Also, explain whether the proposed period of performance is the
> minimum acceptable period necessary to meet mission requirements,
> including why a shorter period is not advisable. If future extensions
> are anticipated, indicate what steps will be taken to encourage and
> solicit competition. \[[NOTE]{.underline}: The length of an order
> awarded under these circumstances cannot exceed one year unless
> approved by the OPDIV Head of the Contracting Activity (HCA).\]
>
> **8. Statement of the actions, if any, the agency may take to remove
> or overcome any barriers that led to the restricted consideration
> before any subsequent acquisition for the supplies or services is
> made.**
>
> **a. Removal of barriers to competition.** Provide a brief statement
> as to whether or not there are future plans to acquire the same type
> of supplies or services, e.g., further extensions or renewals by
> competitive or other means. If subsequent acquisitions are
> anticipated, cite actions taken, or anticipated, to avoid continued
> limitation of sources for the requirement in the future and a schedule
> for accomplishing those actions. ([NOTE]{.underline}: This may involve
> recompeting a successor requirement at a logical juncture in the
> phasing of the project or "breaking out" segments of the requirement
> to facilitate competition, where feasible.) If no actions have been or
> will be undertaken to overcome barriers to competition for future
> acquisitions, so indicate and provide an explanation.
>
> **b. Listing of sources, if any, that expressed an interest, in
> writing, in the acquisition.** List the sources, if any, that have
> expressed an interest, in writing, in the acquisition and provide an
> explanation of why they are not being considered. If no interest has
> been received, enter "No other sources have expressed an interest, in
> writing, in the proposed acquisition." For service orders requiring an
> SOW, document any requests made to the CO by interested organizations
> for a copy of the solicitation or SOW with the following information:
> (a) the name and contact information of the organization that
> submitted the request; (b) any communications with the requestor; and
> (c) the disposition of the request.
>
> **9. Program office certification.** The program officials cited shall
> complete the information required below and sign the certification in
> the blocks provided.
>
> **This is to certify that the portions of this justification that have
> been developed by the undersigned program office personnel, including
> supporting information and/or data verifying the Government's minimum
> needs or requirements, or other rationale for limited sources, are
> accurate and complete.**

  ---------------- ---------------------- -------------------- -----------
  **Official**     **Name & Title**       **Signature**        **Date**

  **Project                                                    
  Officer**                                                    

  **Project                                                    
  Officer's                                                    
  Immediate                                                    
  Supervisor**                                                 

  **Head of the                                                
  Sponsoring                                                   
  Program Office**                                             
  ---------------- ---------------------- -------------------- -----------

> **10. Contracting Officer certification.** The CO shall complete the
> information required below and sign the certification in the block
> provided. \[[NOTE]{.underline}: The CO's signed certification may
> serve as approval of an LSJ over \$100,000 but not exceeding
> \$550,000[^1], depending on OPDIV procedures.\]
>
> ***This is to certify that the justification for the proposed
> acquisition has been reviewed and that to the best of my knowledge and
> belief the information and/or data provided to support the rationale
> and recommendation for approval is accurate and complete.***

  --------------- ---------------------- -------------------- ------------
  **Official**    **Name & Title**       **Signature**        **Date**

  **Contracting                                               
  Officer**                                                   
  --------------- ---------------------- -------------------- ------------

> **11. Chief of the Contracting Office and Head of the Contracting
> Activity signature(s).** The Chief of the Contracting Office (CCO), if
> applicable, and the HCA shall indicate review of, and concurrence
> with, any LSJ over \$550,000[^2] by providing the information required
> below and signing in the applicable block.

  --------------- ---------------------- -------------------- ------------
  **Official**    **Name & Title**       **Signature**        **Date**

  **Chief of the                                              
  Contracting                                                 
  Office**                                                    

  **Head of the                                               
  Contracting                                                 
  Activity**                                                  
  --------------- ---------------------- -------------------- ------------

> **12. Competition Advocate signature.** The designated OPDIV
> Competition Advocate (CA), upon acceptance of the rationale provided
> in the LSJ, shall complete the information required below and sign in
> the block provided as the approving official for any LSJ over
> \$550,000 but not exceeding \$57 million[^3]. However, if the CA does
> not meet the requirements of FAR 8.405-6(h)(3)(ii) for an LSJ over
> \$11.5 million, but not exceeding \$57 million, an individual other
> than the CA shall exercise the approval authority.
>
> The signature of the CA, or that of an individual meeting FAR
> 8.405-6(h)(3)(ii) requirements for an LSJ over \$11.5 million, but not
> exceeding \$57 million, shall serve as concurrence on any LSJ over
> \$57 million that requires the approval of the HHS Senior Procurement
> Executive (SPE).

  --------------- ---------------------- -------------------- ------------
  **Official**    **Name & Title**       **Signature**        **Date**

  **Competition                                               
  Advocate**                                                  
  --------------- ---------------------- -------------------- ------------

> **13. HHS Senior Procurement Executive signature.** The HHS SPE, upon
> acceptance of the rationale provided in the LSJ, shall complete the
> information required below and sign in the block provided as the
> approving official for any LSJ exceeding \$57 million[^4].

  --------------- ---------------------- -------------------- ------------
  **Official**    **Name & Title**       **Signature**        **Date**

  **HHS Senior                                                
  Procurement                                                 
  Executive**                                                 
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[^1]: This dollar range is current as of the date of issuance of interim
    acquisition policy memorandum No. 2008-03, but is subject to change
    -- see FAR 8.405-6(h)(1). See HHSAR 308.405-6(h)(1) for additional
    information regarding CO approval of an LSJ in this dollar range..

[^2]: This review and concurrence requirement is applicable to the
    dollar ranges over \$550,000 cited in the FAR, specifically: (i)
    over \$550,000 but not exceeding \$11.5 million; (ii) over \$11.5
    million but not exceeding \$57 million; and (iii) exceeding \$57
    million -- see FAR 8.405-6(h)(2) through (4). See HHSAR 308.405-6(h)
    for additional information regarding CCO/HCA review of and
    concurrence with an LSJ in these dollar ranges. These dollar ranges
    are current as of the date of issuance of interim acquisition policy
    memorandum No. 2008-03, but are subject to change.

[^3]: This approval authority is applicable to the following dollar
    ranges cited in the FAR, specifically: (i) over \$550,000, but not
    exceeding \$11.5 million; and (ii) over \$11.5 million, but not
    exceeding \$57 million -- see FAR 8.405-6(h)(2) and (3). See HHSAR
    308.405(h)(2) and (3) for additional information regarding this
    approval authority, including when the CA does not meet the
    requirements of FAR 8.405-6(h)(3)(ii). These dollar ranges are
    current as of the date of issuance of interim acquisition policy
    memorandum No. 2008-03, but are subject to change.

[^4]: This dollar range is current as of the date of issuance of interim
    acquisition policy memorandum No. 2008-03, but is subject to change
    -- see FAR 8.405-6(h)(4). See HHSAR 308.405-6(h)(4) for additional
    information regarding SPE approval of an LSJ in this dollar range.