Spreadsheet: 3d531a96-12f6-4503-afc5-91c661cd6a70
Sheet: Sheet1

Unnamed: 0 | PROCUREMENT DELEGATION | Unnamed: 2 | Unnamed: 3 | Unnamed: 4 | Unnamed: 5 | Unnamed: 6 | Unnamed: 7 | Unnamed: 8 | Unnamed: 9 | Unnamed: 10 | Unnamed: 11 | Unnamed: 12 | Unnamed: 13 | Unnamed: 14 | Unnamed: 15 | Unnamed: 16 | Unnamed: 17 | Unnamed: 18 | Unnamed: 19 | Unnamed: 20 | Unnamed: 21 | Unnamed: 22 | Unnamed: 23 | Unnamed: 24 | Unnamed: 25 | Unnamed: 26 | Unnamed: 27 | Unnamed: 28 | Unnamed: 29 | Unnamed: 30 | Unnamed: 31 | Unnamed: 32 | Unnamed: 33 | Unnamed: 34 | Unnamed: 35 | SPO USE ONLY: Procurement Delegation Effective Date | Unnamed: 37 | Unnamed: 38 | Unnamed: 39 | Unnamed: 40 | Unnamed: 41 | Unnamed: 42 | Unnamed: 43 | Unnamed: 44 | Unnamed: 45 | Unnamed: 46 | Unnamed: 47 | Unnamed: 48 | Unnamed: 49 | Unnamed: 50 | Unnamed: 51 | Unnamed: 52 | Unnamed: 53
 | FORM SPO-036
 | SECTION 1 - PURPOSE
 |  | Purpose of this Request
 | SECTION 2 - EMPLOYEE INFORMATION
 | Last Name (Print) |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | First Name (Print) |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Position Level
 | Department |  |  |  |  |  |  |  |  |  |  | Division or Administratively Attached Agency/Office (Print)
 | I acknowledge (1) the delegated procurement authority and responsibility as indicated below and (2) prior to exercising this authority, I am responsible to attend all appropriate SPO training workshops pursuant to Procurement Circular 2010-05 as amended, and as posted on the training website at http://hawaii.gov/spo, click Training for State and County Procurement Personnel.
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | OPTIONAL FOR DEPT/AGENCY USE
 | x
 | Employee Signature |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Date |  |  |  |  | Print Name |  |  |  |  |  |  |  |  |  |  |  |  |  | Signature
 | SECTION 3 - DELEGATES PROCUREMENT AUTHORITY AS PROCUREMENT OFFICER TO CERTIFY (SIGN SPO FORMS) (Check all that apply)           (*) Requires CPO approval
 | HRS chapter 103D - Hawaii Public Procurement Code
 |  |  | SPO-001 Notice and Request for Sole Source* |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | SPO-007B Notice of Amendment to Exemption from Chapter 103D, HRS*
 |  |  | SPO-001B Notice of Amendment to Sole Source Contract* |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | SPO-010 Record of Procurement
 |  |  | SPO-002 Emergency Procurement Request* |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | SPO-014 Restrictive Specifications Request*
 |  |  | SPO-003 Request for Extension of Time on Contracts* |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | SPO-015 Use of Alternative Procurement Method*
 |  |  | SPO-005 SPO Price or Vendor List Contract Purchase Exception |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | [NAME] to Use Purchasing Card for Blocked Purchases*
 |  |  | SPO-007 Notice of and Request for Exemption from Chapter 103D, HRS*
 | HRS chapter 103F - Purchases of Health and Human Services
 |  |  | SPOH-150 Notice of and Request for Exemption from HRS Chapter 103F*
 |  |  | SPOH-300 Request for After-the-Fact Secondary Purchase*
 |  |  | SPOH-500 Notice of and Request for Restrictive Purchase of Service*
 |  |  | SPOH-600 Request for Crisis Purchase of Service*
 | Note: Only Dept Head is authorized to certify (sign SPO forms): SPO-016, SPO-018, SPO-018A
 | [NAME], CONDUCT, PARTICIPATE IN THE VARIOUS PROCUREMENT METHODS, AND TO ACT AS HIePRO APPROVER OR [NAME] (Check all that apply) (*) Requires CPO approval
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Procurement Methods |  |  |  |  |  |  |  |  |  |  |  |  | HIePRO
 | HRS chapter 103D - Hawaii Public Procurement Code |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Procurement Officer |  |  |  |  |  | Conducts/ Participates |  |  |  |  |  |  | Approver |  |  |  | Buyer
 |  | Competitive Sealed Bidding (HRS §103D-302)
 |  | Competitive Sealed Proposals (HRS §103D-303)
 |  | Professional Services (HRS §103D-304)
 |  | Small Purchases (HRS §103D-305)
 |  | [NAME] (HRS §103D-306) *
 |  | Emergency (HRS §103D-307) *
 | HRS chapter 103F - Purchases of Health and Human Services
 |  | Competitive Purchase of Service (HRS §103F-402)
 |  | Restrictive Purchase of Service (HRS §103F-403)  *
 |  | Treatment Purchase of Service (HRS §103F-404)
 |  | Small Purchases (HRS §103F-405)
 |  | Crisis Purchase of Service (HRS §103F-406) *
 | SECTION 5 - DELEGATES PROCUREMENT AUTHORITY FOR PCARD/HIePRO ADMINISTRATOR/ALTERNATE (Check all that apply).   Only one person is authorized to be an Administrator for each department.
 | pCard |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Administrator |  |  |  |  |  |  |  |  |  |  |  |  | Alternate
 |  | pCard Administrator
 |  | Emergency pCard Administrator
 | HIePRO
 |  | HIePRO
 | Attach form SPO-036 to SPO-036transmittal and submit via email to: [EMAIL]. This delegation form SPO-036 supersedes any previous delegation forms for this employee.
 | SPO-036 (5/6/13)