Department Checklist

Informal Competitive Procurement Process

[Insert Title of Posting](PCS# [Insert #]-RFQ)

Once you have completed evaluating the vendor quotessubmit this checklist, emails sent solicitingquotes, quotes received, quote comparison chart or scoring matrix to for PCS review and approval.

RFQPhase:

Posting link: .

Posting DateOpen/Close:[MM/DD/YYYY] / [MM/DD/YYYY]at [TIME] (Pacific Time)

Quotessolicited:In addition to the posting on the PCS website, the department mustactively solicit at least three (3) quotes. The department must solicit at least 1 quote from a certifiedminority-owned, a woman-owned, or an emerging small business (MWESB) vendor. If a certified MWESB vendor is not available, the department must solicit at least 1 proposal from a self-reported MWESB vendor.

List All Vendors Contacted:

1. [Insert vendor name]–[MWESB STATUS]2. [Insert vendor name]–[MWESB STATUS]

3. [Insert vendor name]–[MWESB STATUS]4. [Insert vendor name]–[MWESB STATUS]

5. [Insert vendor name]–[MWESB STATUS]6. [Insert vendor name]–[MWESB STATUS]

List All Vendors WhoseQuotesWere Received and Evaluated:

1. [Insert vendor name] – [Insert quote price]2. [Insert vendor name] – [Insert quote price]

3. [Insert vendor name] – [Insert quote price]4. [Insert vendor name] – [Insert quote price]

5. [Insert vendor name] – [Insert quote price]6. [Insert vendor name] – [Insert quote price]

Attach completed comparison chart (see sample below) or scoring matrix and selected quote.

Contract Award Phase:

Selected Vendor(s):[Insert Name of Legal Entity]

Contact Person: [Insert Name of Contact Person]

Mailing Address:[Insert Mailing Address]

Phone:[Insert Phone Number]Email: [Insert Email Address]

Criteria for selection: (if not lowest price, provide justification for vendor selection; justification must be based on posting specifications):Lowest Price Other:[Insert Justification Details]

Total Award Amount: $[Insert Amount of Award]

Contract Term:[Insert Dates]

Purchasing Warranty or Service Contract?N/A YES NO

If YES, what is warranty/serviceperiod? [Insert Dates]

If YES, do you have any requested changes to warranty/service terms? [Insert Details]

Purchase includes vendor provided training?N/A YES NO

Purchase includes vendor provided installation? N/A YES NO

Additional notes or information for contract phase (identify any additional options selected, vendor terms to include, warranty/service provisions, paid expenses, outstanding issues, etc.):[Insert Details]

Department Certification (Must be checked by department prior to submission):

By submitting this checklist, I certify that the funds are available for this agreement on the previously mentioned index(es), and the Department Budget Authority has expressly authorized this submittal and any expenditure of funds for the purposes of this purchase.

By submitting this checklist I certify that neither I nor anyone authorizing this agreement for the department has any or potential conflicts of interest related to this purchase.

Example Comparison Chart (Modify as Needed)

Price / Specification 1
[Insert Spec] / Specification 2
[Insert Spec] / Specification 3
[Insert Spec] / Strengths / Weaknesses / Notes
Vendor 1
[Insert Name]
Vendor 2
[Insert Name]
Vendor 3
[Insert Name]
Vendor 4
[Insert Name]
Vendor 5
[Insert Name]

Department Checklist – [Insert Title of Posting] (PCS# [Insert #]-RFQ)Page 1 of 2 PCS Rev 08/27/2014