SUBPART 13.1 – Procedures [CH15]
PGI 13.106-3(b) File documentation and retention.
(90)(a)(i) Sample format.
SIMPLIFIED ACQUISITION PRICING MEMORANDUM
PURCHASE REQUEST OR CALL/ORDER NUMBER: ______________________ PRC:________
ITEM NUMBER & NAME: ______________________________________________________
PRICE REASONABLENESS BASED ON (Check one or more):
PRICE COMPARABILITY WITH PRIOR PURCHASE PRICES (Adjusted as appropriate):
Yes _____ No _____ NA _____
Explain: __________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
_____ ADEQUATE PRICE COMPETITION (Attach quotes/abstract) INVOLVING:
_____ ONE MANUFACTURER'S PART or ____ PARTS OF VARIOUS MFRS
Identify type competition (mfgr(s)/dealer(s)/both), competitive
range of offers, etc.: ____________________________________________________
___________________________________________________________________________
___________________________________________________________________________
_____ COMPARISON WITH PRIOR PURCHASE PRICE(s) OF SIMILAR ITEM NAME & NO.:
_________________________________________________________________
CONTRACT & CALL/ORDER NO.________________________________________
VENDOR____________________________________ AWARD DATE___________
UNIT OF ISSUE____________ UNIT PRICE______________ QTY___________
EXPLAIN ADJUSTMENTS AND BASIS FOR DETERMINING PRIOR PRICE
REASONABLE: _______________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
_____ COMMERCIAL CATALOG/PRICE LIST FOR:
_____ SAME ITEM or _____ SIMILAR ITEM
NAME/NUMBER________________________________________________________
DATE_____________________________ PAGE__________________________
EXPLAIN DIFFERENCES:_______________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
_____ ESTABLISHED MARKET PRICE:
MEANS OF VERIFICATION: ____________________________________________
_____ VALUE/VISUAL/COST ANALYSIS BY BUYER/USER/TECHNICAL PERSONNEL
(Attach or reference the review of technical data, examination of sample,
etc.):
EXPLAIN:___________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
_____ OTHER (Explain specific reason, e.g., valid purchase request estimate,
minimum order quantity, high priority delivery, special packaging/marking,
etc.):____________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
SIGNATURE OF CONTRACTING OFFICER DATE
_______________________________________________ ______________________