CPCC and State Bid Requirements Checklist
(Complete the following form if the equipment item(s) cost more than $10,000)
Department: ______________________________
Departmental Program Contact: ____________________
Requisitioner: _____________________________
Departmental Program Contact Phone: ______________
Description of Purchase—Provide a description of the equipment that will be procured and how it meets the department
needs. What does this product do? (I must be familiar with the product and be able to explain it to someone if asked)
What program, students, classes will benefit from this equipment? (Provide additional documentation if necessary for this
section)
I.
Brand Specific VS. Sole Source
**NOTE: The sole source document / brand specific justification must be properly reviewed, accepted and approved by the
Procurement Department. For more information, please review the section titled ‘Designating a Sole Source’ in the Procurement
Manual on the Procurement website.
a.
Do you require this item to be brand specific or would you accept a functional equivalent?
Brand Specific (Yes) ______ OR Functional Equivalent (Yes) ______
(1) If you require brand specific, who is the manufacturer and what is the model number?
Manufacturer_____________________ Model # _________________________
(2) If you require this item to be brand specific please provide justification? How does it differ from a
functional equivalent?
(3) If you will accept a functional equivalent, please provide me with the minimum specifications for the item
you want to purchase. (Attach additional pages if necessary)
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b.
Is this equipment compatible with existing equipment?
Yes_____ No_____
c.
Have we purchased this same equipment in the past?
Yes_____ No_____
d.
Is this piece of equipment from a sole source vendor?
Yes_____ No_____
e.
If yes, have you attached a sole source document that is signed and dated by a company representative? (Reminder:
sole source documents are valid for a period of one year)
Yes_____ No_____
II. Pricing—what is the estimated price of the equipment based on the quote obtained?
Cost-$______________
Did vendor give an educational discount?
Yes_____ No_____
What was the discount amount?
_______
What is the G/L Account # ____________________________
(must specify account number)
E-Procurement requisition:
RQ #_____________________
(must specify RQ#)
III.
Delivery Information
a. Delivery Contact Name: _________________________
b. Location (Campus): ____________________________
c. Building: _____________________________________
d. Room Number:________________________________
e. Are there any special Delivery Requirements? Yes_____ No_____ If yes, please list below.
(i.e. Is a forklift required? Yes_____ No_____ Are rigging services required? Yes_____ No_____)
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f.
Will it be required for this item to be delivered to Shipping/Receiving or directly to the Final Location?
Shipping/Receiving (Yes) ______ OR Final Location (Yes) ______
g.
Does this equipment need to be received and installed by a specific date?
Date: ______________________
Reason (i.e. instructional purposes): ___________________________
IV. Installation
a. Does this equipment require installation?
Yes_____ No_____
b. If yes, has installation pricing been included on the vendor quote?
Yes_____ No_____
c. Where will this equipment physically be installed? Who is the contact for installation?
Where? ___________________________ Who? ____________________________
d. If Facilities Services is responsible for any part of this installation (i.e. electrical, etc.); have they been notified?
Yes_____ No_____
Has adequate budget been set aside?
Yes_____ No_____
V. Quality Acceptance Inspection
a. Does this equipment require inspection according to the NCDOA Commodities Requiring Quality Acceptance
Inspection list?
Yes_____ No_____
b. Does this equipment require UL certification?
Yes_____ No_______
c. Please review the following website for items that require inspection.
http://www.pandc.nc.gov/qcinsp1.htm
Notice: It is Procurement’s sole discretion to require inspection for equipment that may not be on this list
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VI. Warranty
a. Briefly explain the equipment’s warranty requirements?
VII. Training
a. Does this equipment require training for its users?
Yes_____ No_____
b. Is the training included in the total cost of the equipment?
Yes_____ No_____
VII. Maintenance
a. Will this equipment require yearly maintenance?
Yes_____ No_____
b. Is yearly maintenance pricing included on your quote?
Yes_____ No_____
c. Do you want vendors to include pricing for maintenance on their bid response as an option? How many years do
you require this maintenance?
Yes_____ No_____
1, 2, 3, 4, 5+ years? (Circle one)
VIII. Service Contract
a.
Will this equipment require yearly service contract?
Yes_____ No_____
b. Is yearly service contract pricing included on your quote?
Yes_____ No_____
c. Do you want vendors to include pricing for service contract on their bid response as an option? How many years
do you require this maintenance?
Yes_____ No_____
1, 2, 3, 4, 5+ years? (Circle one)
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IX.
Software:
Operational Software: If the equipment requires software in order to operate, this is considered operational software
and equipment funds can be used for that software. End user must provide details of that software to their buyer with
the equipment request.
Application Software: If a software is needed, but the equipment can run/operate without, this type of software is
considered application and equipment funds cannot be used for this. A separate requisition will need to be entered and
all bidding guidelines followed.
Software must be approved by ITS if the software is being used on any college managed system. Scott Lewis in ITS is
the appropriate contact to receive ITS approval.
X.
Lead Time? _________________________________
XI. Responsibility— The Departmental Program Contact has read and completed this entire checklist to the best of their
ability. _________Initial
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