Artificial Division Exception Form
Purchases Are Not To Be Artificially Divided
Executive Order JBE 2020-21 states:
"The Louisiana Procurement Code, in R.S. 39:1596, authorizes the governor to establish procedures for the procurement of small purchases with the caveat that procurement requirements shall not be artificially divided so as to constitute a small purchase under this Section".
State Requisition Numbers and Names of Suppliers to be Considered Excepted:
Requisition No. _____________ Supplier: ________________________________
Requisition No. _____________ Supplier: ________________________________
Requisition No. _____________ Supplier: ________________________________
Requisition No. _____________ Supplier: ________________________________
Check all that qualify (all must be checked to qualify for consideration):
[____] No items requested from suppliers listed are the same
[____] No items requested from suppliers listed are similar by commodity classification
[____] No items requested from suppliers listed are available from other suppliers listed
[____] No items requested shall constitute a division violation under Executive Order
State any further reasons to justify autonomy of above requisitions:
I hereby certify that all information herein is true and accurate to the best of my knowledge. I further certify purchases made at this time are not artificially divided so as to constitute a violation of the Small Purchases Executive Order. I assume all responsibility for any violations and penalties as per Louisiana Revised Statute 39:1679.
Name ____________________ Signature ____________________ Date ___________
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For Purchasing Use Only: __________________________ Date Reviewed ___________