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 ___________