Janitorial Services, Two Months before new CT - Lewiston DC

DocuSign Envelope ID: 3A921DF4-83D3-4B37-A360-6612331D212B DEPARTMENT OF ADMINISTRATIVE AND FINANCIAL SERVICES DIVISION OF PROCUREMENT SERVICES TATE OF MAINE PROCUREMENT JUSTIFICATION FORM (PJF) This form must accompany all contract requests and sole source requisitions (RQS) over $5,000 submitted to the Division of Procurement Services. INSTRUCTIONS: Please provide the requested information in the white spaces below. All responses (except signatures) must be typed; no hand-written forms will be accepted. See the guidance document posted with this form on the Division of Procurement Services intranet site (Forms page) for additional instructions. PART |: OVERVIEW Department Office/Division/Program: | Judicial Branch / Facilities Department Contract Administrator or | Kevin Fogg Grant Coordinator: (If applicable) Department Reference Lewiston DC Janitorial #: Amount: | 44 448 Advantage CT / RQS #: (Contract/(Amendment/Grant) g : 20230512*1394 CONTRACT | Proposed Start Date: | 4/1/2023

Proposed End Date: | 5/31/2023 | Original StartDate:| = sid Effective Date:| = | [| | PreviousEndDate|| | NewEndDate.| a Project StartDate:| == === |_~sGrantStartDate:| sid ot ProjectEndDate:| ~S*YS*SGrantEnd Date:| SSS Vendor/Provider/Grantee Name, Clean Work Services, Bangor, ME. City, State: Brief Description of Goods/Services/Grant: Janitorial Services for Lewiston DC PART Il: JUSTIFICATION FOR VENDOR SELECTION Check the box below for the justification(s) that applies to this request. (Check all that apply.) [A Comptes | Goat ee 6. Sige Source Vendor | | Federal Agony Croce (B. PropistanCoprenvPans | | Wingard uaifeg oo ro E. Emergency K. Client Choice F. University Cooperative Project L. Other Authorization REV 4/4/2023 Page 1 of 3 5/26/2023William J.E. Allen NOI 0520230510 05/26/2023 - 06/01/2023 DocuSigned by: William ). Mew 2D5B6E39F57E44 MAINE JOBS & RECOVERY PLAN (MJRP) Does this request utilize ARPA/MJRP funds? C1 Yes If Yes, please attach the approved Business Case(s). BX) No If No, proceed to Part V. PART V: APPROVALS The signatures below indicate approval of this procurement request. Signature of requesting sho augneat by Departments Commissioner Yeuues (avles (or designee): eS 5/12/2023 Typed Name: | Dennis Corliss Signature of DAFS Procurement Official: Typed Name: Date: REV 4/4/2023 Page 2 of 3 DocuSign Envelope ID: 3A921DF4-83D3-4B37-A360-6612331D212B Procurement Justification Form (PJF) REV 4/4/2023 Page 3 of 3 2023-05-26T06:33:16-0700 Digitally verifiable PDF exported from www.docusign.com