Complete Boundary Survey for Blaine House

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. : Department Office/Divi ion/Program: NM Oh A General Services Department of Administrative and Financial Services, Bureau of Department Contract Administrator or Grant Coordinator: Deane Rykerson, Division of Planning, Design and Construction fF applicable) Department Reference vg | 3375 Amount (Contracvamendment/Grant) Proposed Start Date: Original Start Date: Advantage CT / RQS | Ho Proposed End 1/31/2022 3/21/2022 oe Date CT 18A 20211214*1538 Previous End Date: New End Date: __ Project Start

Date: Grant Start Date: Project End Date: Grant End Date: : Vendor/Provider/Grantee Name. | Northeast Civil Solutions, inc. 381 Payne Road, Scarborough, __ City State _| ME 04074 Complete Boundary Survey for Blaine House, 192 State St. | Augusta, ME . A Compet ve Process _ ia : Grant . Oo] B Amendment H. State Statute/Agency C. Single source que Vendor oR i Federal Agency Directed CO | _D, Proprietary/Copyright/Patents and ( - . E. Emergency . : Cl |. University Cooperative Project || 1 | _L._ Other Authorization REV 11/18/2021 Page 1 of 2 12/21/2021 Justin Franzose DocuSigned by: Quatin Sranypoe AEED9C7B3A8044E... Procurement Justification Form (PJF) Please respond to ALL of the questions in the following sections. PART Ill: SUPPLEMENTAL INFORMATION 4. Provide a more detailed description and explain the need for the goods, services or grant to supplement the response in Part I. Future planning and work at the Blaine House require a complete boundary survey to define scope of construction or alterations. 2. Provide a brief justification for the selected vendor to supplement the response in Part Il. Reference the RFP number, if applicable. The vendor has provided partial surveys of the Blaine House and adjoining properties. The vendor would consolidate into a single document with new established survey markers. 3. Explain how the negotiated costs or rates are fair and reasonable; or how the funding was allocated to grantee. Costs for the work of a licensed surveyor are within a typical range. 4. Describe the plan for future competition for the goods or services. New surveys without existing information will be procured through an RFP process. PART IV: AMERICAN RESCUE PLAN ACT (ARPA) / MAINE JOBS & RECOVERY PLAN (MJRP) Does this request utilize ARPA/MJRP funds? O Yes If Yes, please attach the approved Business Case(s). & No If No, proceed to Part V. PART V: APPROVALS The signatures below indicate approval of this procurement request. Signature of requesting Department's Commissioner (or designee): 4 Yt Vat Lf. (Ci. 22, 2/ Typed Name: | Elaine Clark Date: Signature of DAFS Procurement Official: Typed Name: Date: REV 11/18/2021 Page 2 of 2