"Competitive Procurement Request Form" - Mississippi

Competitive Procurement Request Form is a legal document that was released by the Mississippi Department of Information Technology Services - a government authority operating within Mississippi.

Form Details:

  • The latest edition currently provided by the Mississippi Department of Information Technology Services;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Mississippi Department of Information Technology Services.

ADVERTISEMENT
ADVERTISEMENT

Download "Competitive Procurement Request Form" - Mississippi

664 times
Rate (4.8 / 5) 46 votes
3771 Eastwood Drive
Jackson, Mississippi 39211
Phone 601-432-8000 Fax 601-713-6380
Competitive Procurement Request
Project Title:
Stimulus (ARRA) Funds? Yes__ No __
Customer Contact Information
Agency/Public University:
Contact Person:
Address:
Phone:
Fax:
Email Address:
MAGIC Customer Number (only required from state agencies)
Division/Dept:
Handmail:
Yes
No
Project Summary
Narrative Description of Project
ITS Acquisition Approval (CP-1) should be effective through this date:
(Please allow time for all vendor invoices to be paid)
Cost Estimates
Time Constraints
Fiscal Year
Initial Costs
Ongoing Costs
Item Needed by:
Funds Expire:
Total
Discuss Funding (e.g. how much of needed funding is definite; total project budget; any matching or other non state funds; fund number)
Anticipated Lifecycle of Products/System (i.e. estimate years effective use)
Acquisition Details
Items Requested:
Name
Quantity
Description
Building Location(s)
Describe platform & infrastructure (connectivity; software/hardware platforms; utilization of State Data Center resources: mainframe, eGovernment
portal, payment engine, document management, hosting). For equipment or hosting outside the State Data Center, attach justification:
Progress to Date: What has been done related to this project and utilization?
Vendors Contacted: (Note: attach written estimates or other information received from vendors)
Critical Factor(s): (in the selection of a vendor/brand/solution for this acquisition)
There is a charge for ITS procurement services associated with this request which will be billed to the requestor by ITS. By my signature I acknowledge
that my agency/public university is responsible for these charges/costs.
_______________________________________
___________________________________
Name (Agency Head or Public University CIO)/Title
Signature
Date
3771 Eastwood Drive
Jackson, Mississippi 39211
Phone 601-432-8000 Fax 601-713-6380
Competitive Procurement Request
Project Title:
Stimulus (ARRA) Funds? Yes__ No __
Customer Contact Information
Agency/Public University:
Contact Person:
Address:
Phone:
Fax:
Email Address:
MAGIC Customer Number (only required from state agencies)
Division/Dept:
Handmail:
Yes
No
Project Summary
Narrative Description of Project
ITS Acquisition Approval (CP-1) should be effective through this date:
(Please allow time for all vendor invoices to be paid)
Cost Estimates
Time Constraints
Fiscal Year
Initial Costs
Ongoing Costs
Item Needed by:
Funds Expire:
Total
Discuss Funding (e.g. how much of needed funding is definite; total project budget; any matching or other non state funds; fund number)
Anticipated Lifecycle of Products/System (i.e. estimate years effective use)
Acquisition Details
Items Requested:
Name
Quantity
Description
Building Location(s)
Describe platform & infrastructure (connectivity; software/hardware platforms; utilization of State Data Center resources: mainframe, eGovernment
portal, payment engine, document management, hosting). For equipment or hosting outside the State Data Center, attach justification:
Progress to Date: What has been done related to this project and utilization?
Vendors Contacted: (Note: attach written estimates or other information received from vendors)
Critical Factor(s): (in the selection of a vendor/brand/solution for this acquisition)
There is a charge for ITS procurement services associated with this request which will be billed to the requestor by ITS. By my signature I acknowledge
that my agency/public university is responsible for these charges/costs.
_______________________________________
___________________________________
Name (Agency Head or Public University CIO)/Title
Signature
Date