Serial Number:

(For Procurement use ONLY)

print on double sided

paper only

Bid/Tender Waiver Justification Form (value more than RM 50K)

Project Name / Purchase or Contract Description:
MRV/SR/PID Reference
Number:

Date:

Job No

Estimated Total Purchase /

Contract Value:

Recommended Vendor
Name & Address:

Currency:
Exchange Rate:
Equivalent in RM:

Vendor is:
Please attached relevant
supporting document

Authorized / Sole Agent or

Distributor

No

Proprietory Vendor /
Manufacturer /Principal

Person Negotiated:

Trading Company

Cost Savings:

Has the vendor agreed to LSE terms and conditions?

Yes

Has the above price been

negotiated?:

Yes

RM
%
No

Description of product or services including but not limited to its Uniqueness and/or Specialty

Description of Business Needs that requires such Purchase(s) and or Service(s)?

What is the business justification for recommending this vendor?***

Was there any other vendor/s in the market that can supply or provide similar or equivalent product or services? If YES, why do
we need to waive the competitive bidding?

Serial Number:
(For Procurement use ONLY)

print on double sided

paper only

Bid/Tender Waiver Justification Form (value more than RM 50K)

Project Name / Purchase or Contract Description:
MRV/SR/PID Reference
Number:

Date:

Job No

Estimated Total Purchase /

Contract Value:

What is the Plan B if the recommendation is not approved or the vendor do not accept LSE terms and conditions?

Any Other Special &/or Specific Information?

Reviewers:
Requested By:

Reviewed By:

Confirmed By:

Signature:
Name:
Date:

Approved by Tender Committee:

Signature:
Name:
Date:

*** Among the circumstances which might justify a bid/tender waiver include: single source of supply; safety reason; urgency of a situation; standardisation is economically
justifiable to minimise inventory or inventory carrying costs; professional/specialised services; time factor to secure service/purchase; and other exceptional circumstances,
competition precluded by patents, copyrights, proprietary process or other such mutually exclusive activities; services of a proprietary nature.