Procurement Check List

PROCUREMENT CHECK LIST IT IS MANDATORY TO COMPLETE THIS FORM BASED ON ONE OF THE FOLLOWING REQUIREMENTS: RFP & Contracts Requesting Exceptions / Exemptions to Bid Solicitation Supplier’s Name Description of Procurement Type Goods Goods & services Services Construction work Agreement term: year(s) with irrevocable option(s) to renew for period(s) of one year(s) each. Agreement term from 20YY/MM/DD to 20YY/MM/DD from 20YY/MM/DD until services are completed without exceeding 20 YY/MM/DD no term applicable; one-time purchase One-time purchase Frequency Recurring Type of Expense Capital Non-capital Amendment Global Value $ CAN (excl. taxes) (Including option periods) Requested by Department Title Cost center



1. Has Supply Management Services (SMS) been involved / consulted from the initial stage of the project through to completion while ensuring compliance to the Procurement Policy? Yes No

If the answer is Yes, Name of the SMS representative: Initials: _____

2. Authorized signatories as per DSA:

3. Do the products/services to be acquired include any technological characteristics /interface (re: article 1.2 Appendix C of Procurement Policy 2.3.06)? Yes No If the answer is Yes, Provide the name(s) of Technologies personnel who were involved right from the beginning of the process and who gave their authorization / validation: 4. For requirements in excess of $500,000 has public solicitation (MERX) been used? Yes No N/A

a) If the answer is No, a) Reference 3.2: provide the reference to the appropriate exception listed in the Policy (reference section 3.2 and provide a short and complete justification as to why the exception is applicable Reason: by using the space provided, or if necessary section #14 below. Supply Management Service (SMS) must be consulted with regard to any requested Exceptions / Exemptions to obtaining public offers as prescribed in the Policy.

Provide the name of the SMS representative: Initials : ______5. When bid solicitation is prescribed (re: Appendix B of 2.3.06 Procurement Policy), have Yes No N/A competitive offers been solicited? a) If the answer is No, a) Reference 2.1: provide the reference to the appropriate exception listed in the Policy (reference section 2.1), and provide a short and complete justification as to why the exception is Reason: applicable by using the space provided, or section #14 below.

057d6248e0dae0f03ea8778cc6117a34.docx Version 20130401 1 / 3 IT IS MANDATORY TO COMPLETE THIS FORM BASED ON ONE OF THE FOLLOWING REQUIREMENTS: RFP & Contracts Requesting Exceptions / Exemptions to Bid Solicitation Supplier’s Name b) If the answer is No and no exception listed in the Procurement Policy is applicable, complete an “Exemption – Justification & Approval Form.” All Exemptions must be Form: pre-approved by the Vice-President and Chief Financial Officer. Attach the duly signed Exemption form. Supply Management Service (SMS) must be consulted with regard to any requested Exceptions / Exemptions to obtaining competitive offers as prescribed in the Policy. Provide the name of the SMS representative: Initials : ______

6. Number of invited suppliers 7. Number of responses from suppliers

8. Request method: Price and Availability Request; Request for Quote; Request for PAR RFQ Proposal; Request for Standing Offer; Request for Supply Arrangement RFP RFSO RFSA

If an RFP, RFSO or RFSA was issued, please provide the RFX #:

9. The solicitation document was drafted from a valid standard template provided by Legal services or Supply Management Service (SMS)? Yes No N/A

10 Suppliers’ offers documented and available upon request? Yes No N/A . 11 Evaluation criteria and results documented and available upon request? Yes No N/A . 12 Financial information: . a) Was evaluation of financial health performed? Yes No, b) Were billing & payments, taxes, validated with Finance & Administration, Reasons : documented and available upon request? Name of Finance & Administration resource: Yes No, Reasons : 13 Contract / Agreement /PO information Contract PO . a) Indicate how the purchase transaction will be executed; b) Contract / Agreement was drafted from a valid standard template provided by Legal Yes No N/A services or Supply Management; c) If answer to b) is No or significant changes to standard templates were made, Yes No, has the Contract / Agreement been reviewed and validated by Legal services? Reasons: d) If Legal Services has reviewed the Contract / Agreement, please provide the name of the Legal Counsel: e) Were the amounts related to Risk management clauses (insurance, liability, etc.) in the Contract /Agreement reviewed and validated by Risk Management? Yes No, Name of Risk Management resource: Reasons:

14 OTHER INFORMATION: .

The requester certifies that they do not and will not have any conflict of interest (actual, potential or perceived as per Corporate Policy 2.2.03), with the selected Date: vendor for this business transaction, and that this procurement transaction complies with the principles stated in the Procurement policy 2.3.06.

For CBC/Radio-Canada administrative purposes only Contract reference number:

057d6248e0dae0f03ea8778cc6117a34.docx Version 20130401 2 / 3 PO reference number:

057d6248e0dae0f03ea8778cc6117a34.docx Version 20130401 3 / 3