QUALTRICS CI AMD 2 SIG BLOCS.PDF

Office of Procurement Services 
GOODS AND SERVICES 
COMPETITION IMPRACTICABLE FORM 
This form is to be used when a department believes an acquisition is considered Competition Impracticable and the acquisition 
dollar amount is above $10,000. The Chief Procurement Officer can approve purchases up to $100,000. Board of Supervisors 
approval is required if the acquisition is over $100,000. This form must be submitted for approval to: Office of Procurement 
Services | 160 S 4th Ave | Phoenix, AZ 85003. Fax number: 602.506.6766. The signed form must be retained in the purchasing 
file. Unless approved by the Board of Supervisors in a formal agenda item or the Chief Procurement Officer in a formal Contract 
a CI form is valid from July 1 thru June 30th of each Fiscal Year. 
DEPARTMENT NAME Public Health
DEPARTMENT RX# 
PROPOSED CONTRACT VENDOR 
NEED IDENTIFIED Date: 01/19/2022 
Qualtrics LLC 
Company: 
REQUESTED DELIVERY 02/23/2022
333 W. River Park Dr. 
Address: 
City, State: 
Zip/Postal Code: 
Provo, UT 
QUOTED PRICE: 
Total NTE $359,083.13 
84604 
Phone: 
480-630-7745 
Accounting String:   532 8611 EPIR 86ELC2
Fax: 
Contact Name: 
Stephen Ashton, account rep 
DESCRIPTION OF GOODS OR SERVICES REQUIRED:
The estimated cost of this Procurement is: 
≤ $100k 
✔> $100k
Is this a Technology Procurement? 
✔ Yes 
No 
Qualtrics is a data survey platform that enables users to develop and disseminate surveys for data collection. Qualtrics has been 
utilized for more than 10 years to help in data collection across at least five different offices within the department. The platform allows 
the department to collect surveys from internal and external partners including but not limited to customer satisfaction surveys, partner 
evaluations, and website feedback. We currently have open surveys for our Covid-19 response activities for contact tracing and 
symptom checkers. This software platform is being used constantly by various offices in the department in order to protect the health 
health and wellbeing of our staff and community. This is an on-line survey platform that does not have any installation requirements. 
Our current license ends on 8/5/2022 but we need to purchase additional SMS credits now for our COVID contact tracing efforts. 
COMPETITION IMPRACTICABLE CATEGORY (Check applicable box, attach documentation or provide explanation below.)
Maricopa County Procurement Code MC1-351 states: “Competition Impracticable” means an acquisitionwhere, competition is 
impracticalbecause of standardization, warranty, or otherfactors as approved by the Board of Supervisors. 
NOTE: The following are unlikely to be sufficient Competition Impracticable justifications: 
• Personal or department preference for a product or vendor
• Department perception that the vendor is the best qualified (this should be determined through a competitive process)
• Lack of department planning resulting in limited time to conduct a competitive procurement
• Special incentive or deal offered (can be assessed in open and competitive solicitation)
• Department convenience
Grant specified (supporting documents attached) 
Mailing lists, subscriptions or media advertising 
Warranty voided if service provided by other contract vendor 
Other (Provide written explanation below) 
✔ Software license renewals, additions, or upgrades available 
from only one source
Brand compatibility available from only one source (no other
distributors)
Other proprietary situation

SEARCH 
A search was conducted consisting of: (check all that apply) 
Market research 
Public notice given, list 
✔ Other vendors contacted 
Other 
RESULTS 
no alternatives were identified 
✔ no alternatives were deemed acceptable 
because (explain below): 
Describe the search from above in detail: 
Staff have reviewed other software platforms and Qualtrics has been identified as the only 
platform that can provide the level of performance we need and at a competitive price. This 
software provides more advanced services in comparison to other programs and provides 
advanced operations for data collection. 
 
PRICE 
MC1-352-B states: The Using Agency requesting a Competition Impracticable Procurement shall provide written evidence 
to support a Competition Impracticable determination containing an explanation of why the proposed procurement 
process is advantageous to the County; and the scope, duration, and estimated total dollar value of the procurement. 
Price has been fairly and reasonably established by: 
Comparison to previous comparable purchases 
from a different vendor 
Independent estimate 
Comparison to public sector contract pricing 
✔ Discount off published catalog pricing 
Market survey 
✔ Other, explain: 
Describe methodology and results (attach any written supporting data, e.g., survey or market analysis): 
Qualtrics has been the survey platform our department has used for more than ten years. We 
have several continuous surveys that are within the platform currently with the most important 
ones being utilized for our Covid-19 pandemic response. This is a renewal of the license we 
upgraded last year during the beginning of the pandemic and has all of the necessary features 
our department requires. The price is lower than their advertised price and includes a discount 
for our department being a trusted and established contractor. 
THIS IS  A  COMPETITIONIMPRACTICABLEPROCUREMENTBECAUSE(attach additional page  if  needed): 
Other research platforms have been researched and due to our current Covid-19 response we must ensure 
continuity of operations which means that we will continue to utilize Qualtrics and the surveys we have already 
created within the platform. Qualtrics provides multiple services besides just surveys, including but not limited 
to offline utilization, SMS text messaging, user support, translational tools, file uploads, and more. Qualtrics 
has been utilized by the department for over 10 years and is utilized by over 5 different offices within the 
department. The software is used constantly with many surveys currently active; i.e. Covid-19 response 
surveys for contact tracing. The previous CI was awarded by the BOS on 9/15/2021 in the amount of 
$177,589.13 under C-86-22-232-X-00. This request is to modify the previously authorized dollar amount and 
add an additional $181,500 for a total NTE amount of $359,083.13. We anticipate that that these additional 
expenditures will be able to give us enough credits to last through the end of the current contract (8/5/22).

CERTIFICATIONS 
I certify: 
1) I recognize that the Maricopa County Procurement Code requires the use of competitive solicitations unless
exempted by law. I have reviewed the information and materials relevant to this procurement of goods and services,
and am requesting approval of an exception to the competitive process for the reasons described;
2) the price to be paid to the proposed vendor is fair, reasonable, and provides the best value to Maricopa County; and
3) this request for an exception to the competitive solicitation process is not the result of inadequate advance planning
or for purposes of securing the services of a preferred vendor.
Department Head or Department Head Delegate Signature (Required) 
Digitally signed by Max Porter 
Max Porter 
Max Porter Date: 2022.01.21 09:29:24 
01/24/2022 
-07'00' 
Printed Name 
Signature 
Date 
Office of Procurement Services 
The CPO can approve procurements up to $100,000. If this request is over $100,000 it must be submitted as 
an agenda item to the Board of Supervisors for consideration. 
✔ Recommended to BOS for approval. 
Digitally signed by Kevin Tyne 
Kevin Tyne 
Date: 2022.01.24 10:35:40 
01/24/2022 
-07'00' 
Printed Name 
Signature 
Date 
Office of Enterprise Technology (If this procurement is classified as a technology procurement it must be 
forwarded to OET for coordination and/or approval. If this procurement request is not approved by OET, the form will 
be returned to the requestor.) 
Approved. Recommended purchase is in line with Maricopa County's strategic technology plan or currently installed 
✔ equipment or service, and is considered to be a competition impracticable procurement. 
Not Approved. 
Reasoning: The technology has been reviewed and been determined to be the best available solution for Public Health at this time.
Terry Richardson
Terry Richardson Richardson 
01/24/2022 
Digitally signed by Terry 
Date: 2022.01.24 10:16:28 -07'00' 
Printed Name 
Signature 
Date 
FOR AND ON BEHALF OF 
MARICOPA COUNTY 
By  
Bill Gates, Chairman, 
Board of Supervisors 
Date 
ATTEST: 
Clerk of the Board 
Date 
APPROVED AS TO FORM: 
 Attorney for Maricopa County 
Date