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Agency Request Form for Approval of Services/Goods
(Pursuant to MRSA Title 5, Section 55-A)
Contact Person for Agency
3. Telephone Number
4. E-mail Address
Information about Proposed Services/Goods
5. Describe Services/Goods seeking approval pursuant to MRSA Title 5, Section 55-A
6. Identify any applicable statutes/regulatory/policies that authorize the activity
7. Will the services/goods be offered for sale to the public?
8. Explain reason for offering services/goods
9. Explain services/goods connection with agency's governmental purpose
10. Duration for sale of services/goods (start and end dates)
11. Locations or market areas where services/goods will be offered
12. Identify any potential private business/industry to be impacted by the services/goods
13. Anticipated impact of services/goods on private enterprise/industry (please be as specific as possible)
14. Where are these private businesses located?
15. Are the services/goods currently offered by any private enterprise located within the State of Maine? Outside of the State of Maine? (please list any applicable businesses)
16. Could private enterprise offer the services/goods in the near future?
17. Describe any similar services/goods offered by any private enterprise and explain how it differs from services/goods contemplated for sale by agency.
18. Has agency approached private enterprise to deliver service/goods? What was response?
19. What will be the cost to the public of the services/goods offered? How was this determined?
20. Can the services/goods be offered at market value? If not, why not?
21. Is there a public policy purpose in offering the services/goods for sale to the public?
22. Please provide any additional information that would be helpful to the Advisory Committee in evaluating this request.
Please submit this form to:
David F. Emery, Chair
Advisory Committee on Fair Competition with Private Enterprise
78 State House Station
Augusta, ME 04333-0078