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["附表5："]
["单一来源采购申请表"]
["单位名称（盖章）："]
["序号","单位名称","预算编号","项目名称","金额（需要200万元以上）","申请原因（附专家单一来源论证说明和单一来源公示，表格内补充填写附件编号）"]
[1]
[2]
[3]
[4]
[5]
[6]
[7]
[8]
[9]
[10]
[11]
[12]
[]
["填表人： ",null,null,"审核人：",null,"联系电话："]
["注：200万元以下的采购项目不需要申请"]