BIDDER'S TENDER FORM
Chairman, BIDS AND AWARDS COMMITTEE
Provincial Government of Oriental Mindoro
Provincial Capitol Complex
Camilmil Calapan City
Sir:
We are submitting herewith our Bid Price in the Bill of Quantities in connection with the bidding for the supply and delivery of drugs and medicines for use of OMPH Pharmacy
(Regular 2nd Qtr 2010) to be opened on September 7, 2010 at 10:00 a.m at the BAC Office, Provincial Capitol Complex, Calapan City
We quote in conformity with the specifications described hereunder of the following to wit:
Bill Quantities:
Item No.
Qty.
Unit
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
720
144
360
24
360
240
24
192
288
24
192
48
100
10
30
100
30
100
100
100
100
100
100
2
200
2
60
btl
btl
btl
btl
btl
btl
btl
btl
btl
btl
btl
btl
amp
vl
bxs
amp
btl
vls
vls
vls
vls
amp
vls
tab
amp
bxs
vls
28
20
vls
Particulars
D5LR1L
D5NSS 1L
LRS 1L
NM 1L
NSS 1L
Irrigating Solution
D5LR 500cc
D5 0.3 NaCL 500cc
D5W 500cc
D10W 500cc
D51MB 500cc
Mannitol
Adrenalin Amp 1mg
Amikacin 250mg vl
Amlodipine Besylate 5mg (P-100)
Aminophylline 250mg amp
Amoxycillin 250mg syrup
Ampicillin 250mg vl.
Ampicillin 500mg vl
Ampicillin 1g vl
Ampicillin Na+Sulbactam Na vl
Atropine S04 amp
ATS 1,500 "IU"
Bisacodyl 5mg tab x 100's
Butorphanol Amp (Stadol)
Captopril 25mg tab x 100's
Cefazolin 1g vl
Cefatoxime 1g vl
ABC Per
Unit
70.00
70.00
70.00
70.00
70.00
70.00
68.00
68.00
68.00
68.00
68.00
171.00
32.48
20.88
100.00
9.28
25.00
7.83
12.18
14.50
250.00
6.38
17.40
82.94
475.00
156.60
40.60
31.32
Unit Bid
Price
Unit Bid Price in Words
Total Amount
Bid
Bill Quantities:
Item No.
Qty.
Unit
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
150
600
90
20
4
60
100
6
30
100
60
2
100
20
50
10
100
300
2
6
100
2
8
60
10
200
200
40
200
50
500
150
50
30
200
100
vls
vls
vls
amp
bxs
amp
vls
bxs
bvl
cap
vls
bxs
tab
amp
amp
vls
amp
amp
bxs
btl
amp
bxs
btl
amp
vls
amp
65
66
200
100
Particulars
Ceftriaxone 1g vl
Cefuroxime 750mg (Lazucef/Roxime)
chloramphenicol 1g vl
Chlorphenamine 10mg amp
Ciprofloxacin 500mg tab x 100's
Clonidine HCI amp
Cloxacillin 500mg vl
Cloxacillin 500mg cap x 100's
Co-amoxiclav 1.2g vl
Co-amoxiclav cap
Dexamethasone vl
Diclofenac tab 50mg
Digoxin 25mg tab
Diazepam HCI Amp (Valium)
Dopamine HC Amp
Dobutamine vl
Ephedrine HCI amp(Hizon)
Furosemide amp 20mg/2mg
Gliclazide 80mg tab
Halothane 250ml btl
Hydralazine HCI amp
Hyoscine N Butylbromide 10mg tab
Isoflurane 100ml btl
Isoxsuprine HCI 10mg/2ml amp
Ketamine HCI vl
Ketorolac
polyamp Lidocaine 2% polyamp 5ml
vls
Magnesium sulfate vl. 20ml
amp Methylgometrine HCI amp
amp Metoclopramide HCI amp
vls
Metronidazole 500mg/100ml vl
amp Midazolam 5mg/ml (Dormicum)
amp Midazolam 15mg/3ml (Dormicum)
amp Morphine Sulfate 10ml/ml amp
tab
Morphine Sulfate 20mg tab
amp Nalbuphine HCL (Nubain)
tab
amp
Omeprazole tab 20mg
Ondansetron Amp (Zofran)
ABC Per
Unit
40.60
48.00
20.88
11.60
203.00
115.00
12.18
330.60
195.00
25.00
17.81
46.40
4.20
130.00
45.24
550.00
42.00
6.38
293.48
2,200.00
116.00
236.06
2,250.00
105.00
650.00
85.00
11.44
32.48
25.00
4.64
34.00
175.00
330.00
37.20
3.03
118.00
5.10
575.00
Unit Bid
Price
Unit Bid Price in Words
Total Amount
Bid
Bill Quantities:
Particulars
Item No.
Qty.
Unit
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
30
3
1
200
10
10
10
100
60
60
10
200
100
600
30
5
2
300
150
20
200
1
3
72
72
72
3
3
3
3
24
150
50
50
50
20
200
bxs
bxs
bxs
tab
pcs
pcs
amp
tab
vls
vls
amp
amp
amp
amp
neb
bxs
bxs
amp
amp
pcs
pcs
bxs
bxs
pcs
pcs
pcs
pcs
pcs
pcs
pcs
pcs
pcs
pcs
pcs
pcs
pcs
pcs
Metformin tab (P-100)
Metronidazole 500mg tab
Ibuprofen 400mg tab x 100's
Domperidone tab
Paracetamol Suppository (Pedia)
Paracetamol Suppository (Adult)
Phenobarbital 130mg/ml amp.
Phenobarbital 60mg tab.
Pen G 1M vl
Pen G 5M vl
Phenytoin 100mg/2ml amp
Phytomenadione IM/IV 10mg/ml
Propofol amp 10mg/20ml
Ranitidine 25mg amp
Salbutamol 2.5mg (P-100)
simvastatin 20mg (P-100)
Theophylline 300mg tab x 100's
Tramadol 100mg amp
Tranexamic Acid amp
Asepto Syringe (Irrigating)
Cord Clamp
Disposable Razor (Double) 100's
Disposable Syringe 1cc x 100's Terumo
Chromic 0 CT-1
Chromic 1 CT-1
Chromic 2-0 CT-1
Endo Tube 2.5
Endo Tube 3.0
Endo Tube 5.0
Endo Tube 7.0
Elastic Bandage 4 x 5
Foley Catheter Fr 16
I.V. Catheter G26
I.D Bracelet (Adult) Blue
I.D. Bracelet (Pedia) Green
Jackson Pratt Drain
Microdrip (Pedia)
104
105
106
1
10
25
bxs
pcs
pcs
Micropore 1 inch x 12's
Soluset
Spinal Needle G23
ABC Per
Unit
100.00
73.08
75.56
3.92
13.00
17.00
635.00
4.00
5.80
16.24
522.00
55.00
312.00
8.41
100.00
100.00
85.26
30.74
40.60
30.00
4.06
1,392.00
556.80
190.00
190.00
190.00
60.00
60.00
65.00
65.00
20.88
19.14
56.00
3.19
3.19
1,150.00
19.00
290.00
170.00
62.64
Unit Bid
Price
Unit Bid Price in Words
Total Amount
Bid
Bill Quantities:
Item No.
Qty.
Unit
107
108
109
110
111
112
113
114
115
75
100
100
150
150
50
150
30
400
pcs
pcs
pcs
pcs
pcs
pcs
pcs
pcs
pcs
Particulars
Spinal Needle G25
Suction Catheter Fr. 8
Surgical Gloves 6.5
Surgical Gloves 7.0
Surgical Gloves 7.5
Surgical Gloves 8.0
Urine Bag (Adult)
Urine Bag (Pedia)
Venoset (Adult)
ABC Per
Unit
62.64
15.08
9.05
9.05
9.05
9.05
9.86
4.06
18.00
Unit Bid
Price
Unit Bid Price in Words
Total Amount
Bid
nothing follows
TOTAL AMOUNT BID
AMOUNT IN WORDS
Name of Bidder
NORMANDO S. LEGASPI
End User Representative
Signature Over Printed Name
Owner of Authorized representative
ROWENA R. SANZ
BAC Member
ATTY. KRISTINE GRACE L. SUAREZ
BAC Member
DELIVERY PERIOD: Within ________ (_____) calendar days upon receipt of PO
ANGEL M. SAULONG DR. ERLINDA G. BADILLO SIMPLICIO I. MARAMOT ENGR. ELMER V. DILAY
BAC Member
BAC Member
BAC-Vice-Chairman
BAC Chairman
BIDS AND AWARDS COMMITTEE
ABSTRACT OF BIDS AS CALCULATED
Opened on:
September 04, 2013 at 2:00 p.m. at BAC Office Provincial Capitol Complex Camilmil, Calapan City
For supply & Delivery of sporting goods for use in different barangays of Oriental Mindoro
APPROVED BUDGET FOR THE CONTRACT :
Total Amount of Bid
Form of Bid Security
Bank/company
Number
Validity Period
Bid Security
Required Bid security
Sufficient/Insufficient
Remarks
Php 200,000.00
CHEZ AND ADIE GOLDEN ENTERPRISES
:
:
:
:
:
:
:
:
:
Php 199,098.00
Surety Bond
Country Bankers Insurance Corporation
OR # 839006
120 days
Php 10,000.00
Php 10,000.00
Sufficient
Passed
Particulars
Unit Bid Price
Item No.
QTY
Unit
1
306
pcs
Basketball Ball
300.00
299.00
91,494.00 mikasa
2
200
pcs
Volleyball Ball
280.00
279.00
55,800.00 ordinary
3
65
pcs
Basketball Trophies Fiber Glass 12"
260.00
258.00
16,770.00
4
67
pcs
320.00
318.00
21,306.00
5
66
pcs
Basketball Trophies Fiber Glass 10"
Basketball Trophies Fiber Glass 8"
210.00
208.00
13,728.00
s-s-s-s-s-s-s-s
199,098.00
We hereby certify that this is correct abstract of the bid opened in our presence.
ROBERTO O. MENDOZA
End User Representative
DR. ERLINDA G. BADILLO
BAC Member
shiela/BAC
ROWENA R. SANZ
BAC Member
ATTY. KRISTINE GRACE L. SUAREZ
BAC Member
SIMPLICIO I. MARAMOT JR.
BAC Vice - Chairman
PCI ROMEO U. DELMO (Ret)
BAC Member
ENGR. ELMER V. DILAY
BAC Chairman
BIDS AND AWARDS COMMITTEE
ABSTRACT OF BIDS AS READ
Opened on:
September 04, 2013 at 2:00 p.m. at BAC Office Provincial Capitol Complex Camilmil, Calapan City
For supply & Delivery of sporting goods for use in different barangays of Oriental Mindoro
APPROVED BUDGET FOR THE CONTRACT :
Total Amount of Bid
Form of Bid Security
Bank/company
Number
Validity Period
Bid Security
Required Bid security
Sufficient/Insufficient
Remarks
Php 200,000.00
CHEZ AND ADIE GOLDEN ENTERPRISES
:
:
:
:
:
:
:
:
:
Php 199,098.00
Surety Bond
Country Bankers Insurance Corporation
OR # 839006
120 days
Php 10,000.00
Php 10,000.00
Sufficient
Passed
Particulars
Unit Bid Price
Item No.
QTY
Unit
1
306
pcs
Basketball Ball
300.00
299.00
91,494.00 mikasa
2
200
pcs
Volleyball Ball
280.00
279.00
55,800.00 ordinary
3
65
pcs
Basketball Trophies Fiber Glass 12"
260.00
258.00
16,770.00
4
67
pcs
320.00
318.00
21,306.00
5
66
pcs
Basketball Trophies Fiber Glass 10"
Basketball Trophies Fiber Glass 8"
210.00
208.00
13,728.00
s-s-s-s-s-s-s-s
199,098.00
We hereby certify that this is correct abstract of the bid opened in our presence.
ROBERTO O. MENDOZA
End User Representative
DR. ERLINDA G. BADILLO
BAC Member
shiela/BAC
ROWENA R. SANZ
BAC Member
ATTY. KRISTINE GRACE L. SUAREZ
BAC Member
SIMPLICIO I. MARAMOT JR.
BAC Vice - Chairman
PCI ROMEO U. DELMO (Ret)
BAC Member
ENGR. ELMER V. DILAY
BAC Chairman
CHEZ AND ADIE GOLDEN ENTERPRISES
ARTICLES
ITEM NO.
QTY
UNIT
Unit Price
1
306
pcs
Basketball Ball
mikasa
299.00
91,494.00
2
200
pcs
Volleyball Ball
ordinary
279.00
55,800.00
3
65
pcs
Basketball Trophies Fiber Glass 12"
258.00
16,770.00
4
67
pcs
Basketball Trophies Fiber Glass 10"
318.00
21,306.00
5
66
pcs
Basketball Trophies Fiber Glass 8"
208.00
13,728.00
s-s-s-s-s-s-s-s
For use in Different Barangays of Oriental Mindoro
Total Price
199,098.00