Standard Form Number: SF-GOOD-60
Revised on: May 24, 2004
Standard Form Title: Request for Quotation
Republic of the Philippines
Provincial Government of South Cotabato
BIDS AND AWARDS COMMITTEE
Capitol Compound, Alunan Avenue, City of Koronadal
Tel. No. (083) 228-9951
Date:
Quotation No.
November 18, 2014
SVP 14 - 1164
_______________________
_______________________
______
____
Please quote your lowest price on the items listed below, subject to the General Conditions below, stating the shortest time of delivery and submit
your quotation duly signed by your representative not later than
November 26, 2014 12:00 noon
(SGD)DANILO P. SUPE
Provincial Administrator
BAC Chairman
NOTE:
1. ALL ENTRIES MUST BE TYPEWRITTEN
2. DELIVERY PERIOD WITHIN
10
calendar days
3. WARRANTY SHALL BE FOR PERIOD OF SIX(6) MONTHS FOR SUPPLIES & MATERIALS, ONE(1) YEAR FOR EQUIPMENT, FROM DATE OF ACCEPTANCE BY
THE PROCURING ENTITY
4. PRICE VALIDITY SHALL BE FOR A PERIOD OF
120
DAYS
5. G-EPS REGISTRATION CERTIFICATE SHALL BE ATTACHED UPON SUBMISSION OF THE QUOTATION
6. BIDDERS SHALL SUBMIT ORIGINAL BROCHURES SHOWING CERTIFICATIONS OF THE PRODUCT BEING OFFERED
Item
No.
Item & Description
Quotation Per Item
Estimated
Unit of ABC
Qty.
Unit of
Issue
1
ACICLOVIR , 400mg, tablet, 100's
3,000.00
1
box
2
AMBROXOL , 30mg tablet, 100's
100.00
2
box
3
AMBROXOL , 30mg/15ml, syrup, 60ml
30.00
20
btls
4
AMBROXOL , 15mg/5ml,syrup, 60ml
25.00
30
btls
5
AMBROXOL , 7.5mg/ml, drops. 15ml
20.00
50
btls
6
AMPICILLIN , 250mg
10.00
300
vls
7
AMPICILLIN , 500mg
12.00
200
vls
8
AMPICILLIN , 1gm
15.00
500
vls
9
ATS , 3000"IU"
60.00
144
amps
10
BACILLUS CLAUSII , 2 billion/5ml
15.00
200
btls
11
CEFALEXIN , 500mg,cap.,100's
300.00
5
box
12
CEFUROXIME , 750mg w/ diluent
35.00
600
vls
13
CEFUROXIME , 500mg tablet, 100's
1,000.00
3
box
14
CEFUROXIME , 250mg/5ml susp.,60ml
110.00
30
btls
15
CEFTRIAXONE , 1gm w/ diluent
35.00
500
vls
16
CLONIDINE , 15mcg/1ml
110.00
20
amps
17
CLOXACILLIN , 500mg caps 100s
500.00
3
box
18
CLOXACILLIN , 500mg vial, 10's
150.00
5
box
19
CO-AMOXICLAV , 250mg/5ml susp., 60ml
130.00
30
btls
20
CO-AMOXICLAV , 625mg, tablet, 20's
100.00
20
box
21
DIAZEPAM , 5mg/ml, 2ml
150.00
10
amps
22
DIGOXIN , 250mcg/ml, 2ml
180.00
3
amps
23
DOMPERIDONE , 1mg/ml suspension drops, 30ml
30.00
15
btls
24
DOMPERIDONE , 5mg/5ml susp., 60ml
85.00
20
btls
25
DOMPERIDONE , 10mg, tab, 100s
200.00
2
box
26
EPINEPHRINE , Hydrochloride 1mg/ml
50.00
50
amps
27
FERROUS SULFATE , 325mg, tablet, with folic acid, 100's, 60 elemental iron
80.00
3
box
28
FERROUS SULFATE+FOLIC ACID+VITAMIN B COMPLEX CAPSULE , 100's
100.00
2
box
29
FERROUS SULFATE , drops, 15ml, 15-30mg elemental iron
25.00
10
btls
30
FERROUS SULFATE SYRUP , 220 mg/5ml, bot.. of 60 ml
30.00
20
btls
31
FUROSEMIDE , 40mg/ml
15.00
25
amps
32
FUROSEMIDE , 20mg tablet, 100's
50.00
1
box
Brand and Model
Delivery Period
Warranty
Price Validity
Unit Cost
Total Cost
__________________________
__________________________
_______
__________________________
_____
__________________________
_______
_____
After having carefully read and accepted your General Conditions, I/We quote you on the item at prices noted above.
_________________________________
Printed Name / Signature
______
_________________________________
Tel. No. / Cellphone No.
________
email address
_________________________________
_____
Date
Prepared by: bac-shiela; PR.No.14 - 1215
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Page 1 of 3
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Standard Form Number: SF-GOOD-60
Revised on: May 24, 2004
Standard Form Title: Request for Quotation
Republic of the Philippines
Provincial Government of South Cotabato
BIDS AND AWARDS COMMITTEE
Capitol Compound, Alunan Avenue, City of Koronadal
Tel. No. (083) 228-9951
Date:
Quotation No.
November 18, 2014
SVP 14 - 1164
_______________________
_______________________
_____
____
Please quote your lowest price on the items listed below, subject to the General Conditions below, stating the shortest time of delivery and submit
your quotation duly signed by your representative not later than
November 26, 2014 12:00 noon
(SGD)DANILO P. SUPE
Provincial Administrator
BAC Chairman
NOTE:
1. ALL ENTRIES MUST BE TYPEWRITTEN
2. DELIVERY PERIOD WITHIN
10
calendar days
3. WARRANTY SHALL BE FOR PERIOD OF SIX(6) MONTHS FOR SUPPLIES & MATERIALS, ONE(1) YEAR FOR EQUIPMENT, FROM DATE OF ACCEPTANCE BY
THE PROCURING ENTITY
4. PRICE VALIDITY SHALL BE FOR A PERIOD OF
120
DAYS
5. G-EPS REGISTRATION CERTIFICATE SHALL BE ATTACHED UPON SUBMISSION OF THE QUOTATION
6. BIDDERS SHALL SUBMIT ORIGINAL BROCHURES SHOWING CERTIFICATIONS OF THE PRODUCT BEING OFFERED
Item
Item & Description
Quotation Per Item
No.
33 GENTAMYCIN , 40mg/ml, 2ml, 10's
Estimated
Unit of ABC
100.00
Qty.
10
Unit of
Issue
box
34
HYDROCORTISONE , 100mg, vial, 10's
350.00
1
box
35
HYDROCORTISONE , 250mg vial, 10's
480.00
5
box
36
HYDROCORTISONE , 500mg, vial, 10's
960.00
5
box
37
HYOSCINE N-BUTYL BROMIDE , 20mg/mL, 1mL
25.00
100
amps
38
IBUPROFEN , 200mg, tablet, 100's
100.00
2
box
39
IBUPROFEN , 400mg tablet, 100's
200.00
3
box
40
INOSIPLEX , 500mg tablet, 24's
120.00
5
box
41
INOSIPLEX , 250mg/5ml syrup, 60ml
70.00
10
btls
42
LOSARTAN , 50mg, tablet, 100's
350.00
5
box
43
MEFENAMIC ACID , 50mg/5ml suspension, 60ml
15.00
10
btls
44
MEFENAMIC ACID , 500 mg cap, bx of 100's
60.00
5
box
45
METOCLOPRAMIDE , 5mg/ml, 2ml
10.00
50
amps
46
METRONIDAZOLE , 500mg, tablet, 100's
100.00
3
box
47
MULTIVITAMINS W/ IRON CAPSULE , 100s
100.00
2
box
48
MULTIVITAMIN + VIT. B COMPLEX , drops, 15ml
30.00
20
btls
49
NIFEDIPINE , 5mg, capsule, 100's
150.00
2
box
50
OMEPRAZOLE , 40mg/ml, 10ml
65.00
20
vls
51
OMEPRAZOLE , 20mg, capsule 100s
500.00
5
box
52
PARACETAMOL , 500 mg tab, 100's
bx of 100's
50.00
5
box
53
PARACETAMOL , 250mg/5ml susp., 60ml
19.00
30
btls
54
PARACETAMOL , 125mg/5ml, susp., 60ml
15.00
30
btls
55
PARACETAMOL , 100mg/ml, drops, 15ml
16.50
30
btls
56
PARACETAMOL , 150mg/ml, 2ml
15.50
50
amps
57
RACECADOFRIL , 100mg capsule, 45's
450.00
2
box
58
RANITIDINE , 25mg/ml, 2ml
15.00
129
amps
59
PIROXICAM , 20mg, capsule, 100's
1,000.00
1
box
60
SALBUTAMOL SULFATE + BROMHEXINE HCL + GUAIFENESIN , tablet, 100's
200.00
1
box
61
SALBUTAMOL SULFATE+BROMHEXINE HCL + GUIAFENESIN , Syrup, 100ml
20.00
50
btls
62
SALBUTAMOL + IPRATROPIUM BROMIDE , 2.5mg/500mcg/2.5ml
30.00
200
63
SILVER SULFADIAZINE CREAM , 1%, 500 gms per container, flammazine cream
2,800.00
2
nebule
s
conts
64
STERILE WATER FOR INJECTION , 100ml
45.00
180
btls
Brand and Model
Delivery Period
Warranty
Price Validity
Unit Cost
Total Cost
__________________________
__________________________
_______
__________________________
_____
__________________________
_______
_____
After having carefully read and accepted your General Conditions, I/We quote you on the item at prices noted above.
_________________________________
Printed Name / Signature
_____
_________________________________
Tel. No. / Cellphone No.
________
email address
_________________________________
_____
Date
Prepared by: bac-shiela; PR.No.14 - 1215
Powered by PPDO - ITU
Page 2 of 3
Powered by PPDO - ITU
Standard Form Number: SF-GOOD-60
Revised on: May 24, 2004
Standard Form Title: Request for Quotation
Republic of the Philippines
Provincial Government of South Cotabato
BIDS AND AWARDS COMMITTEE
Capitol Compound, Alunan Avenue, City of Koronadal
Tel. No. (083) 228-9951
Date:
Quotation No.
November 18, 2014
SVP 14 - 1164
_______________________
_______________________
___
_______
Please quote your lowest price on the items listed below, subject to the General Conditions below, stating the shortest time of delivery and submit
your quotation duly signed by your representative not later than
November 26, 2014 12:00 noon
(SGD)DANILO P. SUPE
Provincial Administrator
BAC Chairman
NOTE:
1. ALL ENTRIES MUST BE TYPEWRITTEN
2. DELIVERY PERIOD WITHIN
10
calendar days
3. WARRANTY SHALL BE FOR PERIOD OF SIX(6) MONTHS FOR SUPPLIES & MATERIALS, ONE(1) YEAR FOR EQUIPMENT, FROM DATE OF ACCEPTANCE BY
THE PROCURING ENTITY
4. PRICE VALIDITY SHALL BE FOR A PERIOD OF
120
DAYS
5. G-EPS REGISTRATION CERTIFICATE SHALL BE ATTACHED UPON SUBMISSION OF THE QUOTATION
6. BIDDERS SHALL SUBMIT ORIGINAL BROCHURES SHOWING CERTIFICATIONS OF THE PRODUCT BEING OFFERED
Item
No.
65 TETANUS TOXOID , 0.5ml "iu"
Item & Description
Quotation Per Item
Estimated
Unit of ABC
60.00
100
Unit of
Issue
amps
Qty.
66
TRANEXAMIC ACID , 100mg/mL, 5mL
48.00
30
amps
67
TRANEXAMIC ACID , 500mg caps, 100's
500.00
2
box
68
ZINC SULFATE DROPS , 27.5mg/ml, oral drop,15ml
15.00
30
btls
69
ZINC SULFATE SYRUP , 55mg/ml syrup, 60ml
25.00
30
btls
70
D5 0.9 NACL , 1L
44.00
600
btls
71
D5LR , 1L
44.00
1,300
btls
72
D5LR , 500cc
44.00
120
btls
73
D5 NORMOSOL M , 1L
44.00
500
btls
74
D5IMB , 500cc
44.00
500
btls
75
D5 0.3 NACL , 500cc
44.00
300
btls
76
PLAIN NSS , 1L
44.00
600
btls
Unit Cost
Total Cost
x-x-x nothing follows x-x-x
Note: For use of PMH.
"PLEASE INDICATE BRAND"
"EXPIRATION DATE NOT LESS THAN ONE (1) YEAR FROM THE DATE OF DELIVERY"
Source of Fund: PMH-4421-759-SB#2-MOOE-14-10-1217
Approved Budget: P 325,990.00
Brand and Model
Delivery Period
Warranty
Price Validity
__________________________
__________________________
_______
__________________________
_____
__________________________
_______
_____
After having carefully read and accepted your General Conditions, I/We quote you on the item at prices noted above.
_________________________________
Printed Name / Signature
_______
_________________________________
Tel. No. / Cellphone No.
________
email address
_________________________________
_____
Date
Prepared by: bac-shiela; PR.No.14 - 1215
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