REPAIR & MAINTENANCE - MACHINERY & EQUIPMENT (HEALTH OFFICE) (2) (1)

Local Government Unit of Sibulan Project Reference Number : ______________ Oriental Negros Name of Project : ______________ Location of the Project : ______________ Standard Form Number SF- GOOD-80 Revised on May, 24 2004 Standard Form Title: Request for Quotation Date : ______________________________ Quotation No. _______________________ _______________________________________ _______________________________________ Please quote your lowest price on the item/s listed below, subject to the General Conditions on the last page, stating the shortest time of delivery and submit your quotation duly signed by your representative not later than ________________________________ in the return envelope attached herewith. JAN S. ARCO, M.D End -User Unit Head NOTE: 1. ALL ENTRIES MUST BE TYPE WRITTEN 2. DELIVERY PERIOD WITHIN _________________ CALENDAR DAYS 3. WARRANTY SHALL BE A FOR A PERIOD OF SIX MONTHS FOR SUPPLIES AND MATERIALS ONE (1) YEAR FOR EQUIPMENT FROM DATE TO ACCEPTANCE BY THE PROCURING ENTITY. 4. PRICE VALIDITY SHALL BE FOR A PERIOD OF ___________________ CALENDAR 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. UNIT ITEM DESCRIPTION QTY UNIT PRICE FOR L300 AMBULANCE B8B632 1 pc Battery 11 Plates 1 ABC : P 14,500.00 Charged to: Repair & Maintenance – Machinery & Equipment (Health Office) 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. __________________________________________ Signature/Printed Name __________________________________________ Tel No./Cell No./E-Mail Address __________________________________________ Date