Province Of Northern Samar Tender

Description Republic Of The Philippines Province Of Northern Samar Catarman, Northern Samar Bids And Awards Committee Request For Quotation Date: May 13, 2024 Rfq No.: 24-05-0331 Name Of Supplier (business Name): ________________________________________ Address: ______________________________________________________________ Tin: _______________________ Contact No.: _________________________ The Bdh, Catdh, Gdh, G.b. Tan, Cdh, Sadh & Svdh, Through The Bids And Awards Committee (bac), Intends To Procure Drugs & Medicines, With Pr No. 2024-04 0611 & 2024-04-0610. The Drugs & Medicines Shall Be Procured Through The Alternative Mode Of Procurement In Accordance With Ra No. 9184 As Reflected In Bac Resolution No. Svp 05-13-01. Suppliers Of Known Qualifications Are Invited To Submit Their Quotation/proposal, Signed By You Or Your Duly Authorized Representative Not Later Than____________, Subject To The Terms And Conditions Provided In This Rfq. The Contract Shall Be Awarded To The Supplier With The Lowest And Responsive Quotation. The Following Documents Are Required To Be Submitted Along With The Quotation/proposal: 1. Mayor’s/business Permit 2. Philgeps Reg. No. 3. Omnibus Sworn Statement 4. License To Operate Open Quotations May Be Submitted, Manually Or Through Email At The Address And Contact Numbers Indicated Below. For Queries You May Contact Us At 500-2342 Or Email Address At Pgnsbac1@gmail.com. Dr. Jose Luis A. Acompañado Bac Chairman Rfq No. 24-05-0331 Page 1 Of 6 Pgns-bac-005-fm Rev.00 Effectivity Date: July 17, 2023 Rfq No. 24-05-0331 Page 2 Of 6 Pgns-bac-005-fm Rev.00 Effectivity Date: July 17, 2023 General Instructions: (1) Accomplish The Rfq Completely And Accurately. (2) Alteration Of This Form In Any Way Is Not Allowed. (3) Failure To Comply With Any Of The Technical Specifications Required Will Disqualify Your Quotation. (4) Failure To Follow These Instructions Will Disqualify Your Quotation. After Having Carefully Read And Accepted The Terms And Conditions, I/we Submit My/our Quotation/s For The Items As Follows: Qty. Unit Item Description/technical Specifications Approved Budget For The Contract Quotation/offer Unit Price Total Price Unit Price Total Price Brand / Model Lot 1 – For The Use Of Biri, Catubig & Gamay District Hospitals. (e-cart Use) Regulated Drugs And Medicines (e-cart Use) 90 Sachets Activated Charcoal Sachet 100g 210.00 18,900.00 20 Ampule/ Vial Amiodarone, 150mg/3ml 717.20 14,344.00 3 Ampule Haloperidol 50mg/ml 1,491.70 4,475.10 25 Amp/s Diazepam, 5mg/ml, 2ml Ampule 366.54 9,163.50 20 Amp/s Diazepam, 10mg/ml, 2ml Ampule 366.54 7,330.80 50 Tablet Diazepam, 5mg 38.12 1,906.00 10 Ampule/ Vial Dobutamine 250mg/20ml 828.17 8,281.70 20 Amp/s Aminophylline 25mg/ml, 10ml 75.90 1,518.00 22 Amp/s Verapamil, 2.5mg/ml, 2ml 268.67 5,910.74 10 Amp/s Digoxin 0.5mg/2ml Amps 327.44 3,274.40 20 Vial Dopamine 20mg/5ml 641.67 12,833.40 5 Ampule Noradrenaline 2mg/ml 3,035.00 15,175.00 50 Tablet Isosorbide Dinitrate 5mg Sublingual Tablet 219.90 10,995.00 15 Ampule Phenobarbital 30mg/ml Iv 881.38 13,220.70 5 Tablet Phenobarbital 30mg/ml Iv Or 30mg Tab 5.41 27.05 20 Ampule Sodium Bicarbonate 50meq/50ml 491.97 9,839.40 Remarks: _________________________________________________________________ _________________________________________________________________ Mailyn V. Balleta _____________________________ Canvasser Proprietor/authorized Representative (signature Over Printed Name) Rfq No. 24-05-0331 Page 3 Of 6 Pgns-bac-005-fm Rev.00 Effectivity Date: July 17, 2023 General Instructions: (1) Accomplish The Rfq Completely And Accurately. (2) Alteration Of This Form In Any Way Is Not Allowed. (3) Failure To Comply With Any Of The Technical Specifications Required Will Disqualify Your Quotation. (4) Failure To Follow These Instructions Will Disqualify Your Quotation. After Having Carefully Read And Accepted The Terms And Conditions, I/we Submit My/our Quotation/s For The Items As Follows: Qty. Unit Item Description/technical Specifications Approved Budget For The Contract Quotation/offer Unit Price Total Price Unit Price Total Price Brand / Model 10 Tablet Thiamine, 250mg 24.50 245.00 2 Ampule Noephinephrine, 1mg/ml 1,073.40 2,146.80 10 Ampule Midazolam 5mg/ml, 1ml Ampule 264.17 2,641.70 20 Ampule Nalbuphine 10mg/ml, 1ml Solution For Injection Ampule (supplier With S4 License) 285.22 5,704.40 100 Tablet Phenobarbital, 90mg 6.89 689.00 10 Amp/ Vial Dobutamine 50mg/5ml 598.17 5,981.70 15 Ampule/ Vial Calcium Gluconate 10mg/ml 142.77 2,141.55 Lot 2 – For The Use Of Gbtan Mh, Capul Dh, San Antonio Dh & San Vicente Dh. (e-cart Use) Regulated Drugs And Medicines (e-cart Use) 20 Ampule Amiodarone, 50mg/3ml 717.20 14,344.00 10 Tablet Amiodarone, 200mg Tablet 135.22 1,352.20 30 Ampule Haloperidol 50mg/ml 1,491.70 44,751.00 20 Tablet Phenobarbital, 60mg 5.95 119.00 20 Amps Phenytoin 50mg/ml, 2ml Ampule 1,276.79 25,535.80 50 Cap/s Phenytoin, 100mg 55.10 2,755.00 30 Amp/s Diazepam, 5mg/ml, 2ml Ampule 366.54 10,996.20 Remarks: _________________________________________________________________ _________________________________________________________________ Mailyn V. Balleta _____________________________ Canvasser Proprietor/authorized Representative (signature Over Printed Name) Rfq No. 24-05-0331 Page 4 Of 6 Pgns-bac-005-fm Rev.00 Effectivity Date: July 17, 2023 General Instructions: (1) Accomplish The Rfq Completely And Accurately. (2) Alteration Of This Form In Any Way Is Not Allowed. (3) Failure To Comply With Any Of The Technical Specifications Required Will Disqualify Your Quotation. (4) Failure To Follow These Instructions Will Disqualify Your Quotation. After Having Carefully Read And Accepted The Terms And Conditions, I/we Submit My/our Quotation/s For The Items As Follows: Qty. Unit Item Description/technical Specifications Approved Budget For The Contract Quotation/offer Unit Price Total Price Unit Price Total Price Brand / Model 15 Amp/s Diazepam, 10mg/ml, 2ml Ampule 366.54 5,498.10 30 Tablet Diazepam, 5mg 38.12 1,143.60 20 Amp/ Vial Dobutamine 250mg/20ml 792.00 15,840.00 10 Vial Aminophylline 25mg/ml, 10ml 75.90 759.00 25 Amp/s Verapamil, 2.5mg/ml, 2ml 268.67 6,716.75 10 Amp/s Digoxin 0.5mg/2ml Amps 327.44 3,274.40 5 Amp/s Digoxin 0.25mg/2ml Amps 327.44 1,637.20 10 Vial Dopamine 20mg/5ml 641.67 6,416.70 50 Amp/s Diphenhydramine 50mg/ml 199.31 9,965.50 50 Cap/s Diphenhydramine (as Hydrochloride) 50mg 32.59 1,629.50 3 Ampule Noradrenaline 2mg/ml 3,035.00 9,105.00 70 Tablet Isosorbide Dinitrate 5mg Sublingual Tablet 219.90 15,393.00 5 Tablet Methylprednisolone 4mg 24.25 121.25 25 Tablet Oral Rehydration Solution Salt Preparation Sachet 4.1 Grams 15.68 392.00 10 Ampule Phenobarbital 30mg/ml Iv 881.38 8,813.80 2 Tube Lidocaine Ointment, 50g 611.24 1,222.48 2 Vial Vancomycin, 500mg 470.65 941.30 Remarks: _________________________________________________________________ _________________________________________________________________ Mailyn V. Balleta _____________________________ Canvasser Proprietor/authorized Representative (signature Over Printed Name) Rfq No. 24-05-0331 Page 5 Of 6 Pgns-bac-005-fm Rev.00 Effectivity Date: July 17, 2023 General Instructions: (1) Accomplish The Rfq Completely And Accurately. (2) Alteration Of This Form In Any Way Is Not Allowed. (3) Failure To Comply With Any Of The Technical Specifications Required Will Disqualify Your Quotation. (4) Failure To Follow These Instructions Will Disqualify Your Quotation. After Having Carefully Read And Accepted The Terms And Conditions, I/we Submit My/our Quotation/s For The Items As Follows: Qty. Unit Item Description/technical Specifications Approved Budget For The Contract Quotation/offer Unit Price Total Price Unit Price Total Price Brand / Model 100 Tablet Aluminum Hydroxide+magnesium Hydroxide 200mg+100mg 21.65 2,165.00 10 Ampule / Vial Calcium Gluconate 10%, 10ml 142.77 1,427.70 25 Ampule Sodium Bicarbonate 50meq/50ml 491.97 12,299.25 25 Ampule / Vial Calcium Gluconate 10mg/ml 142.77 3,569.25 Remarks: _________________________________________________________________ _________________________________________________________________ Mailyn V. Balleta _____________________________ Canvasser Proprietor/authorized Representative (signature Over Printed Name) Terms And Conditions 1. Bidders Shall Provide Correct And Accurate Information As Required In This Form. 2. The Price Quotation/s Shall Be Valid For A Period Of 60 Calendar Days From The Date Of Submission. 3. The Price Quotation/s, To Be Denominated In Philippine Peso Shall Include All Taxes, Duties, And/or Levies Payable. 4. All Quotations Which Exceeds The Approved Budget For The Contract Shall Be Rejected. 5. The Award Of Contract Shall Be Made To The Lowest Quotation Which Complies With The Technical Specifications, And Other Terms And Conditions Stated Herein. 6. Any Alterations, Interlineations, Or Overwriting Shall Not Be Allowed Including The Terms And Conditions Of Rfq. 7. The Item/s Shall Be Delivered Within _30_ Calendar Days From Receipt Of The Purchase Order. 8. The Provincial Government Of Northern Samar Shall Have The Right To Inspect And/or Test The Goods To Confirm Their Conformity To The Technical Specifications. 9. Warranty Security For A Minimum Period Of Three Months, In The Case Of Expendable Supplies, Or A Minimum Period Of One Year In The Case Of Semi-/non-expendable Supplies, After Acceptance By The Procuring Entity Of The Delivered Supplies Or Specified Warranty Condition By The End-user. 10. For Drugs, Medicines And Medical Supplier, In Compliance With Coa Circular No. 2023-004 The Following Documents Are The Additional Documentary Requirements Upon Delivery Of Drugs And Medicines And Medical Supplies, To Wit: 1. Certificate Of Product Registration (cpr) 2. Certificate Of Good Manufacturing Practices (cgmp) 3. Batch Release Certificate 4. Certificate As Authorized Distributor/supplier. Liquidated Damages Equivalent To One Tenth Of One Percent (0.1%) Of The Value Of The Goods Not Delivered Within The Prescribed Delivery Period Shall Be Imposed Per Day Of Delay. The Pgns Shall Rescind The Contract Once The Cumulative Amount Of Liquidated Damages Reaches Ten Percent (10%) Of The Amount Of The Contract, Without Prejudice To Other Courses Of Action And Remedies That The Pgns May Take. Rfq No. 24-05-0331 Page 6 Of 6 Pgns-bac-005-fm Rev.00 Effectivity Date: July 17, 2023