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FORMATS FOR REAGENTS/CONSUMABLES, UNIT PRICE BREAKUP & SPARE PART / ACCESSORIES FORMAT A: PRICE for FILMS (X-RAY FILMS PACKS) (For items wherever mentioned in Price BoQ Excel File) which will be taken into account for evaluation. FORMAT B: UNIT PRICE BREAKUP (ULTRASOUND MACHINE) (For items wherever mentioned in Price BoQ Excel File) FORMAT C: SPARE PARTS / ACCESSORIES COST (For all items quoted, which will not be taken into account for evaluation) Instruction: Bidders are required to upload the above formats (wherever mentioned against the items quoted) in One PDF file only, as there is option to upload one PDF file only along with the Price BoQ Excel file. FORMAT A (PRICE for REAGENT/CONSUMABLES/FILMS) (For items wherever mentioned in the schedule of Requirement & Price BoQ) To be uploaded online in Part – II Price Bid (Item Name: ______________________) (Separately for each item) (Exp. CR System/ABG Machine/ACT Machine) To be submitted in Part – II Price Bid COST OF FILMS REQUIRED FOR THE MACHINE AS MENTIONED IN TECHNICAL SPECIFICATION, WHICH SHALL BE TAKEN INTO ACCOUNT FOR EVALUATION Sl. No. Name of the Film Packs (100 films) of each sizes etc. Test / Month (Estimated) Pack Size / Volume (100 films) Unit Pack Rate exclusive of tax (a) Reqd. Qty. for 100 Films in terms of Unit pack (b) Rate / Month (c=a*b) Rate / Year (d=c*12) Rate / 6 Years (e=d*5) 1 100 Test 2 100 Test 3 100 Test . 100 Test . 100 Test . 100 Test . 100 Test Total Amount (for all reagents / cartridges) required for 5 Years (exclusive of tax) Tax (%) : _________ Note: 1. Bidder shall offer the Names & Rate of all Reagents required if any, for the offered model to complete the test / parameters mentioned in the technical specification as per the price bid format given. Total cost required for reagents / solution for a period of 6 years, considering minimum tests / month as mentioned in price bid format shall be taken into account for evaluation. 2. No items shall be purchased by Tender Inviting Authority to complete the tests / parameters mentioned in technical specification other than the list submitted by Bidder as per the price bid format. Hence items which are not mentioned here shall be included in Comprehensive warranty & CMC offered and replacement of such items like electrodes, tubing set or other spares whenever required shall be done free of cost during warranty & CMC period. 3. Purchase orders for the reagents / solutions etc. shall be issued based on actual requirement accordingly to the unit rates of the pack size offered by the bidder, and the prices for the same shall be fixed period of 6 years. 4. Bidder shall submit necessary documents to prove that the offered quantity is sufficient to complete the minimum number of tests / month as mentioned in price bid, & if any deviations noticed by Tender Inviting Authority the equipment shall not be considered for further bid process. Signature of the Bidder Seal FORMAT B (UNIT PRICE BREAKUP) (For items wherever mentioned in Price BoQ Excel File) To be uploaded online in Part – II Price Bid (Item Name: ______________________) (Separately for each item) (Exp. 3D echo USG with TEE/ USG Machine with Doppler/Portable USG/Portable ECHO) Sl. No. Particulars Unit Price (Rs.) (exclusive of installation cost, CST / OVAT / ET) *Qty (Qty of each component etc. as asked in technical specification) Total Unit Price of Basic machine with accessories and all upgradable features as asked in technical specification (exclusive of installation cost, CST / OVAT/ET) (Rs.) A b c= a x b 1 Basic Machine (Exp.: Ultrasound with Color Doppler with accessories / instrument 1 Other items (Attachments as asked in the technical specification 2 Probe-1 3 Probe-2 4

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