BID FORM

TO BE COMPLETED BY BIDDER
CONTRACTOR'S NAME AND HEADQUARTERS

TO BE COMPLETED BY BIDDER

SUBCONTRACTOR

SUBCONTRACTORS NAME AND

SERVICES TO BE DONE FOR THE
CONTRACTOR

NAME OF THE AUTHORIZED PERSON (contract

signatory)

TO BE COMPLETED BY BIDDER

Offer reference number

TO BE COMPLETED BY BIDDER

Offer date

TO BE COMPLETED BY BIDDER

order.
no.

Name

Unit of
measure

Quantity

1.

Flatirons NLM Software

pcs

2.

Annual Software Maintenance

Until 15.12.2017

pcs

Unit Price

TOTAL:
Due Date of Payment
TO BE COMPLETED BY BIDDER
INCOTERMS

TO BE COMPLETED BY BIDDER

Delivery term

TO BE COMPLETED BY BIDDER

Warranty period

TO BE COMPLETED BY BIDDER

Validity of Bids
TO BE COMPLETED BY BIDDER
CONTACT PERSONS
NAME

TO BE COMPLETED BY BIDDER

Telephone

TO BE COMPLETED BY BIDDER

E-mail address

TO BE COMPLETED BY BIDDER

DATE:
SA-07.02.03-007, version 2

Page 1 of 2

Total price

SIGNATURE:
SEAL OF BIDDER:

SA-07.02.03-007, version 2

Page 2 of 2