Republic of the Philippines

Department of Health BA-004-0

CAGAYAN VALLEY MEDICAL CENTER

Regional Tertiary, Teaching and Training Hospital
Carig, Tuguegarao City, Cagayan

REQUEST FOR QUOTATION

Date : April 20, 2021
Quotation No. : H-2021-04-07

Please quote your lowest price on the item/s listed below stating shortest time of delivery and submit your quotation
duly signed by your representative within seven (7) calendar days from the date of receipt hereof.

MARIALISA S. DAUIGOY, MD, MPH, FPAFP

BAC Chair
Bidder’s Proposal
Item and Description QTY. UNIT Unit Cost Total Cost
 FUEL FILTER, I-R-0749 2 Pcs. 3,134.00 6,268.00
 FUEL/WATER SEPARATOR (CATERPILLAR) 2 Pcs. 5,590.00 11,180.00
 OIL FILTER I-R-0716 2 Pcs. 3,200.00 6,400.00

 OIL FILTER 5018A (DOOSAN) 12 Pcs. 4,300.00 51,600.00

 FUEL FILTER 5020B (DOOSAN) 8 Pcs. 2,700.00 21,600.00

 FUEL FILTER 00093 (DOOSAN) 8 Pcs. 2,700.00 21,600.00

ABC : 122,400.00
PR No. : H-2021-04-080

ALL PRICE MUST BE VAT INCLUSIVE

FOR CVMC USE : For Preventive Maintenance of all Gensets

Brand/Model (If Applicable) :
Delivery Date (Required) : 2 to 3 months
Price Validity (Required) : 60 calendar days

After having carefully read and accepted your general condition, I/ we quote you on the items and price noted
above.

Please fill in completely:

INTEGRATED POWER & CONTROL , INC MICHAEL A. MANZANO
_________________________________ ______________________________
Company Name and Address Authorized Representative
(Signature over Printed Name)
5/4/2021
Date: ____________________________ 09178382678
______________________________
Tel No. /CP No. /Fax No.
_________________________________
Buyer/Canvasser

REMINDERS:
1. Please fill-in all fields LEGIBLY and avoid ERASURES
2. Provide brochure of your proposal. Demonstration unit MAY be required for evaluation
3. Attach a copy of the following REQUIRED DOCUMENTS (updated):
a. Mayor’s Permit c. Tax Clearance
b. DTI/SEC Certificate d. PHILGEPS Registration (for items Php50,000.00 above
CAGAYAN VALLEY MEDICAL CENTER
Bids & Awards Committee
Email Address: cvmcbac2020@gmail.com
Tel. No. (078) 302-0000 local 219