No.

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Electricity Generating Authority of Thailand
53 Moo 2 Charansanitwong Rd. Bang Kruai Nonthaburi 11130 www.egat.co.th

REQUEST FORM
This request form is available for purchasing bidding documents of the project specified below.

INVITATION FOR BIDS NO. EGAT 1/2560-PCHP

PHA CHUK HYDROPOWER PROJECT
Please fill out the form below completely.

Bidder Name………………….………………………………………………………………………………………………………………………………………….
Contact Person……………..…………………………………………………………………………………………………………………………………………..
Address……………………………………………………………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………………………………………………………………………….
*Tax ID No.……………………………………..…………………………………………………………………………………………………………………………
Telephone……………………………………………………………………….Facsimile………………………………………………………………………….
Mobile…………………………………………………………………………..E-mail…………………………………………………………………………………

C/O…….………………………………………………………………………….………………………………………………………………………………………...
………………………………………………………………………………………………………………………………………………………………………………….
Address……………………………………………………………………………………………………………………………………………………………………..
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*Tax ID No.……………………………………..…………………………………………………………………………………………………………………………
Telephone……………………………………………………………………….Facsimile………………………………………………………………………….
Mobile…………………………………………………………………………..E-mail…………………………………………………………………………………

เอกสารประกอบการซื้อเอกสารประกวดราคา (Evidences)
ชื่อ-นามสกุลของผูท้ มี่ ารับเอกสาร/ ……..……………………………………………..…………………….………………………………………
Name-Surname of Receiver

เอกสารที่เป็นหลักฐาน/evidences 1. สาเนาบัตรประชาชน/หนังสือเดินทางของผู้ที่มารับเอกสาร
(ID Card/Passport)
2. หนังสือรับรองการจดทะเบียนจากกระทรวงพาณิชย์
กรณีบริษัทไทย (Company Registration for Thai Company)
3. อื่นๆ (others)
.......................................................................................................................................................................................
Authorized only
Cost center
D208020
Available duration for purchasing: March 31 - May 17, 2017
รวพฟ.
Receipt No. ……………………………………………….. Date ……………………………………………
at the amount of  THB …..30,000.-.……or  USD ……1,000.-……………………

Instruction :
1. Please fill out two (2) copies of this form and submit one (1) copy of this form for payment at Receivable Cashier Section, Cash
Management Department, EGAT’s Head Office (1st Floor, TOR 100 Bldg.) Tel no. 02 436 5512
2. Submit the other copy of this form and the receipt of payment to receive the bidding documents (CD) at Power Plant Development
Area Foreign Procurement Department, EGAT’s Head Office (12th Floor, Room 1206, TOR 101 Bldg.) Tel no. 02 433 9774

* Required field