Reference No.

: Effectivity Date:

Title: QUOTATION/ CANVASS FORM

Date: Quotation No.:

Please quote your lowest price on the item/s listed below, subject to the General Conditions on the last page stating the shortest time of
delivery, and submit your quotation signed by your representative not later than in the return envelope attached
herewith.

Canvasser Procurement Officer

ITEM NO. UNIT ITEM AND DESCRIPTION QUANTITY UNIT PRICE

Brand Model: Warranty:

Delivery Period: Price Validity:

After having carefully read and accepted your General Conditions, I/We quote on the item/s at prices noted above.

Printed Name/ Signature

Company Name

Company Address

Contact
No.