CBPM 2021 FORM A-1 Market Survey of Available Suppliers, Service Providers and Contractors

KALAHI-CIDSS NATIONAL COMMUNITY - DRIVEN DEVELOPMENT PROGRAM – Additional Financing

MARKET SURVEY of AVAILABLE SUPPLIERS, SERVICE PROVIDERS and CONTRACTORS

Barangay : Province : ________________________ Municipal Class : _________________________

Municipality : Region : ____ ______ Date Prepared : _________________________

A. Non-registered Suppliers

With Experience in
Name of Supplier,
Products/Materials KALAHI-CIDSS
Service Provider, Address Contact Number Remarks
Supplied1 Procurement
Contractor
(Y/N)

B. Registered Suppliers2
1
General category of materials (e.g. hardware, aggregates, amenities, medical supplies, etc.). Indicate also if with limitations in supplied materials.
2
Arrange suppliers by line of business
CBPM 2021 FORM A-1 Market Survey of Available Suppliers, Service Providers and Contractors

With
Distance from Experience
PhilGEPS
Name of Line of Registered Barangay and Contact E-mail in KALAHI-
Address5 Remarks Registered
Establishment3 Business4 Owner Mode of NUmber Address CIDSS
(Y/N)6
Transportation Procurement
(Y/N)

Prepared by: Reviewed by: Approved by:

______________________________ _______________________________________ _____________________________

Project Preparation Team Technical Facilitator/Municipal Engineer BDC-TWG Chairperson

Notes:
1. The Technical Facilitators (TFs) shall consolidate this form into a municipal-wide inventory list to be submitted to the RPMO;
2. This inventory shall be supported with DTI/SEC/CDA, PCAB License, Mayor’s Permit, BIR Certificate of Registration and Price List of
Materials (CBPM Form A-1b)

3
Based on the DTI Business Name Registration Certificate
4
Based on the valid Mayor’s Permit and BIR Certificate of Registration
5
Based on Mayor’s Permit. Indicate also address of main branch if with multiple branches.
6
Remove/no need to fill-out if procurement is World Bank-funded.