PSR or Internal Price

SUPPLIER QUOTATION Request reference

YEMEN 2021 MOKA 276

Page : … /... Programme Name/Mission (in letters) Year Project/Site Log chrono N°

REQUESTED DATE OF REPLY 07-Dec QUOTATION DATE: 05-12-21

REQUESTED BY: SUPPLIER NAME:
Supplier Contact Name:
Addresse:
Programme / Mission Tel:
Handicap International/Humanity & Inclusion YEMEN
Fax:
Name
email:
Site / Base Name MOKA DELIVERY DATE AND CONDITIONS:

Address:
Risks, Insurrance and transportation costs of the goods at delivery place are under the responsability of the supplier
Tel / Fax / E-mail: fa.mohammed@hi.org / 776660234 / 773181012 PAYMENT TERMS AND CONDITIONS::
Bank transfer (in priority) Payment at the order
Contact Name: Fakhri Mohammed Cheque Partial payment at the order
Cash Deferred payment

Description of Goods or Services

Line Availability (in
Produit Ref. Provide maximum details as possible, technical specifications can be attached in Quantity Unit Unit Price Total Price Origin of goods Remarks (warranty, after sale service, training, other services, etc…)
N° stock or on order)
appendix of this document

Supply and Installation for prefab caravans (For warehousing) 6 Meters Width X
10 Meter length X 3 Meters Hieght, with electricity of 2 lamps only inside th
caravan ,External walls to be prefabricated (sandwich foam) panel boards
1 insulated in the middle and with total nominal thickness of 5cm. 1 Lump-Sum

Installtion of the caravn at space inside HI office premises, Installation area

needs clean and minor surfacing.

End of List

TOTAL Excluding Taxes QUOTATION VALIDITY PERIOD:

Discount (One Month Minimum)

TOTAL including Taxes (if porgramme or

mission non exempted)

Currency

This quotation request is not a definitive order and does not represent a commiment on behalf of Handiciap International. By signing this document, the supplier acknowledges that information provided are correct and commits himself to respect national and
international regulations regarding working conditions, environment respect and ethical rules.

Name, Signature and

Stamp of the
SUPPLIER