LOCAL GOVERNMENT Project Reference Number:

Brgy. Tupol Este, Cabatuan, Iloilo Name of Project: Purchase of Medical Equipment for
Barangay Health Center

Location of Project: Barangay Tupol Este, Cabatuan, Iloilo

Standard Form Number: SF-GOOD-60
Reviced on: May 24, 2004
Standard Form Title: Request for Quotation
Request for Quotation
Date: March 4, 2024
Quotation No: 24-03-002
Company Name:
Address:

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 duly signed by your representative not later than _____________________________________ in the return Envelope attached herewith.

GENEROSA D. FORRO
BAC Chairman
NOTE: 1. ALL ENTRIES MUST BE TYPEWRIITEN/HANDWRITTEN.
2. DELIVERY PERIOD WITHIN_________________________
3. WARRANTY SHALL BE FOR A PERIOD OF SIX _____________________________
YEAR FOR EQUIPMENT FROM DATE OF ACCEPTANCE BY THE PROCURING ENTITY.
4. PRICE VALIDITY SHALL BE FOR A PERIOD OF ________________ CALENDAR DAYS.
5. G-EPS REGISTRATION CERTIFICATION SHALL BE ATTACHED UPON SUBMISSION OF THE QUOTATION.
6. BIDDERS SHALL SUBMIT ORIGINAL BROCHURES SHOWING CERTIFICATIONS OF THE PRODUCT BEING OFFERED.

Item No. Qty. Unit Articles and Description Unit Price TOTAL
1 1 pc BP Apparatus Mannual
2 1 pc Blood Glucose Monitoring System

Total
Brand and Model
Delivery Period
Warranty
Price Validity
Place of Delivery

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

Printed Name/ Signature

Tel. No./Cellphone No.

Date