Drugs and Medicines for the use of OMPH Oncology patients

REQUEST TO SUBMIT PROPOSAL/QUOTATION (Small Value Procurement - Sec. 34.1) Date : Company / Store Name and Address Please quote your lowest price on the items listed below, subject to the Terms and Conditions and submit your quotation duly signed by your authorized representative on the deadline of submission of this quotation together with the documentary requirements in the return sealed envelope to wit: 1. All entries must be typewritten or handwritten. 7. Documentary Requirements: 2. The Approved Budget for the Contract is Php 499,998.00 A. Mayor's/Business Permit 3. Delivery period within seven (7) calendar days B. PhilGeps Registration Certificate upon receipt of Approved NTP C. Income/Business Tax Return for 4. Deadline of submission of quotation/proposal ABCs above 500K not later than D. Omnibus Sworn Statement 5. Price validity shall be for a period of thirty (30) calendar days. for ABCs above P50K 6. Suppliers/Bidders shall submit original brochures showing certifications of the product being offered. JOSIE ANN L. MARCA,MD,MMHoA,CHA,DipHLM BAC Chairperson for Health Item No. Qty. Unit of Issue Goods and its Specification Unit Cost Total Cost 1 9 vials Asparaginase 10,000 IU Iyophilized powder vial _________ _________ 2 1000 tablet Capecitabine 500 mg tablet _________ _________ 3 16 vial Cyclophosphamide 1g vial _________ _________ 4 18 vial Cyclophosphamide 500 mg vial _________ _________ 5 15 vial Etoposide 100 mg powder vial _________ _________ 6 13 vial Etoposide 20 mg/mL, 5 mL vial _________ _________ 7 48 pcs Filgrastim 300mcg/0.5 mL solution, pre-filled syringe _________ _________ 8 24 vial Irinotecan 100 mg/5 mL vial _________ _________ 9 191 tablet Methotrexate 2.5 mg tablet _________ _________ 10 192 tablet Mercaptopurine 50 mg tablet _________ _________ 11 199 tablet Tamoxifen 20 mg tablet _________ _________ 12 8 pcs Trastuzumab 150 mg Iyophilized powder _________ _________ 13 4 vial Trastuzumab 600 mg/5mL (120mg/mL) _________ _________ solution