HealthNetrPo

Vendor Name:

Deadline:

Delivery Date:

Delivery Location:

Dear Sir/ Madam,

ANNEX 1-c Quotation Request Form

All Interested bidders Mar 5,2018 at 2:00PM local time. One week after signing the PO

HeallhNet TPO Office Dehburi , Deh Naw,District 3 Street No.5 House No. 144, kabul

www.he•llhnetlpo.org

Email:farooq@heallhnetlpoaf.org

Ph : 0789880790-0789880715 RFO No.AFI

HealthNet TPO Office, House# 144, Street#5, District-3 , Dehburi , Deh Naw, Kabul Afghanistan.

1-2018-105-KBL

Please send/ provide us with your quotation for the following items below;

Item No. Quantity Unit Procurement Item Specification Company Unit Cost AFN Total Cost AFN

'I 1800 vial lg Arnpid ll in vial1g 2 900 viai1Q Chloramphenecol vial1g Please provide the quotation in yo ur J 360 Amp 200mg Cimelidine Amp 200mg company letterhead , but stamp and 4 720 500ml Dextrose 5% 500ml sign this RFQ for acceptance the t·erms 5 180 Amp10mg Diazepam Amp10mg and conditions. 6 2700 Amp 7Gmg Diclofenac Amp 75mg 7 360 500ml Haemogel (plasma expander) 500ml 8 540 vial100mg Hydrocortison 1% vial100mg 9 540 Amr ?Omo Hyn~r.inP. Amr 20mg

10 ~ I\ !:lottie L1doca1n (solution) !:lottie -- 11 72 Tube Lidocain (gel) Tube -

12 1440 500ml Normal saline 500ml 13 900 Supp. 125 mf raracotamol Supp. 125 mg 14 180 Supp 325 mg Paracetamol Supp 325 mg 15 36000 Ta b 500mg Paracetamol Tab 500mg 16 54 Bags Pa raffin Gauze Bags 17 144 Bottle Povidone Bottle 18 900 500ml Ringer Lactate 500ml 19 1440 1000ml Ringer lactate 1000ml 20 72 inhaler Salbutamol inhaler 21 360 Tube Si lver Sulfadiazine Tube 22 2100 Amp 5ml Water for Injection Amp 5ml 23 72 SOOml Monitol SOO ml 24 1440 lgr Ceftraxone l gr 25 900 SOOgr Ampiciline SOOgr 26 72 unit-ch 8 NG tube unit - ch 8 27 540 Sol Hydrogen peroxide Sol 28 180 bottel Chlorin bottel 29 60 Bottel Detol Bottel 30 720 different size Paris plaster different size 31 9000 tab400 mg Tab Brofine 400 tab400 mg 32 18000 Tab 600 mg Tab Brofine 600 mg Tab 600 mg 33 2700 Tab 100 mg Tab Tramadol100mg Tab 100 mg 34 180 lnj lnj Tramado 100 mg lnj 35 180 lnj lnj Metronidazol lnj 36 180 bottel Syrup Hydraline bottel 37 180 Bottel Syrup Cremafine Bottel 38 180 lnj lnj Decadran lnj 39 180 inj lnj Domperidon - inj

4Q 11100 ltilb T"b Dom~is)2IL tab 41 1800 tab Tab Bisacodyl tab 42 ?Q Roll Cotton wool Roll 43 90 Unit- ch 8 Foley Catheter Unit- ch 8 --44 90 unit- ch1 0 Foley Catheter unit- ch10· ... .,.--......

45 90 unit- ch14 Foley Catheter unit- ch14 , • J ""- -'

46 90 unit- ch 16 Foley Catheter unit- ch 18 I , rr \ 47 126 unit- 50mt Gauze (roll) unit- 50mt l-. I 1 ~ ~ i , \I 'J ...,.. /.\ 48 1800 Pack of 2 Gauze (sterile 10x10) Pack of2 { "'r.~.

' . . \ 49 1800 10cm Gauze bandage 10cm ! .,., ceo 'Jfl1~ ' -~ I 50 1080 unit- 10cm Crepe bandage unit- 10cm

t. I I t...W ,_.....~; I I 51 1080 unit- 15cm Crepe bandage unit - 15cm '

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52 540 unit- G18 I.V. canula unit- G18 ' ·; 53 540 unit- G20 I.V. canula unit- G20 - . ·---· _.-' .. .• / 54 720 unit- G22 I.V. canula unit - G22 ,.

/

55 900 unit- G24 I.V. canula unit - G24 .,e:::7 ~age or s

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56 2700 unit I.V. line set unit 57 420 unit- G19 needle disposable unit- G19 58 90 unit- ch 12 NG tube unit- ch 12 &

59 90 unit- ch 14 NG tube unit - ch 14 60 108 Box of 100 Non sterile gloves (latex) Box of 100 61 72 Box of 100 Non sterile gloves (plastic) Box of 100 62 180 Pair- n7 sterile glove Pair- n7 63 180 Pair- n8 Sterile glove Pair- n8 64 108 unit Suture silk 0 unit 65 108 unit Suture silk 2/0 unit 66 2700 unit- Sml Syringe unit- Sml 67 900 unit- 10ml Syringe unit - 10ml 68 54 unit- 60ml Syringe unit- 60ml 69 36 Roll Sterilization tape Roll 70 360 unit Surgical blade unit 71 270 Roll- Scm Tape Roll- Scm 72 270 Roll- 10cm Tape Roll-10cm 73 36 unit Thermometer digital unit 74 54 Box of 100 Tongue depressor Box of 100 75 36 unit Tourniquets unit 76 360 unit Urine bag unit

GRAND TOTAL AFNI

Annex 1:

N/A

k ii4UIII!ll lJULUIIit!l ll> (Ut Lilli >UI)I)ilt!t 4UdllriL~liUII .

The supplier has to submit the following docume nts along with the quotation

1. Business Licence from Ministry of Commerce or AISA for pharmaceutical are important.

2. Copy of three years re levan t contracts.

3. Quality control certificate from the Ministry of Public Health / 4 . Submission of sa mples a long with quotation is essential.

5. GMP and COPP for the quoted medicines items are essential. /. lrt

2 7 FEB 2Q1J /~) I

Terms and Condition Samples: For medicines and medical supplies samples are required to be submited along with the quotation to Kabul office logistics/procurement department for selection

no later than the specified date and time mentioned in the current RFQ under the Dead line row on the top leaft corner . Samples of medical equipment will be inspected in the

supplier's showrooms before selection. Payment: The payment will be done 100% after the goods receipt, inspected, quality checked and accepted.

Penalty: For each delayed day in peforming the contract odligations a specific penalty which is 0.1% of the total contract valu e will applied to the supplier's payments .

Tax: 2% tax amount will be deducted from the total cost of the bid price from registered suppliers with AISA or MOC ft 7% from unregistered suppliers as Afghanistan governme nt tax law. Delivery Location: All goods to be delivered no later than spesified period from the date of signing of purchase order.

Please state if goods are available ex-stock or state production tim eframe Delivery Time: If the items are not delivered according to the delivery time, HNTPO has the rights to cancel the purchase order.

and the company will be black-listed with HNTPO for future business . Experience: The company should have at least three yea rs similar experience. lncoterm: The goods will be delivered under DDP lncoterms 2010 to HNTPO office Dehbori , Deh Naw, District 3, Street-S, House- 144-Kabul

Inspection: The goods will be inspected according to the specification by HNTPO technical team.

Bid Validity: The bid must be valid for 30 days from the submission date :

Submission Procedure: Please sign the above RFQ and stamp it for final submission to HNTPO office before the deadline .

Accountability: All the bid documents must be stamped and signed by the authorized representative of the company.

GurronGyl Tho bid muGt be quoted in Afgh~n Curr~ncy .

Rights: HNTPO has the right to increase , decrease the quantity .

Packing: All goods must be packed for suitable air/sea or road transportation including rough handling to final destination Marking: All the boxes must be marked with Health Net TPO delivery address Language:A II documents, ma rki ngs and labeling should appear in English .

NOTE: This is to certify by the supplier that the above terms and conditions are acceptable to us and we have no objection.

. ~ubmitted, by: Name: Position : ------------------~

Signature: Date:-----------

Stamp:

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