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ITEM NO. ITEM & SPECIFICATION QTY/UNIT BRAND & MODEL OFFERED UNIT PRICE TOTAL PRICE

1 Disc, Clutch 1 unit

2 Cover Assy, Clutch 1 unit

3 Bearing, Flywheel Drive Pinion 1 pc

4 Oil Seal, Crankshaft, Rear 1 pc

5 Cylinder Assy, Clutch Release Concentric 1 unit

6 Brake Fluid 2 unit

7 Brake Cleaner 3 unit

Labor:

8 Pull down transmission to replace clutch 1 component

9 Miscellaneous

Canvassed by:

JAM 6-21-2023

2. It is mandatory to indicate the brand and/or model of the items being offered and to attach a brochure thereof 3. Indicate the warranty period in cases of equipment or whenever applicable.

5. Suppliers are required and mandated to attach and submit the following documentary requirements:

a) Valid Mayor's/ Business Permit; b) BIR Certificate of Registration; c) Authority to Print Receipt; d) PhilGEPS Membership Certificate and e) Omnibus Sworn Statement

EMAIL ADDRESS:

PhilGEPS Registration No.

1. Please quote your lowest price on the item/s listed below comprising the necessary taxes.

Please indicate days of delivery: _________ Calendar Days upon receipt of Purchase Order

INSTRUCTIONS TO SUPPLIERS:

whenever applicable

Supplier's Representative (Print name and Signature) Date Accomplished : ___________________________

By the authority of the University President.

DR. DOLLY P. MAROMA BAC Chairman ABC: 69,660.00

Republic of the Philippines BULACAN STATE UNIVERSITY

City of Malolos, Bulacan

Quotation No. 23-06-331

Purchase Request No. G-2023-06-0485

**Mandatory to fill in**

COMPANY NAME:

CONTACT No.

REQUEST FOR QUOTATION FOR THE PROCUREMENT OF GOODS AND SERVICES

TIN No.

Purpose: Replacement of clutch component of university vehicle, Mitsubishi Fuso (B4 P866)

Address:

4. Forthwith submit the accomplished quotation duly signed by your representative.

Revision: 1

6. All items must conform with the internationally accepted standard and sub-standard items shall not be accepted.

Accomplished by:

BulSU-OP-PU-03F3

Name and Signature NOTE: Please attach brochure and indicate days

of delivery

Referensi

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