ITEM NO. ITEM & SPECIFICATION QTY/UNIT BRAND & MODEL OFFERED UNIT PRICE TOTAL PRICE
1
Phlebotomy Kit / extraction arm kit I.V. Injection Extraction Arm silicone for basilica
vein, cephalic vein, median cubital vein, dorsal vein
1 injection arm with already mounted tubing system
1 infusion bottle (250ml - 500ml) 1 stand
1 bottle of artificial blood concentrate (250ml) 1 plastic cup
1 disposable syringe and 2 injection cannulas (recommended cannula size: 20 and 21 gauge) 2 tubing systems as replacement parts 1 container of talcum powder
2 units
2
Phlebotomy Chair Key Features
Safe working load 300lb/136kg
Stable four leg design (seat height 18inch/460mm) With tubular frame, Lightweight design only 22lb/10kgs
Multi-Position arm rest
Arm rest can be positioned either side (2 brackets supplied)
Ergonomically designed Moulded seat and back 40mm Deep foam for support and comfort
2 units
BY LOT
Canvassed by:
JAM 11-24-2022
NOTE: Please attach brochure and indicate days of delivery
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 ABC: 260,000.00
Republic of the Philippines BULACAN STATE UNIVERSITY
City of Malolos, Bulacan
Quotation No. 22-11-816
Purchase Request No. G-2023-01-0005
**Mandatory to fill in**
COMPANY NAME:
CONTACT No.
REQUEST FOR QUOTATION FOR THE PROCUREMENT OF GOODS AND SERVICES
TIN No.
Purpose: For the Completion of Laboratory Equipment for BulSU San Rafael Campus
Address:
Supplier's Representative (Print name and Signature) Date Accomplished : ___________________________
By the authority of the University President.
DR. DOLLY P. MAROMA BAC Chairman 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.
Delivery Period: 7 Calendar Days upon receipt of Purchase Order
INSTRUCTIONS TO SUPPLIERS:
whenever applicable
