MAR-MHU-2020-31500 · 2020. 8. 18. · 1 REQUEST FOR QUOTATION (RFQ) Reference no. –...

1

REQUEST FOR QUOTATION (RFQ)

Reference no. – MAR-MHU-2020-31500 Date: 17th August 2020 Project Name: RFQ for Medicine for HFs and MMTs support by IOM-Marib– MAR-MHU-2020-31500 The International Organization for Migration (IOM) is UN Migration Agency established in 1951 and is committed to the principle that humane and orderly migration benefits both migrants and society. The IOM is herewith requesting your Company to submit Quotation in US Dollar for the Medical Supplies support MAR-MHU-2020-31500 as per the following descriptions with delivery at three locations.

Location No1-Medicines for static clinic and Mobile clinic in Marib city and Al-Waddi Camps for three month

NO Items Unit

Qty for three

Month

Band /Description

Origin

Shelf Life/ Expiry date

Price per unit Total

Oral Medicines: - Syrup:

1 Paracetamol sy 120mg Bottle 3000

2 Cold and flue sy (123) Bottle 700

3

Domperidone 1Mg/Ml Suspen 60 ML Bottle 750

4

Paracetamol+Pseudoephdrin+ Chlorpheniramine Maleate (Amol Cold&Flu) 125 oral syrup Bottle 900

5 Domperidone 1Ml Drops Bottle 700

6

Apidone syrup (Chlorphe+Dexam) Bottle 500

7

Chlorpheniramine Maleate -Histat(antihistamine) Bottle 1200

8 Erythromycin 125 syrup Bottle 500

9 Ibuprofen 100/5mg syrup Bottle 3000

10 Albendazole 400mg syrup Bottle 400

11 Bebevit (multivit) drop Drops 700

12 Natural guava syrup Bottle 2500

13 Natural guava drop Drops 2000

14 Multivitamin syrup Bottle 1000

15 paracetamol 100 mg drop drops 3000

16 Azmavent (salbutamol) Bottle 1500

17 Labocof (Anti couph) Bottle 2000

2

18

Protocid (Metranidazole)200 mg syrup

Bottle 600

19

Protocid plus (Metranid+diaxoni) 100 mg syrup Bottle 700

20

Septram(Trimethop+Sulphameth) 240 mg syrup Bottle 700

21 Azimac(azithromycin)250mg Bottle 500

22 Calcium + vitD3 Bottle 300

23 Rafamox (amoxycillin) 250mg

Bottle 500

24

Augmen (Amoxic+clav) 480mg Bottle 500

25 Augmen (Amoxic+clav)312mg

Bottle 500

26

Augmalive(Amoxycillin+cluv)62mg Drops 200

27 Buscocin (hyoscine) Bottle 500

28 Busconil (hyoscine) Drops 500

29

Oral Medicines:- Tablet/Capsule forms and strength:

30 Kold time (antiflu) tab Packs 500

31

Moxicor(amoxycillin) 500 mg tab Packs 500

32 Albendazole 400 mg tab Tab 3000

33

Labclox (ampicl+cloxacill)500mg Packs 300

34 Cefixim 400mg Packs 400

35 Azimac(azithromycin)500mg Packs 1200

36 Histat(antihistamine) Box 500

37 Fluconazol 150mg Box 300

38 Nospa (Dortaverine 40 mg) Tab 500

39 Uricol sachet packet of 12 paket 2000

40 Vomin Box 1000

41 mebendazole 100mg Box 600

42

Omeprazole 40mg capsules Blister of 10 Capsules 700

43 Doxycycllin 150mg Box 300

44 Calcium + vitD3 tab Packs 300

45 Ibuprofen 600mg Box 200

3

46 Meloxicam 15mg Box 500

47 Ibuprofen 400mg Box 200

48 Folic Acid 5mg Box 500

49 Clarithromycin(claritic)500mg

Packs 300

50 Digsten spasmodigestin paket 700

51

Diclofen potassium 100mg Box of 10 strip Box 500

52 Diclofen potassium 50mg Box 500

53 Augmen(amoxil+clauv)1gm Packs 1500

54

Douclav (amoxil+clauv)625mg Packs 1200

55 Ciplox(ciprofloxacin) 500 mg packet 1500

56 Butacid(hyoscine) 20 mg packet 500

57

Labfol (Folic+ferrous) strip of 10 Box 300

58 Amlodipine 10mg tab Packs 300

59

Glucovent (Gliben+metfor)500/5mg Packs 300

60 Omeprazole 40 mg capsule Packs 200

61

Paracetamol 500mg tab packet of 10 packet 2000

62 Vitaplus(multivit) tab Packs 700

63

Trimazole(Trimethop+Sulphameth) tab Packs 300

64

Aldezole plus (metran+diax)500mg tab Packs 300

65 Lesinoor(lisinopril)5mg Packs 300

66 Gyzol 400 mg suppositeries Supp 1000

67 Bisoprolol 5mg Box 300

68 Lesinoor(lisinopril)10mg Packs 200

69 Aspirin (acetylecyclic ) 81mg Box 300

70 Salbutamol inhaler box 500

71 Bisacodyl Tab 5Mg packet 1000

72 Oral Rehydration Salts Ors Sachet 1000

73 Folic Acid 5mg Tab 500

Injections Medicines:

74

Ceftriaxone 1gm box of 50 vial Vials 1000

75

Ceftriaxone 250mg box of 50 vial Vials 1000

4

76

Depo-Provera(medroxyprogesterone) Vials 1000

77 Diclofenac amp 3000

78 lincomycin 600mg Vials 1500

79 Dexamethasone amp 600

80 Avil(antihistamine) Amp 500

81 Hydrocortisone vial Vials 200

82 No spa (Drotaverine mg) amp 500

83

Neurobionics Vitamin B12 ampule Amp 500

84 Anti-tetanus Ampule Ampule 150

85 Ciplox(ciprofloxacin) 500 mg inf 500

86 Gentamycin 80mg amp 400

87 Gentamycin 40mg amp 400

88 Syring 5ml Packet of 100 Box 150

89 Ampiclox(ampicill+colxacillin)

Vials 200

90

Paracetamol 100 ml plastic bottle Drip 500

91

Utabin (benzathine penicillin)1.2m Vials 300

92 Altacip(ciprofloxacin) Drip 300

93 R/L 500 ml Drip 600

94 Glucose 5% Drip 100

95 Normal saline 500ml Drip 800

96

Flagyl Metronidazole 100 plastic bottle Drip 600

97 Vit c 5 ml ampule Amp 1000

98 VitB complex Box 1000

99 Hydrocortisone 100mg Vials 500

100 Distal water 10cc Amp 2000

101

Cannula, IV Short, 24G, sterile, packet of 100 Box 50

102

Cannula, IV Short, 22G, sterile, packet of 100 Box 50

103 Tranexamic acid 500mg Vials 200

Topical Medicines:

104

Betacid(betamethasone) 1%mg tube Cream 500

105 Diclofen gel Cream 500

106 Fusi(fusidic acid) Cream 500

107 Calamine lotion Bottle 300

5

108 Dactonaz (miconazole) tube Cream 500

109

CanV (clotrimazole vaginal) tube Cream 300

110

Trilab(neomycin+nystatin+triamci) tube Cream 1000

111 Hydrocortisone 100mg Cream 300

112 Tetracycllin eye tube Oint 500

113 Apisal eye drop Drops 800

114

Neodrex(neomycin+dexa) eye drop Drops 500

115 Otic ear drop Drops 500

116 Ciplox(ciprofloxacin) drop Drops 500

Location #2 - Medicines for AlShaheed Mohammed Hail Hospital for three months

1 Urinex capsules

pack of 24Tablets 300

2 Tamsulosin Hcl 0.4 mg tab

strip of 10 tab 240

3

Spironalactone 100 mg tablets

strip of 10 tab 300

4 Prednisolone 5mg

Strip of 10 tab 510

5

Paracetamol+Pseudoephdrin+Chlorpheniramine Maleate (Amol Cold&Flu) tab.

Pack of 20 tablets 600

6

Omeprazole 20mg capsules Blister of 10 Capsules 1200

7 Nystatin 100,000 I.U./oral

strip of 10 tab 450

8 Norfloxacin 400 mg tablets

Blister of 10 tablets 750

9

Neomycin+Bacitracin+amylocain

Strip of 10 tablets 600

10 Multivaitamins

Strip of 10 Tablets 600

11 Metronidazole 500mg


12

Metformin 500+Glibenclamide 5mg


13 Meloxicam 15mg tablets


6

14

Meclozine Hydrochloride 25 mg Pyridoxine hydrochloride 50 mg


15

Losartan potassium 50mg tab.

pack of 30 tablets 150

16 Loratadine 10mg tablet. Strip of 10

tab 750

17 Levofloxacin 500mg tablets


18 Ketoprofen 100mg tablets


19 Ibuprofen 400mg


20 Furosomide 40mg tablets


21 Fluconazole 150mg

Pack of 2 capsules 750

22

Ferrous Sulphate. 200mg +Folic Acid cap

Strip of 10 capsules 1800

23 Etamsylate 500mg tab

strip of 10 tab 780

24 Drotaverin 40mg tablets

Strip of 10 tab 450

25

Doxycycline 100mg tab Blister of 10 Capsules 600

26 Diclofenic na 50mg DT

pack of 20 tab 600

27

Diclofenac na 100mg SR capsules


28 Co-trimoxazole 400/80mg


29 Ciprofloxacine 500mg tablets


30 Chlorpheniramine Maleate


31 Cefixim 400 capsules


32 Carbamazepine 200mg CR

pack of 50 tab 150

33

Calcium carbonate 680mg & Mg Carbonate 80

pack of 96 tab 450

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34

Calcium 400mg -Mg 155mg - Zinc & vit D


35 Bromohexine 8mg

pack of 20tab 300

36 Bisacodyle 5mg tablets


37 Atenolol 100m tab

strip of 10 tab 300

38

Amoxicillin as Trihydate 750mg Clavulanic Acid as Potassium Salt 250 mg tablets


39

Amoxicillin as Trihydate 500 mg Clavulanic Acid as Potassium Salt 125 mg tablets


40 Amoxicillin 500mg capsules


41 Azithromycin 500 mg tab

strip of 10 tablets 600

42 Aspirin 81 mg strip of 20 450

43 Albendazole 400mg tablets

Strip of one tab 600

Oral Medicines:- Syrup:

44 Semithicone drop bottle 450

45

Paracetamol 125 mg+Phenylephrine HCL 10 mg+Cetirizine dihydrochloride 2mg

botl of 100 ml 600

46

Nystatin 100,000 I.U./ml suspension, 30 ml

botl of 50 ml 600

47

Metronidazole 200mg syrup + Diloxanide furoate botl.100ml 750

48

Metoclopramide, 4mg/1ml oral drop botl 100ml 450

49 Diflatyl drops

Bottle 50ml 300

50 Iron 50mg/ml oral drops

botl of 50 ml 600

51 Hyoscine-N-butylbromide

Botl.100 ml 600

52

Hexamine 10 mg Piperazine Citrate Anhydrous 3.8 mg Khellin 36.6 mg

Pack of 12 Sachet 450

8

53 Guava syrup bottle 750

54 Guava drop bottle 600

55

Glycerylguiacolat+chlorphinramin+phenylphren botl 100ml 240

56

Ferrous Sulphate. 200mg +Folic Acid susp. Bottle of 300

57 Erythromycin 250 mg sus

Botl.100 ml 450

58 Dompridone Syrup botl 100ml 450

59 Co-trimoxazole syrup botl.50ml 750

60 Co-Amoxiclave 62.5 mg botl.100ml 300

61 Co-Amoxiclave 458mg

Botl. 100ml 450

62 Co-Amoxiclave 312mg

Botl. 100ml 450

63 Co-Amoxiclave 228mg Bot 450

64 Co-Amoxiclave 156 mg

Bolt. Of 100 ml 600

65 Chlorpheniramine Maleate botl.100ml 300

66 valporic acid 250mg/5ml

botl. Of 200ml 270

67

Calcium+vit D - Vit B12 SYRUP

Botl 120 ml 600

68

Amoxicillin 250mg Suspension

Botl. 100ml 1200

69

Aluminum hydroxid 250 mg-Mg Hydroxide 250mg - Simethicone 50mg suspension

Botl.200 ml 300

70 Albendazole 100mg/5ml

Bolt. Of 30 ml 900

Injections Medicines:

71 Cortigen B6 Amp 600

72 Metoclopramide 10mg Amp 300

73 Vit B Complex Amp 900

74 Vit C 5ml ampule Ampule 1500

75 Vit K Amp 210

76 Antitetanous ampule Ampule 600

77

Water for injection sterile, 10-ml ampoule Amp 600

78

Chlorpheneramine 10mg/2ml Amp 300

79 Ciprofloxacin 500 mg inj Bottle 900

80 Drotaverine 40mg Amp 360

9

81 Gentamycin 40mg/ml Amp 450

82

Lidocaine hydrochloride 2% (20mg/ml) injection in 20ml ampoule botl. 900

83

Ceftraiaxone 1gm box of 50 vial Vial 3000

84

Ceftraiaxone 250mg box of 50 vial Vial 3000

Topical Medicines:

85 Benzyl Benzoate lotion

Bottle of 30ml 150

86

Betamethasone 0.1% ointment, 15g

Tube of 15gm 300

87

Betamethasone 0.1% Cream, 15g

Tube of 15gm 300

88 Calamine Lotion

Botl. 100ml 300

89 Ciprofloxacin Eye drops Botl.5ml 450

90 Clotrimazole Vaginal Cream

Tube of 40gm 300

91 Diclofenac 12.5 Suppository

Back of 5 piece 300

92 Diclofenac 25 Suppository

Back of 5 piece 450

93 Diclofenac 75 Suppository

Back of 5 piece 240

94 Diclofenac sodium emulgel

tube of 50gm 300

95 Fucidic Acid

Tube of 15 gm 450

96

Hydrocortisone Cream 1%, 15g

Tube of 15gm 300

97 Ketoconazole 2% cream.

Tube of 15gm 300

98 Miconazole oral gel

Tube of 15gm 300

99

Natural ingredients for burns Oint(Meppo) Tube 30gm 120

100

Nystatin+ Neomycin+Gramicidin+Triamicilone Cream

Tube of 15gm 300

101

Nystatin+ Neomycin+Gramicidin+Triamicilone ointment

Tube 15 gm 300

10

102 Otocol ear drops

Bottle of 5ml 300

103 Sediproct supp,

Backet of 10 piece 180

104

Sodium chlorid0.8g+sodium bicarbonat7.7g

Pack of 10 sachet 240

105 Tantum mouth wash

Bottle of 100ml 75

106 Tetracycline hydrochloride 1 % eye-ointment, 4 g

Tube of 5gm 300

107

Xylometazoline 0.025% nasal drops

Bottle of 5ml 300

108

Xylometazoline 0.05% nasal drops

Bottle of 5ml 450

109 Tourniquet latex Each 45

110

Tongue depressor wooden (disposable) Each/50 102

111

Suture, non-absorbable, monofilament DEC 3 (2/0), 3/8 circle, triangular, 30mm, sterile, single use

packet of 10 15

112

Gauze, compress, 10 x 10cm, sterile, single use

packet of 10 300

113 Creep bandage medium Each 216

114 Creep bandage large Each 216

115

Cotton wool, 500g, roll, non-sterile Each 15

116 Cotton roll 500 gm Each 15

117

Clamp, umbilical, 5.2cm, sterile, single use

packet of 10 1800

118

Brush, hand, scrubbing, plastic

packet of 10 15

119

Blade, scalpel, sterile, single use, no. 22

packet of 10 60

120

Bag (envelope), plastic, for drugs, 10 x 15cm

packet of 10 3000

121

Gauze, compress, 10 x 10cm, sterile, single use

packet of 10 150

122

Extractor, mucus, 20ml, sterile, single use

packet of 10 300

123 DNS 500cc

Infusion 500cc 450

124 Ringer Lactate 500cc

Infusion 500cc 450

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125 Normal salaine 500cc

Infusion 500cc 450

126 Dextrose 40percent

Infusion 500cc 300

127 DILUENT CBC BOX 9

128 LYSES CBC BOTTLE 9

129 CLEANSER CBC BOXES 9

Location # 3- Isolation center medicine

1

ADENOSINE, 3 mg/ml, 2 ml, amp. Ampule 30

2

ALCOHOL-BASED HAND RUB, gel, 100mL, bottle bottle 100

3

ALCOHOL-BASED HAND RUB, solution, 500mL, bottle bottle 100

4

ATENOLOL, 50 mg, tab.strip of 14 tablet strip 200

5

ATROPINE sulfate, 1 mg/mL, 1 mL, ampoule Ampule 500

6

AZITHROMYCIN, 500mg, tab and strip of 3 tablet strip 400

7

CALCIUM GLUCONATE, 100 mg/mL, 10mL, ampoule Ampule 500

8

CEFTRIAXONE sodium, 250mg, powder, vial Vial 400

9

CEFTRIAXONE sodium, eq. 1 g base, powder for inject., vial

Vial 1000

10

DEXAMETHASONE phosphate, 4mg/ml, 1ml, ampoule Ampule 400

11

DEXTROSE (GLUCOSE) 5%, 500mL, plastic pouch Bottle 40

12

DOXYCYCLINE salt, 100mg, tab. Packet of 20 packet 600

13

EPINEPHRINE (adrenaline) tartrate, eq.1mg/mL base, 1mL amp. IV Ampule 1000

14

FUROSEMIDE, 10mg/mL, 2mL, ampoule Ampule 200

15

FUROSEMIDE, 40 mg, tab. Packet 20 packet 200

16

GLUCOSE hypertonic, 50%, 50mL, vial Vial 40

12

17

GLYCERYL TRINITRATE, 0.3mg, sublingual tab. packet 200

18

MAGNESIUM sulfate, 500mg/mL, 10mL, ampoule Ampule 50

19

METOCLOPRAMIDE hydrochloride, 5mg/mL, 2mL, amp. Ampule 200

20

METRONIDAZOLE, 5mg/mL, 100 ml, semi-rigid bot. bottle 200

21 MULTIVITAMINS, tab. packet 400

22

NORADRENALINE tartrate, sol.for infu., eq.1mg/mL base, 4mL, amp/vial 300 (ampule of each type) Ampule 300

23

OMEPRAZOLE, 20 mg, gastro-resistant, caps. Packet of 20

packet 200

24

OMEPRAZOLE, 40mg, powder, vial Vial 200

25

ONDANSETRON hydrochloride, 2mg/ml, 2ml, amp. Ampule 100

26

PARACETAMOL (acetaminophen), 10mg/ml, inject., 100 ml, plastic pouch bottle 160

27

PARACETAMOL (acetaminophen), 500 mg, tab. strip 4000

28

PHENYTOIN sodium, 100mg, coated tab strip of 10 tab strip 900

29

PHENYTOIN sodium, 50mg/mL, 5mL, vial Vial 100

30

POTASSIUM chloride, 100mg/mL, 10 mL, amp. Ampule 200

31

PREDNISOLONE, 5 mg, tab packet of 20 packet 200

32

RINGER lactate, 500mL, plastic pouch bottle 100

33

SALBUTAMOL sulfate, eq.0.1mg base/puff, 200 puffs, inhaler can 200

34

SODIUM BICARBONATE, 8.4%, 1 mEq/mL, 2o ml Ampule Ampule 500

13

35

SODIUM chloride, 0.9%, 500 ml, plastic pouch bottle 50

36

SULFAMETHOXAZOLE 400mg/TRIMETHOPRIM 80mg, tabpacket of 20 tab packet 400

37

WATER for injection, 10 mL, ampoule Ampule 2000

38

ATRACURIUM BESILATE, 10mg/mL, 5mL, amp. Ampule 4000

39

SUXAMETHONIUM CHLORIDE, 50mg/mL, 2mL, amp. Ampule 500

40

DIAZEPAM, 5mg/ml, 2ml, amp. Ampule 500

41

FENTANYL citrate, eq. 0.05mg/mL base, 2 mL, amp. Ampule 1000

42

FENTANYL, 0.05mg/mL, 10mL, amp. Ampule 100

43

KETAMINE hydrochloride, eq. 50 mg/mL base, 10 mL, vial

Ampule 500

44

MIDAZOLAM, 5mg/ml, 3ml, amp. Ampule 2500

45

PROPOFOL, 10mg/mL, 10mL, amp. Ampule 4000

46 GHO request

47 Cefepime 1 gm Vial Vial 250

48 Tazocin 4.5 mg Vial Vial 200

49 meropenam 1 gm Vial Vial 100

50 Imipenem 500 mg Vial Vial 100

51 Vancomycin 1 gm Vial Vial 250

52 Perflgan inf bottle 500

53 Tramadol ampule Ampule 100

54 Ciprofloxacin 500 mg infusion

Ampule 300

55 Levofloxacin 500mg infusion bottle 400

56 Balsam Syrup bottle 100 ml bottle 200

57

Glucovance 500/5mg packet of 30 tab packet 100

58 Vit D3 50000 I.U Can of 50 Can 20

59

Zinc 20 mg tab packet of 40 tab packet 200

14

60

One -alpha tab packet of 20 tab packet 100

61

Triple combination (Lopinavir 400 mg +Ritonavir 100mg + interferon beta 1B 8MCg )

Packet 100

62 Dopamine 240 ml ampule Ampule 1000

63 Doptamine 200 ml ampule Ampule 200

64 Heparin unit 25000 unit vial Vial 500

65 Clexan 40 mg Ampule 1300

66 Clexan 60 mg Ampule 700

67

DIAZEPAM, 5mg/ml, 2ml, amp. Ampule 500

68

Aminophilline 400/250 Ampule Ampule 200

69 Combivent Ampule Ampule 1500

70 Assist Ampule Ampule 500

71 Pethidine 100 mg/ml Ampule

Ampule 500

72 Amidarone 150mg vial Vial 300

73 Pancranium vial Vial 5000

74 Vit K amp 10 ml / ml Ampule 200

75 Hydralazine Amp20 ml /ml Ampule 300

76 Avil Amp 4,5 mg/ 2 ml Ampule 500

77 Labtilol 200mg Amp Ampule 300

78 verapamel Amp Ampule 50

Guideline for submission of quotation. 1- Submission of quotations: Kindly submit your signed & stamped quotation with email subject MAR-MHU-

2020-31500 and RFQ name as HFs and MMTs support by IOM- at not later than Sunday, Sep 03, 2020 by 11:00 Hours 2- Technical specification: clearly mark in column manufacture/ origin/packing should be New, comes with ORIGINAL Packing from respective manufacturer (Brand Owner) and the standard warranty period and as per manufacture guideline. a. Good offered in quotation must be fulfill MOHs and WHO country approved standard. 3- Quotation Price: Prices shall be quoted in US Dollars (USD) are FINAL and All Inclusive from any charges (VAT, Transport, Labors & any other cost) might occur during delivery to designated site. A) Filled quotation form with delivery plan and clearly mark shelf life B) Filled vendor information sheet attached(below) C) Business registration as per country regulation D) Certificate of origin of product (Optional) E) Custom clearance if needed (Optional) F) Attached three reference for similar activities ( PO /contract/ certificate)

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4- Validity of submitted quotation: Quotation offer must be valid for 60 calendar days. 5- Delivery and completion Time: Clearly delivery plan/duration/lead time. 6- Delivery locations: a) Al-Shaheed Mohammed Hail hospital medicine deliver to Al-Shaheed Mohammed Hail hospital warehouse at Serwah round Infront of GHO, Al-Mojama. B) Isolation center medicine deliver to Isolation center warehouse at Saba university , University street ,Al-Mojama. C) fixed clinic and MMT deliver to IOM warehouse at Louvre hotel, Alqardi round, Al-Mojama D) Prodeuct should be New, comes with ORIGINAL Packing from respective manufacturer (Brand Owner) and the standard warranty period and as per manufacture guideline. b. Good offered in quotation must be fulfill MOHs and WHO country approved standard. 7- Payment: Payment will be released as per agreed terms and conditions within 30 Calendar days after 100% delivery 8- Selection Evaluation Criteria: IOM shall evaluate and compare the Quotations based on the following: (a) Financial offer (Compliance with technical specifications including delivery requirement) (b) Specification of the product (make, origion, shelf-life and warranty) (c) Relevant experience: al least three evidence (PO/contract) from any of UN/INGO’s 9- Provision of sample of product: after reviewing of financial offer/ quotation. IOM may request all bidder or from selective bidder to provide us sample to complete the process. 10- Supplier is responsible to bear the cost of samples and its transportation vice versa. Should you need any additional technical information, please send us your queries in writing to the following. [email protected] or : [email protected] not later than 25th of August 20. Query respond time with24 hours. NOTE: IOM reserves the right to accept or reject any quotation, and to cancel the procurement process and reject all quotations at any time prior to award of Purchase Order or Contract, without thereby incurring any liability to the affected Supplier/s or any obligation to inform the affected Supplier/s of the ground for IOM’s action. IOM reserves the right to split the awards in any combination as it may deem necessary or appropriate in its sole discretion in the best interest of IOM. General conditions of PO are attached to this RFQ. Sincerely yours, Procurement UNIT IOM Yemen

mailto:[email protected]:[email protected]

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GPSU.SF-19.6

VENDOR INFORMATION SHEET (VIS)

Name of the Company __________________________________________________________ Address Leased Owned Area: _______sqm House No __________________________________________________________ Street Name __________________________________________________________ Postal Code __________________________________________________________ City __________________________________________________________ Region __________________________________________________________ Country __________________________________________________________ Contact Numbers/Address Telephone Nos. ____________________ Contact Person: __________________ Fax No. ____________________ E mail Address ____________________ Website: ___________________ Location of Plant/Warehouse Leased Owned Area: ______sqm _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ Business Organization Corporation Partnership Sole Proprietorship Business License No.: ____________ Place/Date Issued:___________ Expiry Date __________ No. of Personnel ____________ Regular ___________ Contractual/Casual ____________ Nature of Business/Trade Manufacturer Authorized Dealer Information Services

Wholesaler Retailer Computer Hardware

Trader Importer Service Bureau

Site Development/ Consultancy Others _____________ Construction ___________________

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Number of Years in business: _________ Complete Products & Services _______________________________________________________________________ _______________________________________________________________________ Payment Details Payment Method Cash Check Bank Transfer Others Currency Loc.Currency USD EUR Others Terms of Payment 30 days 15 days 7 days upon receipt of invoice Advance Payment Yes No % of the Total PO/Contract Bank Details: Bank Name ___________________________________________________ Bldg and Street ___________________________________________________ City ___________________________________________________ Country ___________________________________________________ Postal Code ___________________________________________________ Country ___________________________________________________ Bank Account Name ___________________________________________________ Bank Account No. ___________________________________________________ Swift Code ___________________________________________________ Iban Number ___________________________________________________ Key Personnel & Contacts (Authorized to sign and accept PO/Contracts & other commercial documents)

Name Title/Position Signature _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ Companies with whom you have been dealing for the past two years with approximate value in US Dollars: Company Name Business Value Contact Person/Tel. No. _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ Have you ever provided products and/or services to any mission/office of IOM?

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Yes No If yes, list the department and name of the personnel to whom you provided such goods and/or services. Name of Person Mission/Office Items Purchased _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ Do you have any relative who worked with us at one time or another, or are presently employed with IOM? If yes, kindly state name and relationship. _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ Trade Reference Company Contact Person Contact Number _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ Banking Reference Bank Contact Person Contact Number _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________

IOM is encouraging companies to use recycled materials or materials coming from sustainable resources or produced using a technology that has lower ecological footprints.

REQUIREMENTS CHECK LIST Please submit the following documents together with the Information Sheet:

No. Document For IOM use only

19

Submitted Not

Applicable

1 Company Profile (including the names of owners, key officers, technical personnel)

2 Company's Articles of Incorporation, Partnership or Corporation, whichever is applicable, including amendments thereto, if any.

3 Certificate of Registration from host country's Security & Exchange Commission or similar government agency/department/ministry

4 Valid Government Permits/Licenses

5 Audited Financial Statements for the last 3 years*

6

Certificates from the Principals (e.g. Manufacturer's Authorization, Certificate of Exclusive Distributorship, Any certificate for the purpose, indicating name, complete address and contact details)

7 Catalogues/Brochures

8 List of Plants/Warehouse/Service Facilities

9 List of Offices/Distribution Centers/Service Centers

10 Quality and Safety Standard Document / ISO 9001

11 List of all contracts entered into for the last 3 years (indicate whether completed or ongoing ) *

12 Certification that Non-performance of contract did not occur within the last 3 years prior to application for evaluation based on all information on fully settled disputes or litigation

13 For Construction Projects: List of machines & equipment (include brand, capacity and indication if the equipment are owned or leased by the Contractor)

* For Competitive Biddings, number of years may increase depending on the estimated contract amount. ** Indicate if an item is not applicable. Failure to provide any of the documents mentioned above will result in automatic "failed" rating.

I hereby certify that the information above are true and correct. I am also authorizing IOM to validate all claims with concerned authorities.

Received by:

_______________________ _______________________ Signature Signature

_______________________ _______________________ Printed Name Printed Name

_______________________ ______________________ Position/Title Position/Title

_______________________ _______________________ Date Date

_________________________FOR IOM USE ONLY___________________________ Purchasing Organization ___________________ Account Group ___________________ Industry 001 002 003

where 001 - Transportation related to movement of migrants 002 - Goods (e.g. supplies, materials, tools) 003 - Services (e.g. professional services, consultancy, maintenance) Vendor Type Global Local

MAR-MHU-2020-31500 · 2020. 8. 18. · 1 REQUEST FOR QUOTATION (RFQ) Reference no. –...

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Transcript of MAR-MHU-2020-31500 · 2020. 8. 18. · 1 REQUEST FOR QUOTATION (RFQ) Reference no. –...