<p> Republic of the Philippines OFFICE OF THE OMBUDSMAN Ombudsman Building, Agham Road, North Triangle, Diliman, Quezon City Trunkline: 479-73-00 local 206; TeleFax #: 929-37-59 Email: [email protected] ; [email protected] Website: www.ombudsman.gov.ph</p><p>OPEN CANVASS QUOTATION NO.: 2013-0052-APR P.R. NO.: CO-13-12-0023 REMARKS: 1 st Canvass . DATE: April 08, 2013 </p><p>Gentlemen: Page 1 of 3 pages Please quote your lowest government price for the following items specified below:</p><p>Item ABC Qty./ UNIT TOTAL OMBUDSMAN SPECIFICATIONS No. (P) UNIT PRICE PRICE  5,000.00 10 boxes Gloves Nitrile, small, 100’s 1 comply 400.00 50 pcs. Gauze, 12 ply, 4 x 4  2 comply  3,000.00 10 boxes Gloves latex, small, 100’s 3 comply  4,000.00 10 boxes 3 cc Syringe, 23x1, 100’s 4 comply 3,000.00 2 rolls Gauze, 28 x 24  5 comply 2,000.00 5 boxes Micropore 24mm x 5mm, 12’s  6 comply 210.00 3 boxes Face mask, 50’s  7 comply  2,200.00 20 packs Cotton balls, 250’s 8 comply 450.00 50 pcs. Stool container  9 comply 550.00 5 boxes Plastic Strips, 100’s  10 comply x------continued on next page------x Deadline of submission: ______TOTAL: ______Important: 1. Prices and specifications for the bid should be valid for 45 days. 2. DELIVERY PERIOD: 7 WORKING DAYS upon the receipt of the Purchase Order (Please state the number of days of delivery if beyond the required 7 working days.) 3. Term of Payment: CHARGED ACCOUNT, unless specified 4. The total price quoted above is subject to withholding tax and payable check. 5. For NON-ACCREDITED OFFICE OF THE OMBUDSMAN suppliers, please call 929-3759 regarding the accreditation requirements.</p><p>______BY THE AUTHORITY OF THE Supplier’s Representative (Print Name) BIDS AND AWARDS COMMITTEE :</p><p>______(Sgd.) REME S. FETIZA Signature / Date Director II, FMS Head, BAC Secretariat Canvassed by: Marjorie Hazel G. Rañola Date: ______Republic of the Philippines OFFICE OF THE OMBUDSMAN Ombudsman Building, Agham Road, North Triangle, Diliman, Quezon City Trunkline: 479-73-00 local 206; TeleFax #: 929-37-59 Email: [email protected] ; [email protected] Website: www.ombudsman.gov.ph</p><p>OPEN CANVASS QUOTATION NO.: 2013-0052-APR P.R. NO.: CO-13-12-0023 REMARKS: 1 st Canvass . DATE: April 08, 2013 </p><p>Gentlemen: Page 2 of 3 pages Please quote your lowest government price for the following items specified below:</p><p>Item ABC Qty./ UNIT TOTAL OMBUDSMAN SPECIFICATIONS No. (P) UNIT PRICE PRICE 5 boxes 1,125.00 Glass Slide, frosted  11 comply 10 vials 5,000.00 Heparinized Capillary tube  12 comply 3 packs 2,700.00 Yellow Pipette tips  13 comply 10 pcs. 250.00 Tourniquet, flat, elastic  14 comply 5 boxes 1,500.00 Blood auto lancet, 200’s  15 comply 1 pc. 7,000.00 Counting Chamber, Neubauer  16 comply 5 boxes 1,500.00 Needle 25G x 5/8  17 comply Glucose Strips 25’s, compatible with Medi 1 pack 4,000.00  18 Smart glucometer comply 2 bottles 800.00 Hydrogen Peroxide 500 ml  19 comply 30 pcs. 1,500.00 Medicated plaster  20 comply x------continued on next page------x Deadline of submission: ______TOTAL: ______Important: 1. Prices and specifications for the bid should be valid for 45 days. 2. DELIVERY PERIOD: 7 WORKING DAYS upon the receipt of the Purchase Order (Please state the number of days of delivery if beyond the required 7 working days.) 3. Term of Payment: CHARGED ACCOUNT, unless specified 4. The total price quoted above is subject to withholding tax and payable check. 5. For NON-ACCREDITED OFFICE OF THE OMBUDSMAN suppliers, please call 929-3759 regarding the accreditation requirements.</p><p>______BY THE AUTHORITY OF THE Supplier’s Representative (Print Name) BIDS AND AWARDS COMMITTEE :</p><p>______(Sgd.) REME S. FETIZA Signature / Date Director II, FMS Head, BAC Secretariat Canvassed by: Marjorie Hazel G. Rañola Date: ______Republic of the Philippines OFFICE OF THE OMBUDSMAN Ombudsman Building, Agham Road, North Triangle, Diliman, Quezon City Trunkline: 479-73-00 local 206; TeleFax #: 929-37-59 Email: [email protected] ; [email protected] Website: www.ombudsman.gov.ph</p><p>OPEN CANVASS QUOTATION NO.: 2013-0052-APR P.R. NO.: CO-13-12-0023 REMARKS: 1 st Canvass . DATE: April 08, 2013 </p><p>Gentlemen: Page 3 of 3 pages Please quote your lowest government price for the following items specified below:</p><p>Item ABC Qty./ UNIT TOTAL OMBUDSMAN SPECIFICATIONS No. (P) UNIT PRICE PRICE 2 pcs. 200.00 Bulb Aspirator  21 comply 3 packs 4,500.00 Mini Collect EDTA tube 0.5ml, 100’s  22 comply 2 bottles 300.00 Triple Distilled water, 1 liter  23 comply 1 kit 5,000.00 Hematology-Giemsa Stain  24 comply 6 pcs. 1,800.00 Wax sealer  25 comply 3 boxes 450.00 Applicator stick, 500’s  26 comply 5 pcs. 1,500.00 Serological pipet, 10ml  27 comply x------nothing follows------x Deadline of submission: ______TOTAL: ______Important: 1. Prices and specifications for the bid should be valid for 45 days. 2. DELIVERY PERIOD: 7 WORKING DAYS upon the receipt of the Purchase Order (Please state the number of days of delivery if beyond the required 7 working days.) 3. Term of Payment: CHARGED ACCOUNT, unless specified 4. The total price quoted above is subject to withholding tax and payable check. 5. For NON-ACCREDITED OFFICE OF THE OMBUDSMAN suppliers, please call 929-3759 regarding the accreditation requirements.</p><p>______BY THE AUTHORITY OF THE Supplier’s Representative (Print Name) BIDS AND AWARDS COMMITTEE :</p><p>______(Sgd.) REME S. FETIZA Signature / Date Director II, FMS Head, BAC Secretariat Canvassed by: Marjorie Hazel G. Rañola Date: ______</p>