<p> Annex No. 1</p><p>TENDER FORM</p><p>…………………………………………………………………………………………………………………………………………………………… Name of contractor</p><p>……………………………………………………………………………………………………………………………………………………………. . Address of company seat</p><p>…………………………………………………………………………………………………………………………………………………………… phone / fax number</p><p>……………………………………………………………………………………………………………………………………………………………</p><p>NIP, REGON</p><p>Participating in the proceedings conducted in the mode of inquiry for:</p><p>Purchase of raw materials – Grinding media</p><p>I/we offer the realization of the delivery specified in this inquiry under the terms and conditions specified therein.</p><p>Technical parameters required for the order We offer execution of the order with the following parameters, as described below:</p><p>YES / NO (Note: Parameter Parameter name and requirements You must fill in every field) (Note: You must fill in every field and enter the value of the parametr for the offered product. Do not fill the darkened fields.)</p><p>Grinding media 1 – quantity 400 kg</p><p>Specification Chemical composition / D22 properties</p><p>Diameter [inch] 7/8”</p><p>AL2O3 [%] 90,0 ± 0,5</p><p>3 Bulk density [g/cm ] 3,63 ± 0,07</p><p>DELIVERY TERMS I confirm terms of delivery: EXW</p><p>Grinding media 2 – quantity 350 kg</p><p>Specification Chemical composition / D25 properties</p><p>Diameter [inch] 1”</p><p>AL2O3 [%] 90,0 ± 0,5</p><p>3 Bulk density [g/cm ] 3,63 ± 0,07</p><p>DELIVERY TERMS I confirm terms of delivery: EXW</p><p>Grinding media 3 – quantity 1 425 kg</p><p>Specification Chemical composition / D30 properties</p><p>Diameter [inch] 1 1/4”</p><p>AL2O3 [%] 90,0 ± 0,5</p><p>3 Bulk density [g/cm ] 3,63 ± 0,07 DELIVERY TERMS I confirm terms of delivery: EXW</p><p>Grinding media 4 – quantity 1 175 kg</p><p>Specification Chemical composition / D40 properties</p><p>Diameter [inch] 1 1/2”</p><p>AL2O3 [%] 90,0 ± 0,5</p><p>3 Bulk density [g/cm ] 3,57 ± 0,07</p><p>DELIVERY TERMS I confirm terms of delivery: EXW</p><p>Grinding media 5 – quantity 650 kg</p><p>Specification Chemical composition / D45 properties</p><p>Diameter [inch] 1 3/4”</p><p>AL2O3 [%] 90,0 ± 0,5</p><p>3 Bulk density [g/cm ] 3,57 ± 0,07</p><p>DELIVERY TERMS I confirm terms of delivery: EXW</p><p>Grinding media 6 – quantity 1 250 kg</p><p>Specification Chemical composition / D50 properties</p><p>Diameter [inch] 2”</p><p>AL2O3 [%] 90,0 ± 0,5</p><p>3 Bulk density [g/cm ] 3,57 ± 0,07</p><p>DELIVERY TERMS I confirm terms of delivery: EXW</p><p>1. Tender selection criteria</p><p> a) Price of the order Grinding media 1 – quantity 400 kg</p><p>Net price for 1 ton of product Grinding media 1:</p><p>Total net price for Grinding media 1: VAT rate ...... %</p><p>VAT amount:</p><p>The total gross price for Grinding media 1:</p><p>Grinding media 2 – quantity 350 kg</p><p>Net price for 1 ton of product Grinding media 2:</p><p>Total net price for Grinding media 2: VAT rate ...... %</p><p>VAT amount:</p><p>The total gross price for Grinding media 2:</p><p>Grinding media 3 – quantity 1 425 kg</p><p>Net price for 1 ton of product Grinding media 3:</p><p>Total net price for Grinding media 3: VAT rate ...... %</p><p>VAT amount:</p><p>The total gross price for Grinding media 3:</p><p>Grinding media 4 – quantity 1 175 kg</p><p>Net price for 1 ton of product Grinding media 4:</p><p>Total net price for Grinding media 4: VAT rate ...... % VAT amount:</p><p>The total gross price for Grinding media 4:</p><p>Grinding media 5 – quantity 650 kg</p><p>Net price for 1 ton of product Grinding media 5:</p><p>Total net price for Grinding media 5: VAT rate ...... %</p><p>VAT amount:</p><p>The total gross price for Grinding media 5:</p><p>Grinding media 6 – quantity 1 250 kg</p><p>Net price for 1 ton of product Grinding media 6:</p><p>Total net price for Grinding media 6: VAT rate ...... %</p><p>VAT amount:</p><p>The total gross price for Grinding media 6:</p><p>TOTAL PRICE FOR REALIZATION OF THE ORDER</p><p>Total net price of the order (Grinding media 1, Grinding media 2, Grinding media 3, Grinding media 4, Grinding media 5, Grinding media 6):</p><p>VAT rate ...... %</p><p>Total amount of VAT:</p><p>Total gross price of the order (Grinding media 1, Grinding media 2, Grinding media 3, Grinding media 4, Grinding media 5, Grinding media 6):</p><p>Deadline for realization of the order: Grinding media 1, Grinding media 2, Grinding media 3, Grinding media 4, Grinding media 5, Grinding media 6: ….……………………………………..………………………………….………………</p><p>I /we declare that we are acquainted with the contents of the inquiry and I / we have no objection to it and I /we accept the terms contained therein.</p><p>In case our bid is selected as the best I / we undertake to conclude a written contract in place and time specified by the Ordering Party.</p><p>We declare that the offered subject of the contract meets all the requirements of the Ordering Party.</p><p>Tender validity………………………………………..</p><p>……………………………………………….…. …………………………………………………………</p><p> place, date signature of the person/persons autorized to represent the Contractor</p>
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