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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
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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
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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
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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
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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
Pack of 20 tablets 750
12
Metformin 500+Glibenclamide 5mg
Pack of 30 tablets 450
13 Meloxicam 15mg tablets
Strip of 10 Tablets 300
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14
Meclozine Hydrochloride 25 mg Pyridoxine hydrochloride 50 mg
Pack of 10 tablets 450
15
Losartan potassium 50mg tab.
pack of 30 tablets 150
16 Loratadine 10mg tablet. Strip of 10
tab 750
17 Levofloxacin 500mg tablets
Strip of 10 Tablets 600
18 Ketoprofen 100mg tablets
Strip of 15 Tablets 750
19 Ibuprofen 400mg
Strip of 10 Tablets 450
20 Furosomide 40mg tablets
Strip of 10 Tablets 540
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
Strip of 10 Tablets 450
28 Co-trimoxazole 400/80mg
Strip of 10 Tablets 600
29 Ciprofloxacine 500mg tablets
Strip of 10 Tablets 600
30 Chlorpheniramine Maleate
Pack of 20 tablets 600
31 Cefixim 400 capsules
Strip of 6 Tablets 870
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
Pack of 30 tablets 600
35 Bromohexine 8mg
pack of 20tab 300
36 Bisacodyle 5mg tablets
Pack of 20 tablets 300
37 Atenolol 100m tab
strip of 10 tab 300
38
Amoxicillin as Trihydate 750mg Clavulanic Acid as Potassium Salt
250 mg tablets
Pack of 10 tablets 750
39
Amoxicillin as Trihydate 500 mg Clavulanic Acid as Potassium
Salt 125 mg tablets
Pack of 20 tablets 750
40 Amoxicillin 500mg capsules
Strip of 10 Tablets 1800
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
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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
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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
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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
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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
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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
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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 _______________________
_______________________ _______________________
_______________________ _______________________
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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
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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.
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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