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HealthNetrPo

ANNEX 1-c Quotation Request Form

Vendor Name: AU Interested bidders

Deadline: Jan 7,2018 at 1:00PM local time.

Delivery Date: two weeks after signing the PO

HealthNet TPO Office Dehburi , Deh Naw,District 3 Street No.5 House No. 144, kabul www.heallhnettpo.org Email:farooq@healthnettpoaf.org Ph : 0789880790·0789880715 RFQ No. AF276M0-2017-659-KBL

Delivery Location: HealthNet TPO Office, Housel/ 144, Street#S, District-3, Dehburi , Deh Naw, Kabul Afghanistan

Dear Sir/ Madam,

PI P<=\C:P c:Pnrl/ r rovide lli with your quotition for thg fo llowing ite m' bolow;

Item No. Quantity Unit Procurement Item Company Unit Cost Total Cost

AFN AFN

1 2000 Tab Acetylsalicylic acid 1 OOmg tab

2 6000 Tab Acetylsalicylic acid 500mg tab Please provide the quotat ion In

Al11min11m Hyrlrn~irlA 1 ?nmo + MAQnA~i llm HyrtrnvirlP ?finmo rhAINAhiP your company letterhead, but

3 T>tlJ ~t~hip ahd Sign this I<HJ l or 2000 t"blet acceptance the terms and

4 1000 Tab Amitriptyline hydrochloride 25mg tab condit ions. 5 20000 Cap Amoxici llin 250mg tab/cap

6 1800 Btl Amoxicillin 250mg/5ml syrup

7 15000 Cap Amoxicillin 500mg tab/cap

0 'lbUU VIti I Atii~ I LIII II t suLI IUUIJIIIU Ill] '>' WHII-!t

9 1300 Vial Ampicillin sod 500mg inj. +water

10 20 Amp Anti Tetanus Serum(ATS} Injection 1500 IU ampoule

11 1:>1111 I HU A\t:;IJUIUI !lOIIIY MJ 12 100 Tub Benzoic acid 6% + salicylic acid 3% oiler 40gr

13 500 Tab Bisacodyl enteric coated 5mg tab

14 2000 Tab Carbamazepine 200mg tab

15 5000 Vial Ceftriaxon 1 gr vial + water

16 3500 Vial Ceftriaxon 500 mg vial + water

17 60 Drap Chloramphenicol sod succ 0.5% eye drops 1Om I

18 6000 Tab Chlorphenamine hydrogen maleate 4mg tab

19 50 Tab Chlorpromazine 100mg tab coated

20 20 Amp Chlorpromazine 50mg/2ml inj

21 4000 Tab Ciprofloxacin 250mg

22 8000 Tab Ciprofloxacin 500mg

23 2000 Tab Cloxacillin sodium 250mg cap

24 3000 Tab Cloxacillin sodium 500mg cap

25 200 Vial Cloxacillin sodium 500mg vial

26 500 Syp Cotrimoxazole (suWmthx+tmp) 120mg

27 450 Bag Dextrose 5% iv 500ml btl with infusion set

28 2500 Amp Diclofenac injection 25mg per ml in 3 ml ampoule

29 150 Btl Diphenhydramine compound oral solution 125ml

30 3000 Tab Doxycycline hyclate 1 OOmg tab/cap

31 500 Btl Erythromycin stearate 200mg/5ml 60ml

32 5000 Tab Erythromycin stearate 250mg tab/cap

33 30000 Tab Ferrous suW 200mg +folic acid 0.25mg tab

34 10000 Tab Ferrous suWate 200mg tab

35 30000 Tab Folate 5mg tab

36 1800 Amp Furosemide 20mg/2ml amp

37 150 Amp Heparin sodium 25000 IU/5ml inj

38 170 Amp Hydralazine hydrochloride 20mg inj

39 500 Amp Hydrocortisone sodium sue 1 OOmg inj

40 2000 Tab Hyoscine butyl bromide 1 Omg tab

41 10000 Tab Ibuprofen 200mg lab I I

42 600 Tab Imipramine 25mg tab ' 43 150 Cyc-28 Levonorgestrel 0.03mg tab ,cycle .\

\

2 8 DEC 2017

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~4 f\00 inj M<mn~~ i~m ~~~i1tfl fiO% ini ~Om I

45 100 Vial MedroxyprogeGtcronc 150mg/ml depot inj 1 ml

46 2000 Tab Methyldopa 250mg tab (L) coated

47 /000 T~h Metoclopr<~m ide hci1DmQ t<~b

48 2000 Amp MetoclopramJdc hcl 1 Umg/2ml 1nj

49 1800 Btl MP.trnnirlFiml1/!imot!iml "''P 10nmr

50 2000 Tab Metronidazole 400mg tab

b'l HlUU lnvos1on IVI!!!~ohld~~ol!! bUUI\'I ~/~UU~IIhj

52 30 Tub Neomycin su~ 5mg + bacitracin zinc 5001U oint 15gr

53 500 Tab Nifedipine 1 Omg IR tab

54 400 Tab Nifedipine 20mg Retard tab

55 300 Tab Nystatin 1 OO,OOOIU tab oral non coated

56 200 Tab Nystatin SOO,OOOIU tab oral coated

67 00 lub Nyototlno 10010001U/g oint 30g

58 20000 Tab Omeprazole 20mg cap

59 50 Amp Pancranium 4mg

60 100 Btl Paracetamol1 OOmg Drap

61 1800 Btl Paracetamol120mg/5ml syrup

62 50000 Tab Paracetamol 500mg tab

63 250 Amp Phenobarbital100mg/ml inj 2ml

64 140 Btl Povidone-iodine 10% solution 500ml

65 3000 Tab Prednisolone 5mg tab

66 1400 Bag Ringer lactate iv 1 DOOm I with infusion set

67 100 Pee Sa lbutamol 100mcg/dose aerosol1 00ml 200 doses

68 JOO l 'ce ::>olbUtamol rcoplrOtor oolut lon bmg/ml JU ml

69 120 Tub Silver oulfodiozino 1% cream 50gm

70 15 eye drop Tetracaine hcl 0.5% eye drops 1Om I

71 600 Tub Tetracycline hcl1 % eye oint tube 5gr

72 60 Tub Zinc oxide 1 0% oint 1 OOgm

73 300 Amp Transamin

74 250 Bag Sodium chloride 0.9% iv 500ml with infusion set

75 800 Bag Ringer lactate iv 500ml with infusion set

76 1800 Vial Ciprofloxacin 100 ML

77 10000 Tab Ibuprofen 400mg tab

78 200 Amp Ephedrine 50mg

79 60 BAG Dextros 10% 500ml Serum

80 250 BAG Dextros 5% 1000ml Serum

81 3000 Amp Dexamethson 4Mg

82 1800 Btl Amoxicillin 1 25mg/5ml syrup

83 6000 Tab Cotrimoxazole (su~mthx+120mg tab

84 4000 Tab Diclofenac 50Mg

85 500 Tab Alprazolam 0.5

86 60 Amp Enoxaprin

87 300 Amp pethidine

88 90 Bag Dextrose 10% iv 500ml btl with nipple with infusion set

89 3000 Tab Erythromycin stearate 500mg

90 300 Amp Adrenalin 1mg/ml

91 300 Amp Aminophylline 250mg/1 Om I

92 3000 Tab Aminophylline 100mg

93 100 Pomad Betamethasone 0.1%

94 300 Amp Calcium Gluconat 100/ml-10ml

95 2000 Cap Chloramphenical 250mg

96 300 Vial Chloramphenical1gr

97 200 Amp Chlorphenamine

98 8000 Tab Co-trimoxazol 480mg

99 60 Amp Digoxine 500mic/2ml

100 500 Cap Fluxitine 20mg

101 800 Amp Hyoscine butylbromide 20mg

102 4000 PCS Infusion Giving Set 7 103 100 Vial lnsuline human 100 IU -104 200 Vial Ketamine HCL 50mg/ml r 105 300 Tube Lidocaine Topical gel 2% ( 106 600 Tab Mebendazol 1 OOmg -107 2000 Tab Metformine 500mg

108 10000 Tab Metronidazole 200mg

109 120 Amp Morphen 10mg/ml I C) ',_ . :... 3 r -r 2 .. )17 .__...., :.:I

110 70 Amp Naloxane HCL 400mic/ml

111 300 Amp Neostigmine 2.5mg/ml

112 300 Tab Nystatin pessaries 1 OOOOOIU

113 8000 Amp Oxitocine 10 IU/ml1ml

114 1000 Tab Pencillin V 250mg

115 1000 Tab Pencillin V 500mg

116 100 Vial Propofal 200mg

117 300 Tab M isoprostol 200mic

118 90 Tab Primaquine 15mg

119 40 Tab lmmunoglobolin (Rabies) 150

120 500 Amp Ranitidine 50mg /2ml

121 600 Cap Vitamin A 200000 IU

122 600 Cap Vitamin A 50000 IU

123 60 Amp Sodium Bicarbonate 8.4% 20ml

124 400 Amp Suxamethanium CL 100mg/2ml

125 800 Amp Tramadol100mg /2m l

120 eo 3etUIII Mon itol 20% !:iOOtn l

127 300 Amp Gravinate 10mg

GRAND TOTAL AFN

Annex 1: N/ ~

Required documents for the supplier qualification:

The supp lier has to submit the followin g docume nts along with the quotation

1. Business Licence from Ministry of Commerce or AISA for pharmaceutical are important.

2. Copy or thr ee years relevant corr lr acts.

3. Quality control certi ficate from the Ministry of Public Health

4. Ce rtificate of a pharmaceutical product (COPP)

Date:

Terms and Condition Payment: The payment will be done 100% after the goods receipt, inspec ted, quality checked and accepted.

Tax: 2% tax amount wilt be deducted from the total cost of the bid price from registered suppliers with AISA or MOC & 7% frorn unregistered suppliers as Afghanistan government tax law.

Delivery Location: Al l goods to be delivered no later than spesified period from the date of signing of purchase order.

Please state if goods are available ex-stock or state production timeframe

Delivery Time: If the items are not delivered according to the delivery time, HNTPO has the rights to cancel the purchase order.

and the company will be black-listed with HNTPO for future business. Penalty:for each delayed day in performing the contract odligations a specific penalty which is 0.1% of the total contract value will applied to the

supplier's payment.

Experience: The company should have at least three years simila r experience .

lncoterm: The goods will be delivered under DDP lncoterrns 2010 to HNTPO office Dehbori , Deh Naw, District 3, Street-5, House-144-Kabul

Inspection: The goods will be inspected according to the specification by HNTPO technical team.

Bid Validity: The bid must be valid for 30 days from the submission date:

Submission Procedure: Please sign the above RFQ and stamp it for final submission to HNTPO office before the deadline.

Accountability: All the bid documents must be stamped and signed by the authorized representative of the company.

Currency: The bid must be quoted in Afghan Currency.

Rights: HNTPO has the right to Increase , decrease the quantity .

Packing: All goods must be packed for suitable air/sea or road transportation including rough handling to final destination

Marking: All the boxes must be marked with Health Net TPO delivery address

Language:AII documents, markings and labeling should appear in English.

NOTE: This is to certify by the supplier that the above terms and conditions are acceptable to us and we have no objection.

Submitted by: Name: Position:---------

Ciienr~tiJrP: ---------------------------- llatP; ---------

Stamp: