Price Schedule: Goods Manufactured Outside the Country, to be Purchaser’s Imported Date:_________________________ (Group C bids, goods to be imported) ICB No: _____________________ Alternative No: ________________ Currencies in accordance with ITB 15 Page N ______ of ______ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Product Product Strength Dosage Unit Qty. Unit prices Total Total Local Shipment Name of Ctry. code form pack offered unit price per weight manufac- of agent’s size [a] [b] [c] price item and turer origin [a+b+c] [6 x 8] as a % of volume CIP Inland Other named transp., incidental CIP price place of insurance & costs as included in other local defined in the quoted costs SCC price (specify incidental to one) delivery if specified Total Bid Price: Currency: In figures: In words: Name of Bidder Signature of Bidder Date [insert complete name of Bidder] [signature of person signing the Bid] [Insert Date] In the capacity of: [ insert: title or other appropriate designation ]
Price Schedule: Goods Manufactured Outside the Purchaser’s Country, to be Imported (Group C bids, goods to be imported) Currencies in accordance with ITB 15 Date:_________________________ ICB No: _____________________ Alternative No: ________________ Page N ______ of ______ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Product code Product Strength Dosage form Unit pack Qty. offered Unit prices Total unit Total price per Local agent’s Shipment weight Name of manufac- Ctry. of size [a] CIP named place of (specify one) [b] Inland transp., insurance & other local costs incidental to delivery if specified [c] Other incidental costs as defined in the SCC price [a+b+c] item [6 x 8] as a % of CIP price included in quoted price and volume turer origin Total Bid Price: Currency: In figures: In words: Name of Bidder [insert complete name of Bidder] Signature of Bidder [signature of person signing the Bid] Date [Insert Date] In the capacity of: [ insert: title or other appropriate designation ]
Health_Sector_Goods-EN-1July14.docx