INFORMATION The information in this questionnaire can be shared confidentially between USAID | GHSC and partner organizations, WHO and The Global Fund for procurement purposes. If approved, the approval (including product identification, manufacturing sites, approved specifications and publicly available information) may also be shared with other procurement agencies. If applicant has any objections, mark an X in the box: objection to sharing information between USAID | GHSC and partner organizations. Request for Proposal Number Questionnaire Submission Date (DD/MON/YYYY) Company Name (Supplier) (name of company submitting bid) Physical address Postal address Telephone number Fax Website e-mail Link to product (Select all that apply) Marketing license holder Distributor/wholesaler Manufacturer Other (Specify): Provide contact information for each of the following:
The information in this questionnaire can be shared confidentially between USAID | GHSC and partner organizations, WHO and The Global Fund for procurement purposes. If approved, the approval (including product identification, manufacturing sites, approved specifications and publicly available information) may also be shared with other procurement agencies. If applicant has any objections, mark an X in the box: objection to sharing information between USAID | GHSC and partner organizations. Request for Proposal Number Questionnaire Submission Date (DD/MON/YYYY) Company Name (Supplier) (name of company submitting bid) Physical address Postal address Telephone number Fax Website e-mail Link to product (Select all that apply) Marketing license holder Distributor/wholesaler Manufacturer Other (Specify): Provide contact information for each of the following: INFORMATION
Supplement%201%20Medical%20Device%20Product%20Questionnaire.docx