Republic of the Philippines

National Kidney and Transplant Institute

Bids and Awards Committee
East Avenue, Quezon City 1100
981-0300 / 981-0400 local 1157
http://www.nkti.gov.ph/

NOTICE OF PROCUREMENT OPPORTUNITY

(SMALL VALUE PROCUREMENT)

1. The NATIONAL KIDNEY AND TRANSPLANT INSTITUTE (NKTI) invites interested entities
to submit their REQUEST FOR QUOTATION (RFQ) PR No. 58399C, through a formal
SEALED PROPOSAL for the;

Approved Budget for the

Item/Description
Contract (ABC)

RFQ No. 24-088:

Supply and Delivery of Various Pharmaceuticals

Php 582,112.00
(6 Line Items)

2. Prospective Suppliers should meet all other minimum legal, financial, and technical eligibility
requirements as required by the BAC.

3. Any entity interested in the project must submit their FORMAL PROPOSAL not later than
February 19, 2024 (Monday) 8:00 – 5:00 PM at the BAC Office together with samples of the
offered brand and the following Legal Documents:

• Valid PhilGEPS Certificate (Platinum)/ Registration No.

• Mayor’s Permit
• Income/Business Tax Return
• Duly accomplished and Notarized Omnibus Sworn Statement
• Duly accomplished and signed Technical Specification

4. General Conditions:

• Delivery Period: Seven (7) Calendar Days upon receipt of NTP/PO succeeding on
staggered basis as per Purchase Order
• Payment Terms: Sixty (60) calendar days from Invoice/DR/IAR/Certificate
of Final Acceptance from End-user, staggered

5. The Opening of Formal Proposals shall be on February 20, 2024 (Tuesday) at the NKTI BAC
Conference Room.

6. This submission of Formal Proposals is not governed by the non-discretionary “pass/fail” criteria.

7. All documents should be placed in a folder in any color and should be properly tabbed, sealed
and labelled (e.g. Company Name, Address and Telephone Number) during submission.

8. The NKTI reserves the right to accept or reject any bid, to annul the bidding process, to reject all
bids at any time prior to contract award, or to reduce the corresponding ABC and Terms of
Reference (TOR) and to award the contract to the bidder with the most advantageous offer,
without thereby incurring any liability to the affected bidder of bidders.

(SGD)ARNOLD S. UY, MD
BAC Chairperson
 Omnibus Sworn Statement

REPUBLIC OF THE PHILIPPINES )

CITY/MUNICIPALITY OF ______ ) S.S.

AFFIDAVIT

I, [Name of Affiant], of legal age, [Civil Status], [Nationality], and residing at [Address of Affiant],
after having been duly sworn in accordance with law, do hereby depose and state that:

1. [Select one, delete the other:]

[If a sole proprietorship:] I am the sole proprietor or authorized representative of [Name of

Bidder] with office address at [address of Bidder];

[If a partnership, corporation, cooperative, or joint venture:] I am the duly authorized and
designated representative of [Name of Bidder] with office address at [address of Bidder];

2. [Select one, delete the other:]

[If a sole proprietorship:] As the owner and sole proprietor, or authorized representative of [Name
of Bidder], I have full power and authority to do, execute and perform any and all acts necessary
to participate, submit the bid, and to sign and execute the ensuing contract for [Name of the Project]
of the [Name of the Procuring Entity], as shown in the attached duly notarized Special Power of
Attorney;

[If a partnership, corporation, cooperative, or joint venture:] I am granted full power and authority
to do, execute and perform any and all acts necessary to participate, submit the bid, and to sign and
execute the ensuing contract for [Name of the Project] of the [Name of the Procuring Entity], as
shown in the attached [state title of attached document showing proof of authorization (e.g., duly
notarized Secretary’s Certificate, Board/Partnership Resolution, or Special Power of Attorney,
whichever is applicable;)];

3. [Name of Bidder] is not “blacklisted” or barred from bidding by the Government of the Philippines
or any of its agencies, offices, corporations, or Local Government Units, foreign
government/foreign or international financing institution whose blacklisting rules have been
recognized by the Government Procurement Policy Board, by itself or by relation, membership,
association, affiliation, or controlling interest with another blacklisted person or entity as
defined and provided for in the Uniform Guidelines on Blacklisting;

4. Each of the documents submitted in satisfaction of the bidding requirements is an authentic copy
of the original, complete, and all statements and information provided therein are true and correct;

5. [Name of Bidder] is authorizing the Head of the Procuring Entity or its duly authorized
representative(s) to verify all the documents submitted;

6. [Select one, delete the rest:]

[If a sole proprietorship:] The owner or sole proprietor is not related to the Head of the Procuring
Entity, members of the Bids and Awards Committee (BAC), the Technical Working Group, and
the BAC Secretariat, the head of the Project Management Office or the end-user unit, and the
project consultants by consanguinity or affinity up to the third civil degree;

Omnibus Sworn Statement -1-

 [If a partnership or cooperative:] None of the officers and members of [Name of Bidder] is
related to the Head of the Procuring Entity, members of the Bids and Awards Committee (BAC),
the Technical Working Group, and the BAC Secretariat, the head of the Project Management
Office or the end-user unit, and the project consultants by consanguinity or affinity up to the third
civil degree;

[If a corporation or joint venture:] None of the officers, directors, and controlling stockholders
of [Name of Bidder] is related to the Head of the Procuring Entity, members of the Bids and
Awards Committee (BAC), the Technical Working Group, and the BAC Secretariat, the head of
the Project Management Office or the end-user unit, and the project consultants by consanguinity
or affinity up to the third civil degree;

7. [Name of Bidder] complies with existing labor laws and standards; and

8. [Name of Bidder] is aware of and has undertaken the responsibilities as a Bidder in compliance
with the Philippine Bidding Documents, which includes:

a. Carefully examining all of the Bidding Documents;

b. Acknowledging all conditions, local or otherwise, affecting the implementation of the
Contract;
c. Making an estimate of the facilities available and needed for the contract to be bid, if any;
and
d. Inquiring or securing Supplemental/Bid Bulletin(s) issued for the [Name of the Project].

9. [Name of Bidder] did not give or pay directly or indirectly, any commission, amount, fee, or any
form of consideration, pecuniary or otherwise, to any person or official, personnel or
representative of the government in relation to any procurement project or activity.

10. In case advance payment was made or given, failure to perform or deliver any of the
obligations and undertakings in the contract shall be sufficient grounds to constitute
criminal liability for Swindling (Estafa) or the commission of fraud with unfaithfulness or
abuse of confidence through misappropriating or converting any payment received by a
person or entity under an obligation involving the duty to deliver certain goods or services,
to the prejudice of the public and the government of the Philippines pursuant to Article 315
of Act No. 3815 s. 1930, as amended, or the Revised Penal Code.

Omnibus Sworn Statement -2-

IN WITNESS WHEREOF, I have hereunto set my hand this __ day of ___, 20__ at ____________,
Philippines.

[Insert NAME OF BIDDER OR ITS AUTHORIZED REPRESENTATIVE]

[Insert signatory’s legal capacity]
Affiant

ACKNOWLEDGEMENT

REPUBLIC OF THE PHILIPPINES)

QUEZON CITY ) S.S.

BEFORE ME, a Notary Public for and in ____________________, this _____ day of ___________,
personally appeared the following:

Name Competent Evidence of Identity Date Issue/Expiry Date Place of Issue

He/She are/is both known to me to be the same person/s who executed the foregoing document and he/she
acknowledged to be that their signature/s confirm his/her own voluntary act/s and the entities he/she represent.

SIGNED AND SEALED at the place and on the date above written.

NOTARY PUBLIC

Doc. No. ______________

Page No. ______________
Book No. ______________
Series of 20_____________

Omnibus Sworn Statement -3-

 REQUEST FOR PRICE QUOTATIONS
RFQ No. 24-088

Date: ________________
ARNOLD S. UY, MD
Chairperson
Bids and Awards Committee

Dear Sir/Madam:

We are pleased to submit our price quotation for the following articles and/or services, to wit:
ABC Brand
Item ABC Total Articles/Services/ Suppliers Suppliers
Qty. Unit Unit Name
No. Cost Specifications Unit Cost Total Cost
Cost Offered
1 139 bot 150.00 20,850.00 Acetone

2 63 jug 1,400.00 88,200.00 Alcohol, Ethyl 95%

Disinfectant Wipes
for Medical Devices
3 300 pack 649.00 194,700.00
and Sensitive
Surfaces
4 310 gal 690.00 213,900.00 Formalin

5 338 bot 99.00 33,462.00 Hydrogen Peroxide

Skin Antiseptic Swab
(for pre/post
6 6,200 pc 5.00 31,000.00 operative / wound
preparation) contains
10% povidone iodine
GRAND TOTAL 582,112.00

Note: Use separate sheet if necessary and attach picture/s or brochure/s and submit sample/s or demo unit of
the actual item (when required).

Delivery Period: Seven (7) Calendar Days upon receipt of NTP/PO succeeding on staggered basis
as per Purchase Order
Replacement of Defective Items: within two (2) calendar days
Payment Terms: Sixty (60) calendar days from Invoice/DR/IAR/Certificate of Final
Acceptance from End-user, staggered

I hereby undertake to supply and deliver the goods and services indicated above within the
period prescribed by the NKTI, I further undertake that the price quoted shall be binding upon us
until a NOA/NTP is issued.

Name of Company/Corporation:
Address
E-mail :
Telephone Number
_______________________________
Authorized Company Representative
Signature Over Printed Name
 Technical Specifications
RFQ No. 24-088: Supply and Delivery of Various Galenicals (6 Line
Items)

INSTRUCTION: Bidders must state here either “Comply” or “Not Comply” against each of the
individual parameters of each Specification stating the corresponding performance parameter of
the equipment offered. Statements of “Comply” or “Not Comply” must be supported by evidence
in a Bidders Bid and cross-referenced to that evidence. Evidence shall be in the form of
manufacturer’s un-amended sales literature, unconditional statements of specification and
compliance issued by the manufacturer, samples, independent test data etc., as appropriate. A
statement that is not supported by evidence or is subsequently found to be contradicted by the
evidence presented will render the Bid under evaluation liable for rejection. A statement either in
the Bidders statement of compliance or the supporting evidence that is found to be false either
during Bid evaluation, post-qualification or the execution of the Contract may be regarded as
fraudulent and render the Bidder or supplier liable for prosecution subject to the provisions of ITB
Clause 3.1(a) (ii) and/or GCC Clause 2.1(a)(ii).

Statement of
Particulars Requirements/Technical Specification
Compliance
Can easily remove nail polish without
leaving film on nail plate

No offensive smell / light fragrance

Container allow easy visual identification

of remaining volume inside the bottle
1 Acetone
Should be appropriately labelled (easily
readable)

Technically stable for at least 12 months

1 liter plastic bottle

Scented or unscented

2 Alcohol, Ethyl 95% Non-Irritating to skin

At least 20 liters / jug

Disinfectant Wipes for Colorant and fragrance free

3 Medical Devices and
Sensitive Surfaces Material friendly (non-corrosive, non-
staining) suitable for sensitive materials

1
 Rapid acting
At least 80 sheets per pack / container
Disinfectant Wipes for
3 Medical Devices and Size of Wipes: At least 300 x 200 mm,
Sensitive Surfaces 35cm per piece
With broad spectrum activity (bactericidal,
virucidal including non-envelope viruses,
fungicidal, yeasticidal
10% neutral buffered

4 Formalin With Certificate of Analysis

At least 3.7L per glass gallon

6% solution (20 volumes)

5 Hydrogen Peroxide
1 liter plastic bottle

Leaves no stain to the skin / can be

Skin Antiseptic Swab (for removed easily after washing
pre / post operative /
wound preparation) Less skin irritation / hypoallergenic
6 contains 10% povidone
iodine > leaves no stain to Mildly scented or unscented
the skin / can be removed
easily after washing At least 3.7L per gallon
CONFORME:

(Company Name)

(Name and Signature of Authorized Representative)

2
 TERMS OF REFERENCE
SUPPLY AND DELIVERY OF VARIOUS PHARMACEUTICALS

• DOCUMENTARY REQUIREMENTS:

1. Drug product must have complete information on the label of each container
of name drug product, manufacturer, lot / batch number, expiry date (if
applicable). Supplier must submit a picture of the label as pasted on the
container and other portion of the container stating all other information.
(compatibility / operability with instruments or materials being used by the
end-users).

2. Drug label must display a Biohazard Symbol, if required.

• GENERAL TERMS AND CONDITIONS:

1. All deliveries must have complete information on the label. In addition, the
Invoice must state the lot / batch number and expiry date (if applicable).

2. The License to Operate of both distributor and Manufacturer / packer must

be current.

3. The distributor, principal company, and the manufacturer and packer must
have good track record related to prompt delivery, no product recalled by Phil.
FDA, no blacklisting by FDA, to name a few.

4. The supplier must have a “Returned Goods Policy” for defective products.

5. Duration of contract is one (1) year.

The number of liters per container must be indicated (container may pertain to liter or
gallon).

CONFORME:

__________________________ ____________________ ______________________

Printed Name of Company Date Signature

__________________________ ____________________ ________________________

Address Tel. No. Printed Name and Designation