10(25-26)

Select, Excess (+), Less (-)

Tender Inviting Authority: DDG(Prov)O/o DGAFMS

Name of Work: Supply of PVMS No NIV/22/DG/20185, Tomotherapy System and Associated accessories on full Turnkey Basis

Contract No: 10(25-26)

Name of the Bidder/ Bidding Firm / Company :

Sl. No. Item Description Item Code / Make Quantity Units Estimated Rate in Rs. P Addition / Deduction Addition / Deduction Values Currency Convertion against each Item Quoted Currency in INR / Other Currency BASIC RATE In Figures To be entered by the Bidder in Rs. P Excise Duty Amount in INR Rs. P GST in % Freight Charges ( Unloading & Stacking) in Rs. P GST per item in Rs. P Col (11) = Col (7) x Col (9) Total GST in Rs. P Col (12) = Col (4) x Col (11) IIIrd Party i.e DGS&D / RITES etc Inspection Charges @0.34%+Service Tax Less for Cenvat Credit,if any respect of Supplies Under full Excise Duty Category TOTAL AMOUNT Without GST col (13) = (4) x (7) in Rs. P TOTAL AMOUNT With GST col (14) = Col (12) + Col (13) in Rs. P TOTAL AMOUNT In Words

1 PVMS No NIV/22/DG/20185, Tomotherapy System and Associated accessories on full Turnkey Basis item1 2 No 0 Excess(+) Full Conversion INR 1.01 Supplying, Conveying and fixing spls. Including eart item1 123.223 Nos

Total in Figures 4 Construction of chamber for 100mm sluice plates item5 10 Nos

Quoted Rate in Figures Select %

Quoted Rate in Words