Purchase of Ear Drops Clotrimazole LignocaineHydrochloride Gentamycin Beclomethasone

Select, Excess (+), Less (-) Less (-)

Tender Inviting Authority: Seth A.J.B. Municipal ENT Hospital, Fort, Mumbai-01

Name of Work: Purchase of Ear Drops Clotrimazole1%+ LignocaineHydrochloride2% + Gentamycin0.3% + Beclomethasone0.025%

Contract No: Sanction No. CH.MS./HOD/9146 /SHCS DT.05.12.2025 Adv. No. HO/2835/ENT dt.11.12.2025

Name of the Bidder/ Bidding Firm / Company :

Sl. No. Item Name / Description Item Code / Make Quantity Units Estimated Rate 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 (Rate per Vials) Rs. P Excise Duty VAT Freight Charges ( Unloading & Stacking) Any Other Taxes/Duties/Levies Other Taxes 2 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 Taxes (Exclusive Of GST) TOTAL AMOUNT With Taxes TOTAL AMOUNT In Words

1 Ear Drops Clotrimazole1%+ LignocaineHydrochloride2% + Gentamycin0.3% + Beclomethasone0.025% (Rate per Bottle) (1 X 5ml) BI01010001010000000000000515BI0100001113 6500 Bottle 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