Purchase of Ortho-Phthaladehyde and Alcohol based surgical dry hand antiseptic

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

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

Name of Work: Purchase of 1) Ortho- Phthaladehyde 0.55 w/w , 2) 70% to 80% Alcohol based surgical dry hand antiseptic

Contract No: Sanction No. CH.MS./HOD/9144 /SHCS DT.05.12.2025 Adv. No. HO/2834/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 Ortho- Phthaladehyde 0.55 w/w , (1 x 5Litr) 60 Can 0 Excess(+) Full Conversion INR 1.01 Supplying, Conveying and fixing spls. Including eart item1 123.223 Nos

2 70% to 80% Alcohol based surgical dry hand antiseptic (1 X 500ml) 1300 Bottle 0 Excess(+) Full Conversion INR

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

Quoted Rate in Figures Select

Quoted Rate in Words