Procurement of Medicines

Select, Excess (+), Less (-)

Tender Inviting Authority: Government of India Dr. Ram Manohar Lohia Hospital

Name of Work: Procurement of Medicines

Contract No: 011-23404428

Name of the Bidder/ Bidding Firm / Company :

Sl. No. Name of medicines Item Code / Make Quantity Dosage Form Estimated Rate in Rs. P Strength/Specification 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 Excise Duty Amount in INR Rs. P GST Amount % Freight Charges ( Unloading & Stacking) in Rs. P Any Other Taxes in Rs. P MFG/MKTD 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 col (13) = (4) x (7) in Rs. P TOTAL AMOUNT With Taxes TOTAL AMOUNT In Words

1 Name of Medicines 1 Construction of chamber for 100mm sluices valve item1 10 1 Nos

1.01 Tablet Cabergoline 0.5mg item1 Tab Excess(+) Full Conversion INR 1.01 Supplying, Conveying and fixing spls. Including eart item1 123.223 Nos

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