Repair and Maintenance of the Hyundai Starex with Plate Number K1V 528

RFQ Form 1: Goods and Other Services Request for Quotation Date: August 11, 2026 RFQ No.: RBAC II-08-665 P.R No. 26-07-1140 Approved Budget for the Contract: Php 284,247.00 Dear Interested Bidders: Please submit your best offer, inclusive of all applicable taxes and other incidental charges, for the item(s) listed below. Your duly accomplished and signed quotation, signed either by you or your duly authorized representative, together with all required documentary requirements, must be submitted on or before the prescribed deadline for submission. JEFFREY P. EDIZA Administrative Officer I Procurement Management Unit TECHNICAL REQUIREMENTS: Procuring Entity’s Requirement Supplier’s Offer Item No. Qty Unit of Measure Technical Specifications Statement of Compliance Bidders must state “Comply” or “Not Comply” for each specification and provide the corresponding performance parameters for the offered item(s) Set 1 Lot Repair and Maintenance of Motor Vehicle (inclusive of labor) Vehicle Make: Hyundai Grand Starex Vehicle Year: 2020 Plate No.: K1V 528 For repair/replacement: -Suspension Bushing -Balljoint -Front Stabilizer Link -Stabclamp Bushing -Tierod End and bar -Wheel Alignment -Clutch Disc Assy -Dual Mass -Release Bearing -Primary Clutch Master -Oil Seal -Gear Oil -Brake Fluid -Brake Cleaner Delivery Schedule : 20 Calendar days Deadline of Submission of Quotation : August 17, 2026 10:00 AM Note: Any quotation that fails to comply with the required specifications and technical requirements shall be disqualified from further evaluation. FINANCIAL OFFER: Project Description Approved Budget for the Contract (ABC) Bid Offer (Inclusive of all taxes and other charges) ABC Per Unit Total ABC Bid Offer Per Unit (In figures and in words) Total Bid Offer (In figures and in words) For the Repair and Maintenance of the Hyundai Starex with Plate Number K1V 528 Php 284,247 .00 Php 284,247 .00 Two hundred Eighty-four Thousand two Hundred Forty-seven Pesos Only Two hundred Eighty-four Thousand two Hundred Forty-seven Pesos Only Note: Any quotation exceeding the Approved Budget for the Contract (ABC) shall be automatically rejected. Interested bidders are required to submit copies of the following documents together with their duly accomplished quotation on or before the prescribed deadline for submission: Philippine Government Electronic Procurement System (PhilGEPS) Organization ID or PhilGEPS Certificate of Registration (Platinum Membership) Valid Mayor’s/Business Permit Income/Business Tax Return, for ABCs above Php 500,000.00 If Consulting Services – Professional License/CV If Infrastructure Project – PCAB License and Registration For ABCs above Php 50,000.00: Notarized Omnibus Sworn Statement, and If applicable, Original Notarized Secretary’s Certificate in case of a corporation, partnership, or cooperative; or Original Special Power of Attorney of all members of the joint venture giving full power and authority to its officer to sign the OSS and do acts to represent the Bidder. Template may be accessed through this link: https://docs.google.com/document/d/1YJ20Xc2nyn_Pri7LHNxMu9Q91a6K-C9E/edit After having carefully read and accepted the terms and conditions, I/we hereby certify that we have submitted our quotation/s for the item/s listed above : Name of Company Name and signature Address Phone Numbers Date Email Address ----------------------------------------------------------------------------------------------------------------------------------------------- I hereby certify that the prices quoted in this form are true and correct, and that the company submitting this quotation is a legitimate business entity. _________________________________ Name and Signature of Canvasser Submission of price quotations may be sent through email @ procurement@mimaropa.doh.gov.ph or manual submission at DOH MIMAROPA Center for Health Development, Procurement Management Unit QMMC Compound Proj. 4, Quezon City Telephone No. 912-01-95 loc 423 & 424

confirm these in the bid documents

• Price quotation on the RFQ form issued with this noticeIRR §53.9
• Valid Mayor's / business permitGPPB Res. 09-2020
• PhilGEPS registration number (Red membership suffices)IRR §54.6
• Omnibus Sworn Statement (for ABC above ₱500K)GPPB Res. 09-2020
• Income / business tax returns (for ABC above ₱500K)IRR §53.9