Name of Vendor/ Company

i) Registered Business Address

ii) Corporate Address (if different)

Name of Proprietor/MD with Contact Number

Name of Contact Person with Contact Number

Trade License Number and validity

VAT Registration Number

Taxpayer's Identification Number

Any Other Information

Tender No.

Name of Item with Location

Name of Package

Total Quoted Amount

Total Bid Security Amount

Pay Order Number and Date

Name of Bank

Name of Branch

Any Other Information

Signature

Designation

Date

Company Seal

ISLAMIC RELIEF WORLDWIDE BANGLADESH

INDIVIDUAL SUMMARY SHEET FOR ATTENDING TENDER

Company Information

Tenderer's Signature, Date & Seal

I/We hereby declare that the information and documents provided along with the bid submission are true and authentic.

House # 10, Road #10, Block-K, Baridhara, Dhaka 1212

Tender Relevant Information

RFQ No: 01/2018/HP/PANI (Package # 01) Please complete, sign and return to PR No: 03/2018 Islamic Relief Worldwide BangladeshDate: January 04, 2018 Tel: 9893458, 8819392, 8859128, 8859128

To

Qty Unit Price Total Price(A) (B) (C=AxB)

1 Shallow/Semi Deep Tube

Well

As per attached BOQ and

Design of Deep Tube Well

No's 200

TERMS AND CONDITIONS:

1

2

3

4

5

6 Mode of Payment: Through A/C payee cheque only in favor of the name of the organization.

7

8 Terms of Payment: Advance payment is not allowed.

9

10

11

12

13

14

15

16 All quotation should be intact at the time of submission. Please write the Package number and your company name on the envelop.

17

18 Others (if any):

Shahidul IslamSenior Procurement Officer

Islamic Relief Worldwide Bangladesh

Quotation Submission Date: The price offer/quotation must be submitted as per our attached Bill of Quantities (BOQ) to the "Procurement

Department" on or before January 21, 2018 at 02: 00 PM (Tender Box # 01)

Grand Total =

(Total Amount in words : Taka only………………………….…………………………………………………………………………..)

ISLAMIC RELIEF WORLDWIDE BANGLADESHRequest for Quotation (RFQ)

Address: HOUSE # 10, ROAD # 10, BLOCK – K,

BARIDHARA, DHAKA – 1212,

Subject: Request for Price Quotation for 200 units of Shallow/ Semi Deep Tube Well under HP Program of PANI Project at

Companygonj Upazila, Sylhet.

Attention:Tel/ Fax #

Please quote for your best price for supply the following:

SL Name of items Specification Unit Remarks

Signature of supplier (with seal & date)

Child Protection Policy: IR reserves the right to terminate this agreement without any notice if any vendor is engaging child labours or supporting

any forms of illegal practices.

Anti Bribery Policy: IR follows ZERO-TOLERENCE policy for any form of bribery or corruption.

Special Condition: The authority of Islamic Relief reserves the right to accept or reject any or all of the quotations and right to stop supply at any

stage of delivery without assigning any reason whatsoever

Condition of the Items: Shallow/ Semi Deep Tube Well must be install as per our requirement and as our given drawing, design and specifications.

Time of Delivery: Within 180 days (Tentative) from receiving the Work Order.

VAT & IT: Supplier must provide VAT challan with the bill. Otherwise, VAT will be deducted as per Govt. rules. For IT Deduction at Source (TDS) will

be applicable as per rule.

Security Deposit : 2.5% of total quotation value should submit with the price offer by a pay order from any schedule bank in favor of Islamic

Relief.

Documents: All relevant documents like Trade License, VAT, Tax etc. must be up-to-date and copy attached with your quotation.

Offer Letter: You are requested to provide a forwarding letter on your organization's letterhead pad with seal and signature from the authority

with this offer along with duly filled in Summary of Tender Submission as per attached format.

Penalty amount: A. 2% of work order amount will be deducted from your total bill amount for each and every belated day. B. 5% of work order

amount will be deducted for any deviation with the given specification in your quotation if supply does not rectify immediately.

Contractor/Vendor/Supplier undertakes to comply with all applicable laws and to ensure that it does not engage in any kind of criminal activity

including but not limited to bribery, fraud, corruption, terrorism and to maintain ethical business practices as well as not to commit any Prohibited

Acts defined as:-

(i) to offer, promise or give any person a financial or other advantage;

(ii) to request, agree to receive or accept any financial or other advantage.

Distribution of Works : IRB has the authority to divide the works among the qualified vendors.

AML & ATF Policy: IR will terminate this agreement without any notice if any supplier is found to be in violation of Anti Money Laundering & Anti

Terrorist Funding policy.

Place and Cost of Delivery : Including carrying, loading, unloading up to the delivery spot at household level of Islampur Poschim, Islampur Purbo,

Ishakalas, Telikhal, Ranikhai Dakkin Union of Companygonj Upazila under Sylhet District.

Page 1 of 1

Reference Purchase Order# Dated#

QTY/

Tube-

well

No of

Tube

well

Unit Rate Total Amount

( A) ( B ) ( C ) D=AxBxC

1 Mobilization Ls 1 200

Transportation of Men power, materials, equipments and

boring tools at spot, labor fooding, labor accomodation all

complete as per direction of the Engineer-in-charges (EIC).

2 uPVC Blind Pipe (Rising pipe/ Sand Trap Pipe) Rft 265 200

Supplying & lowering of uPVC pipe of dia 1.5" ( D Grade-

Water Class,having physical, chemical, thermal,fire

resistivity properties etc. as per BSTI approved

manufacturer such as RFL/Bashundhara/National Polymer

or any approved brand (by IR) including required Solvent

Cement (Adhesive Glue) & Coarse Sand with necessary

fitting and fixing .

Wall thickness of pipe should be within range of 2.5mm - 03

mm , Surface of the pipe should be smooth and free from

any kind of defects .The length may be vary based on the

situation of under ground aquifer and as per the instruction

of Engineer In Charge. Details is in the annexure.

3 PVC Strainer Rft 15 200

Supplying & lowering the PVC Strainer (water grade) of 38

mm dia with uniform thickness (2.5mm - 3 mm) without

any defect and fitting and fixing.RFL Robo type prefered

Length may be vary based on the situation of the under

ground aquifer and as per the instruction of the Engineer In

Charge. Details is in the annexure.4 GI Pipe (38 mm dia) Rft 5 200

Supplying and lowering the Galvanised Iron (GI) pipe (Gold

Type; Brand: hatim/National Ploymer/RFL Equivalent

approved by IRB)having physical, chemical, thermal,fire

resistivity properties etc. as per BSTI approved

manufacturer of 38 mm, uniform thickness (2.5mm to 2.9

mm) with MS welded rod (12 mm in diameter) at the top

end and the pipe should be without any defect, all complete

including the fitting and fixing in position as per direction of

Engineer In Charge. Details is in the attached annexure.

5 Tube well Head No. 1 200

Supplying of Tube-well complete Head (No-6), Color:

Blue/Green Brand: RFL (Heavy Type), Minimum weight #

31 (±0.5) Kg. The pump should be free from any defects

such as cavity, cracks etc. Inner side of the barrel should be

smooth. Back washing should be untill withdrawling doing

fresh water (without any sand), painting of the Tube-well

Head (2-Coats, Coloring-Bluish/ As per instruction), all

complete as per direction of the Engineer-in-charges.

ISLAMIC RELIEF, BANGLADESH

Humanitarian Programms

Promoting Appropriate Water, Sanitation and Hygiene facilities for the vulnerable communities living in North Eastern

Part of Bangladesh-(PANI), Sylhet

Scope of Work: Supply of materials with necessary equipment and mobilisation of manpower and Installation Tube-

well (TW) at different locations of Companigonj upzila, Sylhet.

Bill of Quantities (BoQ)

SL Descriptions Unit

Page 1 TW BOQ_WatSan Germany

QTY/

Tube-

well

No of

Tube

well

Unit Rate Total AmountSL Descriptions Unit

6 Tube-well Platform(6'-0"x6'-0"x2'-0") No. 1 200

Earth cutting and Earth filling and Construction of concrete

platform (6'-0"x6'-0" ) with stair (following as per the

attached design and specification)will be constructed with

19 mm downgraded brick chips/ stone chips (1st class),

coarse sand (FM=1.2-1.5) and ordinary portland cement in

proportion of 1:2:4 including plastering (12mm thick, 1:4)

& neat cement finishing (NCF) Mixed with best quality of

Red Oxide Powder to the outer visible surface which laying

above the Ground level with drainage provision and 07 days

curing(two times each day). Brick/stone chips and Sand will

be netted and washed accordingly. Inside Earth/sand will be

compacted enough, all complete as per design and

aspecification and as per direction of Engineer In Charge.

7 Drainage System rft 10 200

Supplying of Drainage pipe (3 inch in dia, C Grade-Water

Class, minimum thickness 3.50 mm to 4.10 mm, Brand:

RFL/Bashundhara/National Polymer or any approved brand

by IR) with necessary earth cutting, earth filling and fittings

such as bend, elbow,glue, stainless steel screen etc as per

attached design. Sand (3inch) will be around the drainage

pipe below the ground level along with the platform. The

length of drainage pipe may be vary as per field actual

requirement and as per instruction of Engineer In Charge.

8 Tube well installation

Mechanical Boring/manual hand Drilling by using 50-75 mm

dia cutter and 40mm dia GI pipes and another materials

such as bentonides, Sample soil collection at 1000 mm

interval and filling the boring voids around the pipe by

Coarse sand (lower 6 m),clay (top 6 m) and local clay

(middle portion) , contractor should ensure safe water in

boring, all complete as per direction of Engineer In Charge.

a) At 0-150 ft depth from Ground level Rft 150 200

b) At 151-300/ above ft depth from Ground level Rft 150 200

9 Tube-wells Name Plate Supply No. 200

Supplying, fitting and fixing of marble stone name plate (1'-

6"x1'-0"x 18-20mm thickness) with Islamic Relief logos and

written text (Bangle/English/Arabic/all), 4 color, all

complete as per given sample and instruction of Engineer In

Charge.10 Locking Arrangement No. 1 200

Supplying of 12 mm dia M.S. rod for making round clamp

with barrel & supplying 8 mm dia M.S. rod for preparing

chain up to SS 4-0'' 3-0˝ long, fitting and fixing the chain

with upper M.S ring and lower part fitted with 6˝long - 12

mm dia M.S. rod clamp (upper ring to be fitted with pump

body through welding of ring and lower ring to be fitted

with clamp through welding; this fittings are to be done in

welding shops) and placed the clamp with CC block etc. all

complete including necessary welding,others as per

direction of the Engineer-in-charge.

Project Working areas:

______________________________

Signature of Contractor (with seal)

islampur poschim, Islampur purbo, Isakalash, Telikhal and Ranikhai Dakkahin of Companigonj Upazila of Sylhet

Total Amount (Taka) =

Page 2 TW BOQ_WatSan Germany

W1

W2

W3

W4

W5

W6

W7

W8

W9

W10

W11

W12

W13

W14

W15

W16

W17

W18

W19

W20

W21

W22

W23

W24

1 Site Location Receiving

2 Material/Equipment/Manpower Mobilization

3 Material Mobilization

4 Tube-well Boring

5 Platform Installation

6 Making Sign board and fitting-fixing

7 Site Cleaning and Latrine Formal Handover

8 Bill Processing

1) Companigonj Upazila Selected Union of Sylhet District

___________________

Signature (with seal)

Month-1 Month-2 Month-3 Month-4 Month-5

Annex-2: Project Areas

I, the following signatory have the capacity to maintain the proposed action flow (Annex-1) to work in project areas (Annex-2)and signed below

ISLAMIC RELIEF, BANGLADESH

Humanitarian Programs

Promoting Appropriate Water, Sanitation and Hygiene facilities for the vulnerable communities living in North Eastern Part of Bangladesh-(PANI),

Sylhet

Annex-1: Action Flow of Water wells (Tube-well) Instalaltion

SL Activity Breakdown Work Accomplishing period (Weekwise)

Month-6