Republic of the Philippines

DEPARTMENT OF PUBLIC WORKS AND HIGHWAYS

PANGASINAN 1ST

DISTRICT ENGINEERING OFFICE

REGIONAL OFFICE I

Alaminos City, Pangasinan

Name of Procuring Entity : DPWH 1ST Pangasinan Engineering District Request for Quotation No. : RFQ-2021-04-0015

Revised on : Date : April 21, 2021

Standard Form/ REQUEST FOR QUOTATION Office/End-User : DPWH Pang 1

COMPANY NAME :

ADDRESS :

TEL. NO./FAX NO. : TIN No.

Please quote your lowest price on the item(s) listed below, subject to the Terms and Conditions stated below and submit your quotation duly signed by your representative not later than 10:00 AM on April 29, 2021 of in the return envelope attached herewith, to the BAC Secretariat, DPWH 1ST Pangasinan Engineering District Alaminos City, Pangasinan.

MIENRADO V. INACAY

Chief, Construction Section

Chairperson, Bids and Awards Committee

Item

No. ITEM & DEION QTY. UNIT UNIT PRICE TOTAL PRICE

1 Emulsified Asphalt (Cationic SS1) 2.00 Drums

2 Premix Asphalt 20.00 MT

3 Thermoplastic Powder (White) 184.00 Bags

4 Primer for Thermoplastic 13.00 Pails

5 Thinner/Reducer for Thermoplastic 10.00 Gallon

6 Glass Beads (Premium Quality) 7.00 Bags

Brand and Model : Warranty :

Delivery Period : Price Validity :

After having carefully read and accepted your General Conditions, I / We quote you on the item (s) at

Prices noted above. If the space for Delivery Period, Warranty and Price Validity are left blank, it means that I concur with the Terms and Conditions specified by DPWH.