i. invitation to bid provision of dfpc healthcare services...

I. Invitation to BidProvision of DFPC Healthcare Services

HRMD1705The Duty Free Philippines Corporation (DFPC), through its Corporate Budget 2018 intends to apply the sum of Forty Five Million Pesos (PhP45,000,000.00) being the Approved Budget for the Contract (ABC) to payments under the contract for the Provision of DFPC Healthcare Services. Bids received in excess of the ABC shall be automatically rejected at bid opening.

DFPC now invites bids for Provision of Healthcare Services. Prospective bidders must have at least five (5) years experience in providing corporate healthcare services. The prospective bidder should be duly licensed to operate as HMO by the Bureau of Health Facilities and Services of the Department of Health (DOH). The description of an eligible bidder is contained in the Bidding Documents, particularly, in Section II. Instructions to Bidders.

DFPC will not accept brokers/agents to represent any HMO company.

Bidding will be conducted through open competitive bidding procedures using a non-discretionary “pass/fail” criterion as specified in the 2016 Revised Implementing Rules and Regulations (IRR) of Republic Act (RA) 9184, otherwise known as the “Government Procurement Reform Act” and is restricted to Filipino citizens/sole proprietorships, partnerships, or organizations with at least sixty percent (60%) interest or outstanding capital stock belonging to citizens of the Philippines, and to citizens or organizations of a country the laws or regulations of which grant similar rights or privileges to Filipino citizens, pursuant to RA 5183.

Interested Bidders may now obtain further information from DFPC and inspect the Bidding Documents at the address given below from 9:00AM – 5:00PM, Mondays thru Fridays.

A complete set of Bidding Documents may be acquired by interested Bidders on 06 September 2017 from the address below and upon payment of the applicable fee for the Bidding Documents, pursuant to the latest Guidelines issued by the GPPB, in the amount of Twenty Five Thousand Pesos (PhP25,000.00).

It may also be downloaded free of charge from the website of the Philippine Government Electronic Procurement System (PhilGEPS) and the website of the Procuring Entity, provided that Bidders shall pay the applicable fee for the Bidding Documents not later than the submission of their bids.

DFPC will hold a Pre-Bid Conference on 18 September 2017, 10:00AM at the address given below which shall be open to prospective bidders.

Bids must be duly received by the BAC Secretariat at the address below on or before 02 October 2017 at 10:00AM. All Bids must be accompanied by a bid security in any of the acceptable forms and in the amount stated in BDS under ITB Clause 18.

Bid opening shall be on 02 October 2017, 10:15AM at the address below. Bids will be opened in the presence of the Bidders’ representatives who choose to attend. Late bids shall not be accepted.

DFPC reserves the right to reject any and all bids, declare a failure of bidding, or not award the contract at any time prior to contract award in accordance with Section 41 of RA 9184 and its IRR, without thereby incurring liability to the affected bidder or bidders.

BAC SecretariatDuty Free PhilippinesEHA Bldg, Fiesta Mall, Columbia ComplexNinoy Aquino Ave., Parañaque City(632) 552-4343; (632) 5524-337 loc. 3039Fax No. (632) 879 3664 / 552-4345 Email add.: [email protected]

(Sgd.) MR. BERNARDINE R. BELMONTEBAC Chairman

III. Bid Data SheetITB Clause

1.1

The PROCURING ENTITY is DUTY FREE PHILIPPINES CORPORATIONThe name of the Contract is Provision of DFPC Healthcare Services.

The identification number of the contract is HRMD1705.

ITB Clause

1.2

The lot and reference is:

Memorandum HRMD-ESD-BENEFITS SECTION (17)-022

2 The Funding Source:

The Government of the Philippines (GOP) through the 2018 Corporate Budget of DUTY FREE PHILIPPINES CORPORATION in the amount of:

Forty Five Million Pesos (PhP45,000,000.00)

The name of the project is :

PROVISION OF DFPC HEALTHCARE SERVICES (HRMD1705)

3.1 No further instructions.

5.1

No further instructions.

ITB Clause

5.2

Foreign bidders, except those falling under ITB Clause 5.2(b), may not participate in this Project.

5.4Bidder must have completed, within the period specified in the Invitation to Bid and ITB Clause 12.1(a)(ii), a single contract that is similar to this Project, equivalent to at least fifty percent (50%) of the ABC or:

Twenty Two Million Five Hundred Thousand Pesos (PhP22,500,000.00).For this purpose, similar contract shall refer to provision of corporate healthcare services.

7


8.1

Subcontracting is not allowed.

ITB Clause

8.2

Not applicable.

9.1The Date and Venue of the Pre-Bid Conference is:

18 September 2017, 10:00AM DUTY FREE PHILIPPINES CORPORATIONEHA Building, Fiestamall,Columbia Complex, Ninoy Aquino Ave.Parañaque City

10.1 The PROCURING ENTITY’s address is:

Duty Free Philippines Corporation Ground Floor, EHA Building, Fiestamall, Columbia Complex, Ninoy Aquino Avenue, Parañaque CityMR. BERNARDINE R. BELMONTEBAC Chairman

Thru: BAC Secretariat Tele No : 552 4337 loc 3039/3096, 552 4343Fax No. 879 3664 / 552 4345 / 552 4399 loc. [email protected]

12.1(a)


ITB Clause

12.1(a)(ii)

The bidder’s SLCC similar to the contract to be bid should have been completed within the last five (5) years (2012-2016) prior to the deadline for the submission and receipt of bids.

13.1

Proposed Rates for Section IX Employee-Paid Dependents (Refer to Annex 1 of Section IX, original).

13.1(b)


13.1(c)

No additional requirements.

ITB Clause

13.2

The ABC is


Any Bid with a financial component exceeding this amount shall not be accepted.

15.4(a)(iv)

No incidental services are required.

15.4(b)

No incidental services are required.

16.1(b)

The Bid prices for Goods and services supplied from outside of the Philippines shall be quoted in Philippine Pesos.

ITB Clause

16.3

Not applicable.

17.1

Bids will be valid until 30 January 2018.

ITB Clause

18.1 The bid security shall be in any of the following amounts:

ACCEPTABLE FORMS AMOUNT

1. Cash or cashier’s/manager’s check issued by a Universal or Commercial Bank

Two Percent (2%) of the ABC orNine Hundred Thousand Pesos

(PhP900,000.00)

2. Bank draft/guarantee (signed by the appointee) or irrevocable letter of credit (original and notarized) issued by a Universal or Commercial Bank: Provided, however, that it shall be confirmed or authenticated by a Universal or Commercial Bank, if issued by a foreign bank

3. Surety bond callable upon demand issued by a surety or insurance company duly certified by the Insurance Commission as authorized to issue such security.

Five Percent (5%) of the ABC orTwo Million Two Hundred Fifty

Thousand Pesos (PhP2,250,000.00)

4. Bid-Securing Declaration Refer to Bidding Form No. 2

ITB Clause

18.2

The bid security shall be valid until 30 January 2018.

20.3

Each Bidder shall submit one (1) original and three (3) copies of the first and second components of its bid.

21 The Address for Submission of Bids is:

DUTY FREE PHILIPPINES CORPORATIONGround Floor EHA Building, Fiestamall,Columbia Complex, Ninoy Aquino Ave., Parañaque City

The deadline for Submission of Bids is on

02 October 2017 at 10:00AM.

24.1The place of Bid Opening is

Duty Free Philippines Corporation, EHA Building, Fiestamall, Columbia Complex, Ninoy Aquino Avenue, Parañaque City

The date and time of Bid opening is on:

02 October 2017 at 10:15AM.

ITB Clause

24.2


24.3


27.1


28.3(a)

Partial bid is not allowed. The goods are grouped in a single lot and the lot shall not be divided into sub-lots for the purpose of bidding, evaluation, and contract award.

ITB Clause

28.4


29.2 1. 2016 Income Tax Return (form 1701/1702) with Audited Financial State-ment.

2. Business Tax Return (forms 2550M/2551M and 2550Q/2551Q) for the last six (6) months (March to August 2017) prior to opening of Bids filed thru Electronic Filing and Payment System (EFPS).

Only tax returns filed and taxes paid through the BIR Electronic Filing and Payment System (EFPS) shall be accepted.

3. Updated General Information Sheet received by the SEC.

4. BIR Certificate of Registration.

32.4(f)

No additional requirement.

V. Special Conditions of the Contract

GCC Clause

1.1(g) The PROCURING ENTITY is Duty Free Philippines Corporation.

1.1(i) The Supplier is _______________________

1.1(j) The Funding Source is:

The Government of the Philippines (GOP) through the Corporate Budget of Duty Free Philippines Corporation 2018 in the amount of :


1.1(k) The Project Site is :

DUTY FREE PHILIPPINES CORPORATION, Ground Floor, EHA Building, Fiestamall, Columbia Complex, Ninoy Aquino Avenue, Parañaque City

2.1 No further instructions.

5.1 The PROCURING ENTITY’s address for Notices is:

DUTY FREE PHILIPPINES CORPORATION, EHA Building, Fiestamall, Columbia Complex, Ninoy Aquino Ave., Parañaque City

Vicente Pelagio A. Angala Maria Teresa C. PanopioChief Operating Officer HRMD Manager-OICTel. Nos. (632) 879-3559 Tel. Nos. (632) 552 4346Fax No. (632) 552 4301 [email protected]

The Supplier’s address for Notice is:__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

GCC Clause

6.2 Services To Be Rendered and DocumentsDelivery of Services shall be made by the SUPPLIER in accordance with the terms specified in the Schedule of Requirements.

I. Membership

1. For purposes of determining eligibility of members, the following provisions shall govern: The age to be considered for purposes of enrolment is the age in years, regardless of the months or days, except in the case of newly born children. 2. The enrolment of the Immediate Dependent Members shall follow the hierarchy:

2.1 Married Principal Members - spouse first, followed by the eld-est child, second child and so on.

2.2 Single Principal Members - parents first, followed by the eld-est sibling, second to the eldest sibling, and so on.

2.3 Single-Parent Principal Members - eldest child first, followed by second child and so on, then last, parents.

3. Hierarchy shall be waived for members covered by our previous SUPPLIERs for the last three (3) years. For this purpose, proof of membership shall be submitted. Hierarchy shall not apply under the following circumstances:

3.1 Spouse working or living abroad or covered by another SUP-PLIER or separated (legally or de facto);

3.2 Children studying or living abroad or covered by another SUPPLIER

4. Members who reach the age of ineligibility within the contract year shall remain covered until the contract expires, provided the full contract premium for the said members have been paid.5. Principal members who changed their civil status during the contract period may opt to enroll their former immediate dependents, if any, as specified in Section IX - Employee-Paid Dependents under Item I.1.1 for the remaining period of the contract.

6. Enrolment shall be for a period of thirty (30) days following the commencement of the contract. Should a member be classified as Senior Citizen (SC) under R.A. 9994 and/or persons with disability (PWD) under R.A. 7277, he/ she shall submit a photocopy of his/her OSCA/PWD ID.

7. Members who will be enrolled during the contract period shall be entitled to full coverage. Enrolment of additional members after the enrolment period shall only be allowed for the following:

7.1 Newly regularized employees as Principal Members and their immediate dependents.

GCC Clause

10.4 Not applicable.

10.5 Payment using LC is not allowed.

11.3 Maintain the GCC Clause.

13.4(c) No further instructions.

16.1 None.



21.1 No additional provision.

VI. Schedule of RequirementsI. SCOPE OF SERVICES

SUPPLIER shall arrange for the following Healthcare services using its Medical Service Units, Accredited Hospitals or Medical Centers, to all members and employee-dependents enrolled by the Procuring Entity for a period of one (1) year. The services shall include:

1. MEDICAL SERVICES

As prescribed by the SUPPLIER’s Accredited Physician/Specialist/Coordinator, all medical services for the diagnosis, treatment and procedures for all types of illnesses, diseases and accidents related injuries shall be covered up to the Maximum Benefit Limit (MBL), per illness, per member unless specified under dreaded illnesses, limitations and/or exclusions under 1.4, 1.5 and 1.6 of this title. Under no circumstances shall the member be required to pay in advance any cost due and for the account of the SUPPLIER.

1.1 INCLUSIONS:

The medical services shall include, but not necessarily limited to the following:

1.1.1 Access to hospital facilities including necessary supplies ordinarily provided by hospitals and clinics.1.1.2 Administration of Drugs and Medications including supplemental vitamins and minerals when prescribed during confinement.1.1.3 Administration of first passive and active dose of anti-rabies, anti-venom and an-ti-tetanus.

1.1.4 Administration of Steroid Shots and its costs as prescribed by accredited specialist.

1.1.5 Processing/Screening and infusion of human blood products.1.1.6 Professional Medical Services.

1.1.7 Laboratory/Radiology/Diagnostic Procedures including skin tests.

1.1.8 Modern/Complex diagnostic/Rehabilitation and Therapeutic modalities, examinations/treatment and interventional surgical procedures.

1.2 PROCEDURE FOR AVAILMENT:

To avail of the medical services, the members shall, except in emergency cases, se-cure the issuance of a Letter of Authorization (LOA) from the following:

1.2.1 Supplier’s Clinics.1.2.2 Accredited Clinics.

1.2.3 Accredited Hospitals.

1.2.4 Accredited Coordinators.

1.3 MODES OF AVAILMENT:

The medical services can be availed of under any of the modes as follows:

1.3.1 OUT-PATIENT- Availment of all medical services as described above, except prescribed home-medication, not requiring confinement in a medical facility, clinic or hospital.

1.3.2 IN-PATIENT- Availment of all medical services which requires confinement in a medical facility, clinic or hospital.

1.3.3 EMERGENCY CARE- Availment of all medical services in any hospital or clinic by a member who is in imminent danger of losing one’s life or any part of the body or is in severe pain that requires medical attention or relief without delay subject to the following conditions:

1.3.3.1 Emergency Care in Accredited Hospitals/Clinics.

1.3.3.2 Emergency Care in Non-Accredited Hospitals/Clinics- The SUPPLIER agrees to reimburse one hundred percent (100%) of the total hospital bills inclusive of professional fees. Emergency care may include the confinement of the member until such time that the member has been issued a clearance for transfer to an accredited hospital/clinic by the attending physician of the non-accredited hospital/clinic.

The SUPPLIER shall pay the said amount when it is verified that the SUPPLIER’s facilities were not used because in doing so it would entail a delay resulting in death, serious disability or signific-ant jeopardy to the member’s condition, or the choice of hospital was beyond the control of the member or the member’s family. Fol-low-up care/consultations in non-accredited hospitals/clinics shall not be covered.

1.3.3.3 Emergency Care in a Foreign Country- In the event that a principal member is in need of emergency care in a foreign territory, the SUPPLIER shall reimburse in Philippine currency 100% of the total hospital bills and professional fees for a maximum of USD 1,000 or its equivalent, provided the MBL for such illness has not yet been

exceeded.

1.4 DREADED ILLNESSES- Principal members diagnosed with cancer, cardiovascular diseases and chronic kidney diseases shall be entitled to an additional 20% of Maximum Benefit Limit per aforementioned illness.

1.5 LIMITATIONS- All medical services shall be subject to the Maximum Benefit Limit (MBL) provided in the Technical Specifications, except for the following:

1.5.1 Medically prescribed sleep study and sclerotherapy are each covered up to Twenty Thousand Pesos (PhP20,000.00).

1.5.2 Medically prescribed cauterization of warts in all parts of the body are covered up to Fifteen Thousand Pesos (PhP15,000.00) inclusive of facial warts which is covered up to Three Thousand Pesos (PhP3,000.00).

1.5.3 Implants, artificial aids, prosthetic devices and corrective appliances including lens for post cataract extractions (implants for brevity) are each covered up to Forty Thousand Pesos (PhP40,000.00). Eyeglasses, contact lenses, hearing aids, dentures and dental braces are not covered.

1.5.4 Availment of Executive Check Up shall be allowed to any Supplier’s accredited hospitals and clinics except for the five (5) major hospitals namely: Asian Hospital, Alabang, Muntinlupa City, Makati Medical Center, Makati City, Cardinal Santos Medical Center, San Juan City, St. Luke’s Medical Center, Quezon City and the Medical City, Pasig City.

1.6 EXCLUSIONS- Medical services availed under any of the circumstances/conditionsas follows:

1.6.1 Use by a member from a non-accredited physician/hospital or other provider of care except as described in the emergency care in non-accredited hospital or referred to by an accredited Specialist /Coordinator.

1.6.2 Plastic and reconstructive surgery for cosmetic purposes and for physical congenital deformities and abnormalities.

1.6.3 Dermatological care for aesthetic purposes such as chemical treatment for skin tags, xanthelesma, keloids, scars, etc. or any exposed areas of the body. Surgery for purposes of beautification.

1.6.4 Corrective eye surgery for error of refraction including laser surgery for correction of myopia and hypermyopia.

1.6.5 Experimental medical procedures like accupuncture, accupressure, reflexology and chiropractics.

1.6.6 Services to diagnose and/or reverse infertility or fertility and virility potency (erectile dysfunction).

1.6.7 Medical expenses incurred by donor of organ transplantation.

1.6.8 Diagnostics for hypersensitivity and desensitization treatment EXCEPT for Allergen test.

1.6.9 Purchase or lease of durable medical equipments, oxygen dispensing equipment and oxygen except during hospital confinement under the Hospital Confinement Benefit.

1.6.10 Psychiatric and psychological illnesses including neurotic and psychotic behavior disorders.

1.6.11 Treatment for any chemical dependencies or deliberate overdose reaction for the use of drugs.

1.6.12 Hormonal therapy.

1.6.13 Developmental disorders and eating disorders.

1.6.14 Any disease acquired through active sexual lifestyle with multiple partners such as AIDS (except if secondary to accidental needle injection or blood transfusion, which is covered up to maximum benefit limit per member), Hepatitis B (except through other forms of transmission which shall be covered up to a maximum benefit limit per member), condyloma, gonorrhea, syphilis, herpes etc. and their attendant complications.

1.6.15 Physical examinations required for obtaining or continuing employment, insurance or government licensing.

1.6.16 Injuries or illnesses resulting from participation in war-like or combat operations, riots, insurrection, rebellion, strikes and other civil disturbances.

1.6.17 Treatment of self inflicted injuries or injuries attributable to the member’s own misconduct, gross negligence, use of alcohol and/or drugs, vicious or immoral habits, commission of a crime, violation of a law or ordinance, unnecessary exposure to imminent danger or hazard to health or engagement to extreme sports.

1.6.18 Custodial, domiciliary care, convalescent and intermediate care.

1.6.19 Temporal mandibular joint disease surgery (TMJ) done by dental practitioner.

1.6.20 Circumcision except for correction of phymosis.

1.6.21 Prescribed take home medicines on an out-patient basis.

1.6.22 Treatment of injuries sustained in an accident if the member or his guardian fails or refuses to execute the deed of Subrogation (if applicable). The SUPPLIER shall be subrogated to the right of the member up to the extent of actual cost incurred by the SUPPLIER in connection with medical services rendered to such member.

1.6.23 Professional fees in Medico – legal cases.

1.6.24 Laboratory examinations for screening of sexually related illnesses.

1.6.25 All other items not directly related to the medical management of the confined member such as services of a private nurse or doctor, use of extra bed or other appliances, and extra food for companion.

2. MATERNITY ASSISTANCE

2.1 Maternity Assistance shall include the following services:

2.1.1 Room and Board.2.1.2 Use of the labor, delivery/operating and recovery rooms.

2.1.3 ICU confinement.

2.1.4 Medical Profession services.2.1.5 Administration of drugs and medications including human blood products.2.1.6 All laboratory examinations (including VDRL) except for pregnancy test and ultrasound to determine gender. Laboratory examination costs are deductible from the limit set in Item 2.2.2.1.7 Pediatric Care is covered while mother is still confined in the hospital, also deductible from the limit as provided below except for illness/complications suffered by the newly-born. If child is pre-enrolled, medical services required for such illnesses/complications shall be subject to child’s Maximum Benefit Limit (MBL).2.1.8 Prenatal consultations and one (1) postnatal consultation per member (not deductible from the maternity benefit limit).

2.2 Maternity Assistance may be availed of by female principal members or legal spouses of married male principal members, and subject to the following limits:

Type of Delivery Maternity Assistance Limitper member

Caesarian Section PhP 40,000.00

Normal Spontaneous Delivery 30,000.00

Miscarriage 20,000.00

Complications of pregnancy 15,000.00

Threatened Abortion 10,000.00

2.3 Complication of pregnancy shall refer to conditions but not limited to Abruptio Placenta, Placenta Previa, Post Partum Atony, H-Mole, Hyperemesis Gravidarum, Ecclampsia, Ectopic Pregnancy.

2.4 Expenses incurred relative to the availment of the maternity assistance under the following conditions shall be subject to reimbursement based on the HMO Relative Value and to the maternity assistance limit:

2.4.1 Confinement in a Non-Accredited Hospital and attended to by a Non-Accredited Doctor.2.4.2 Confinement in a Non Accredited Hospital and attended to by an Ac-credited Doctor.2.4.3 Confinement in an Accredited Hospital and attended to by a Non Ac-credited Doctor.

3. DENTAL SERVICES

3.1 The following dental care services may be availed by the members from any of the SUPPLIER’s accredited dentists and dental clinics and not limited to dental associations/organizations/classifications/groups:

3.1.1 Consultations and oral examinations.3.1.2 Twice a year prophylaxis.3.1.3 Unlimited temporary fillings.

3.1.4 Permanent light cure filling is covered up to five (5) surfaces per member.3.1.5 Simple tooth extractions only, complicated cases not covered.3.1.6 Annual scaling and polishing.3.1.7 Orthodontic and aesthetic consultation and oral examination.3.1.8 Gum treatment except alveolectomy and gingivectomy.3.1.9 Adjustment of dentures.3.1.10 Recementation of loose jackets, crowns, in-lays and on-lays.3.1.11 Treatment of mouth lesions wounds and burns.3.1.12 Emergency desensitization of hypersensitive teeth.

3.2 Retainer dentist to be stationed at Procuring Entity’s Head Office Clinic three times (3x) a week at eight (8) hours per visit.

4. ANNUAL PHYSICAL EXAMINATION (APE)

4.1 Annual Physical Examination (APE) shall be provided to the principal members (Rank & File and Supervisors) only by the SUPPLIER’s designated Medical Service Units which shall include the following:

4.1.1 Taking of medical history.4.1.2 Physical Examination.4.1.3 Complete Blood Count.4.1.4 Urinalysis (urine examination).4.1.5 Fecalysis (stool examination).4.1.6 Chest X-ray.

4.1.7 Electrocardiogram (for members age 35 and above, or if indicated).4.1.8 Pap’s Smear (for women age 35 and above, or if indicated).4.1.9 Eye refraction.4.1.10 Management of Health Problems.

4.2 Upon payment of the 2 nd quarter premium, APE shall be conducted at the SUPPLIER’s Head Office Clinic or at the PROCURING ENTITY’s premises through the SUPPLIER Mobile Medical Team, to be scheduled for a minimum of fifty (50) principal members.

5. ANNUAL EXECUTIVE CHECK-UP (ECU)

5.1 Executive Check-up (ECU) to be provided to forty five (45) principal members, Manager category at the clinics/hospitals except in the five (5) major hospitals, namely, ASIAN Hospital and Medical Center, St. Luke’s Medical Center-Quezon City The Medical City General Hospital, Cardinal Santos and Makati Medical Center. It shall include the following procedures:

5.1.1 Comprehensive Physical Examination.5.1.2 Complete Blood Count.

5.1.3 Blood Chemistry (FBS, BUN, BUA, Creatinine, Cholesterol, Sodium, Potassium, Total Protein, Albumin, Calcium, Alkaline, Phosphatase, Total Bilirubin, SGOT, SGPT, HDL/LDL, Triglycerides, PSA).5.1.4 Urinalysis.5.1.5 Fecalysis, w/ Occult Blood.5.1.6 Chest X-ray.5.1.7 Electrocardiogram.5.1.8 Spirometry.5.1.9 Pap’s Smear and Mammography for female.5.1.10 Whole abdomen ultrasound, to include pelvis for female & prostate for male.5.1.11 Treadmill Stress Test.

5.2 SUPPLIER shall arrange the ECU with accredited clinics/hospitals except for the five (5) major hospitals as provided above (1.5.4) for the following locations: Manila, Quezon City, Paranaque, Mandaluyong, Pasig, Makati, Alabang and provincial areas. Procuring Entity may schedule the ECU immediately upon payment of the 2 nd quarter premium.

5.3 Should there be more than forty five (45) principal members who will avail of the ECU, SUPPLIER shall assist PROCURING ENTITY in the scheduling of the ECU at the prescribed clinics upon request, however, actual expenses shall be charged directly to the Procuring Entity.

6. OTHER SERVICES

6.1 Provide Preventive Health Care services to all members:

6.1.1 Counseling on health habits, diet and Family Planning.6.1.2 Wellness Program (6 times a year).

6.2 Ambulance services shall be covered on a reimbursement basis up to Five Thousand Pesos (PhP5,000.00) per conduction from location to hospital including transfer of patient to another hospital as per medical advice.

6.3 Secure GROUP LIFE INSURANCE for all members with benefits as follows

Schedule of Insurance Benefits

Principal Members Immediate Dependents

Death PhP 50,000.00 PhP 50,000.00

Loss of both hands 20,000.00 20,000.00

Loss of both feet 20,000.00 20,000.00

Loss of sight (both eyes) 20,000.00 20,000.00

Loss of one hand & one foot 20,000.00 20,000.00

Loss of one hand & sight of one eye 20,000.00 20,000.00

Loss of one foot & sight of one eye 20,000.00 20,000.00

Loss of one hand or one foot 10,000.00 10,000.00

Loss of sight of one eye 10,000.00 10,000.00

The claim must be filed within sixty (60) days from the occurrence of death or dismemberment.

For this purpose, the member should designate his/her beneficiary in the enrollment form (to be provided by the Supplier) at the commencement of the contract. Should his/her beneficiary be a minor, a trustee should be named in the same enrolment form.

Payment of claims shall be made within fifteen (15) days from receipt of complete requirements.

Payment made by SUPPLIER under this section shall not be considered as availed medical services, thus, not form part of the utilization.

The member will not be entitled to the insurance benefit if the cause of death is among those listed in the exclusions under item 1.6.

II. MANPOWER

3.3.1. The SUPPLIER agrees to provide the following personnel to be stationed at PROCURING ENTITY’s Head Office Clinic in Parañaque City:

Position Qty Schedule

Dentist 1 Eight (8) hours a day, three times (3x) a week.

Nurse 1 Eight (8) hours a day, five times (5x) a week.

Doctor 1 Eight (8) hours a day, five times (5x) a week.

1.1 The assigned/stationed doctor shall provide his/her own medical equipment and be authorized by the SUPPLIER to issue the necessary Letter of Authority (LOA) for members’ availment of out-patient medical services under the following circumstances:

1.1.1 Referral to accredited specialist.

1.1.2 Request for laboratory/diagnostic procedures required by a duly accredited specialist. Copy of the request shall be attached to the LOA.1.1.3 Request for laboratory/diagnostic procedures as recommended in the results of the annual medical check-up of the member.1.1.4 Request for laboratory/diagnostic procedures required for his/her assessment of the member-patient.

1.2 The assigned/stationed nurse shall also be authorized to issue LOA but shall be limited to referrals to specialist/s and requests for laboratory/diagnostic procedures, examination by an accredited physician.

1.3 The assigned/stationed dentist shall provide his/her own dental equipment and materials.

2. The SUPPLIER shall designate an Account Officer who shall be responsible for answering queries, problems etc., concerning HMO matters. Attend to reimbursement of employees’ hospital bills and other charges but not necessarily stationed at DFP Medical Clinic.

3. The SUPPLIER shall ensure proper dissemination of DFPC HMO package to its customer care and/or call-center agents and hospitals.

III. ACCREDITED MEDICAL INSTITUTIONS AND PHYSICIANS

1.1.1. The SUPPLIER shall maintain its accreditation with Metro Manila Hospitals, including but not necessarily limited to the following hospitals/clinics as enumerated below:

1.1 ASIAN Hospital and Medical Center

1.2 Capitol Medical Center

1.3 Cardinal Santos1.4 Delos Santos Medical Center

1.5 Dr. Victor R. Potenciano Medical Center - Edsa, Mandaluyong

1.6 Makati Medical Center1.7 Manila Doctor’s Hospital – U.N. Avenue, Manila

1.8 The Medical City Hospital and Medical Center – Ortigas, Pasig City

1.9 MPI – Medical Center Muntinlupa – Putatan, Muntinlupa1.10 Olivarez General Hospital, Inc., - Paranaque City

1.11 Our Lady of Lourdes Hospital – Sta. Mesa, Manila

1.12 Perpetual Help Medical Center-Las Pinas City1.13 St. Luke’s Medical Center – Quezon City

1.14 St. Luke’s Medical Center Global – Taguig City

1.15 Sto. Tomas University Hospital – Sampaloc, Manila1.16 San Juan de Dios Hospital & Medical Center – Roxas Blvd, Pasay City

1.17 National Kidney Institute – East Ave., Quezon City1.18 Philippine Heart Center – East Ave., Quezon City1.19 Premier Medical Center – Paranaque City

1.1.2. The SUPPLIER shall maintain its accreditation with at least one (1) hospital per Provincial Store Location; except for Cebu Store where the SUPPLIER shall maintain its accreditation with at least two (2) hospitals from the list below:

II.1 Angeles University Foundation Hospital & Medical Center – Angeles City, Pampanga

II.2 Mother Theresa of Calcutta Medical Center – San Fernando, PampangaII.3 V.L. Makabali Mem. Hospital – San Fernando, PampangaII.4 Cebu Doctor’s Hospital – Osmeña Blvd., Cebu CityII.5 Chong Hua Hospital – Fuente Osmeña Ave., Cebu City

II.6 Perpetual Succour Hospital – Gorordo Ave., Cebu CityII.7 Davao Doctor’s Hospital – Davao CityII.8 San Pedro Hospital – Davao CityII.9 Ricardo Limso Med. Cntr. – V. Ilustre St., Davao CityII.10 De La Salle Medical Center – Dasmariñas, CaviteII.11 Our Lady of the Pillar or Imus Medical Center – Imus, CaviteII.12 Divine Grace Med. Cntr. – Gen. Trias, CaviteII.13 Perpetual Help Medical Center – Binan, LagunaII.14 Los Baños Doctors Hospital – Los Baños, LagunaII.15 MMG-PPC Cooperative Hospital – Burgos cor. Madrid Sts. Puerto Princesa

CityII.16 Palawan Adventist Hospital – San Pedro, Puerto Princesa CityII.17 RTN Foundation Inc. – Bataraza, PalawanII.18 Aklan Cooperative Mission Hospital – Roxas Ave. Ext., Andagao, Kalibo, AklanII.19 Aklan Med. Cntr. – Estancia, Kalibo, AklanII.20 Iloilo Doctor’s Hospital – West Ave., Molo, Iloilo CityII.21 Iloilo Mission Hospital – Mission Road, Jaro, Iloilo CityII.22 St. Paul’s Hospital Iloilo, Inc. – Gen. Luna St., Iloilo CityII.23 The Medical City – Brgy. Tap-Oc, Molo, Iloilo CityII.24 St. Paul Hospital Hosp Inc., Bocaue, BulacanII.25 Our Lady of Mercy General Hosp. Inc. – Pulilan, BulacanII.26 Manila East Medical Center, Taytay, RizalII.27 Antipolo Doctors Hospital – AntipoloII.28 Bio-Clinica Labortory - Silay, Bacolod CityII.29 Therapea Medica Laboratorico – Burgos St. Bacolod CityII.30 Bacolod Adventist Medical Center – Tacuiling, Bacolod CityII.31 Bacolod Our Lady of Mercy Specialty Hospital – Mandalagan, Bacolod CityII.32 The Doctors Hospital – Benigno Aquino Drive, Bgy Villamonte, Bacolod City

3. For the whole duration of the Contract, the SUPPLIER must maintain accreditation of at least twelve (12) different types of specialists for in-patient and out-patient per hospital located in Metro Manila, Cebu and Davao as enumerated under items 1 and 2. However, for other provin-cial hospitals, each accredited hospital shall maintain one (1) doctor/coordinator. The types of specialists may include, but not necessarily limited to the following:

3.1 Cardiologist/Intensivist3.2 Endocrinologist/Diabetologist3.3 ENT 3.4 Gastro Enterologist 3.5 OB Gynecologist 3.6 Anesthesiologist3.7 Surgeon

3.8 Pediatrician 3.9 Oncologist 3.10 Ophthalmologist3.11 Pulmonologist3.12 Hematologist 3.13 Nephrologist 3.14 Orthopedic – Rehab Medicine 3.15 Urologist

National Kidney Institute and Philippine Heart Center need not comply with the “twelve (12)-specialist requirement”.

Implementation Schedule:

Commencement of healthcare services shall be thirty (30) days from the receipt of the Notice to Proceed.

_____________________________ _____________________________Signature over printed name Position

Duly authorized to sign this compliance to the Schedule of Requirements for and on behalf of ________________________.

VII. TECHNICAL SPECIFICATIONSBidders must state here either “Comply” or “Not Comply” against each of the individual parameters of each Specification stating the corresponding performance parameter of the equipment offered. Statements of “Comply” or “Not Comply” must be supported by evidence in a Bidders Bid and cross-referenced to that evidence. Evidence shall be in the form of manufacturer’s un-amended sales literature, unconditional statements of specification and compliance issued by the manufacturer, samples, independent test data etc., as appropriate. A statement that is not supported by evidence or is subsequently found to be contradicted by the evidence presented will render the Bid under evaluation liable for rejection. A statement either in the Bidders statement of compliance or the supporting evidence that is found to be false either during Bid evaluation, post-qualification or the execution of the Contract may be regarded as fraudulent and render the Bidder or supplier liable for prosecution subject to the provisions of ITB Clause 3.1 (a.2) and/or GCC Clause 2.1 (a.2).

Minimum Specification STATEMENT OF COMPLIANCE

I. MATRIX OF MEMBERS

MEMBER CLASSIFICATION

MEMBERPRINCIPA DEPENDENTS

MALE FEMALE MALE FEMALEA. COO

Age Bracket : 00-25 126-3940-59 1 160-65

Subtotal 1 0 1 1B. Manager

Age Bracket : 00-25 27 2826-39 1 0 0 440-59 19 34 14 1060-65 4 8 4 1

Subtotal 24 42 45 43C. Supervisor

Age Bracket : 00-25 4 2 115 12326-39 28 34 15 1440-59 95 93 47 7460-65 4 14 18 16

Subtotal 131 143 195 227D. Rank & File

Age Bracket : 00-25 8 28 269 22526-39 54 67 40 3740-59 265 132 88 23460-65 18 11 38 28

Subtotal 345 238 435 524

TOTAL ENROLLEES 501 423 676 795

GRAND TOTAL 924 1471 Note: Figures stated above are subject to change.

Basis 2nd Quarter Billing (as of 31 March 2017 pax count)

1. MEMBERSHIP:

1.1 PRINCIPAL MEMBERPermanent or regular employees of the Procuring Entity, 18 to 65 years old with the following classifications:

Chief Operating Officer ManagersSupervisorsRank and File

1.2 IMMEDIATE DEPENDENT OF MARRIED PRINCIPAL

Additional Documentary Requirements to be submitted on the date of Opening of Bids:1. Valid and current certificate of clearance to operate as HMO from the Bureau of Health

Facilities and Services of the Department of Health (DOH) or Certificate of Authority is-sued by the Insurance Commission (IC).

2. Latest and updated list of accredited hospitals and clinics in Metro Manila and Provincial Hospitals, including but not necessarily limited to the following hospitals/clinics as enumer-ated below (hard copy and soft copy)

Metro Manila Hospitals - Refer to the list enumerated in the Schedule of Requirements under III.1

Provincial Hospitals at least one (1) hospital per Provincial Store Location; except for Cebu Store where the SUPPLIER shall maintain accreditation with at least two (2) hospitals . Refer to Schedule of Requirements under III.2

3. Certificate of Good Standing from at least ten (10) of the above mentioned Metro Manila hospitals and one (1) per provincial location hospitals (Cavite, Laguna, Rizal, Pam-panga, Cebu City, Davao City, Kalibo, Iloilo, Bacolod City and Puerto Princesa):

4. Latest and updated list of accredited specialists for in-patient and out-patient of at least twelve (12) different types of specialists per hospital located in Metro Manila, Cebu and Dav-ao as enumerated under item 2. The types of specialists may include, but not necessarily limited to the following :

a. Cardiologist/Intensivist b. Endocrinologist/Diabetologist c. ENTd. Gastro Enterologiste. OB Gynecologistf. Anesthesiologistg. Surgeonh. Pediatriciani. Oncologistj. Ophthalmologistk. Pulmonologistl. Hematologistm. Nephrologistn. Orthopedic – Rehab Medicineo. Urologist

National Kidney Institute and Philippine Heart Center need not comply with the “twelve (12)-specialist requirement”.

5. Latest and updated list (hard and soft copy) of at least one hundred thirty (130) accred-ited dentists in Metro Manila and at least two hundred (200) in the following areas in Cebu City, Davao City, Kalibo, Iloilo, Puerto Princesa, Bacolod City and Pampanga.

________________________________ _____________________________Signature over printed name Position

Duly authorized to sign this compliance to the Technical Specifications for and on behalf of

________________________.

Bidding Form No. 1

FINANCIAL DOCUMENTS FOR ELIGIBILITY CHECK

Year 20___

1 Total Assets

2 Current Assets

3 Total Liabilities

4 Current Liabilities

5 Net Worth (1-3)

6 Net Working Capital (2-4)

The Net Financial Contracting Capacity (NFCC) based on the above data is computed as follows:

NFCC = [(Current assets – current liabilities) (15)] minus value of all outstanding or uncompleted portions of the projects under ongoing contracts including awarded contracts yet to be started coinciding with the contract to be bid.

The values of the domestic bidder’s current assets and current liabilities shall be based on the latest Audited Financial Statements submitted to the BIR.

NFCC = PhP ____________________________________

Submitted by:

_____________________________________________Name of Bidder

_____________________________________________Signature of Authorized Representative over Printed Name

Date: __________________________

Bidding Form No. 2Page 1 of 2

REPUBLIC OF THE PHILIPPINES ) CITY OF _______________________ ) S.S. x-------------------------------------------------------x

BID-SECURING DECLARATION

Invitation to Bid/Request for Expression of Interest No.1: [Insert reference number]

To: Duty Free Philippines CorporationFiestamall, Columbia Complex,Ninoy Aquino Avenue, Parañaque City

I/We, the undersigned, declare that:

1. I/We understand that, according to your conditions, bids must be supported by a Bid Security, which may be in the form of a Bid-Securing Declaration.

2. I/We accept that: (a) I/we will be automatically disqualified from bidding for any contract with any procuring entity for a period of two (2) years upon receipt of your Blacklisting order; and, (b) I/we will pay the applicable fine provided under Section 6 of the Guidelines on the Use of Bid Securing Declaration, within fifteen (15) days from receipt of the written demand by the procuring entity for the commission of acts resulting to the enforcement of the bid securing declaration under Sections 23.1(b), 34.2, 40.1 and

69.1, except 69.1(f), of the IRR of RA 9184; without prejudice to other legal action the government may undertake.

3. I/We understand that this Bid-Securing Declaration shall cease to be valid on the following circumstances:

(a) Upon expiration of the bid validity period, or any extension thereof pursuant to your request;

(b) I am/we are declared ineligible or post-disqualified upon receipt of your notice to such effect, and (i) I/we failed to timely file a request for reconsideration or (ii) I/we filed a waiver to avail of said right;

(c) I am/we are declared as the bidder with the Lowest Calculated and Responsive Bid/Highest Rated and Responsive Bid, and I/we have furnished the performance security and signed the Contract.


IN WITNESS WHEREOF, I/We have hereunto set my/our hand/s this ____ day of [month] [year] at [place of execution].

[Insert NAME OF BIDDER’SAUTHORIZED REPRESENTATIVE]

[Insert signatory’s legal capacity]Affiant

SUBSCRIBED AND SWORN to before me this __ day of [month] [year] at [place of execution], Philippines. Affiant/s is/are personally known to me and was/were identified by me through competent evidence of identity as defined in the 2004 Rules on Notarial Practice (A.M. No. 02-8-13-SC). Affiant/s exhibited to me his/her [insert type of government identification card used], with his/her photograph and signature appearing thereon, with no. ______ and his/her Identification Card No. _______ issued on ______ at ______.

Witness my hand and seal this ___ day of [month] [year].

NAME OF NOTARY PUBLIC Serial No. of Commission ___________ Notary Public for ______ until _______ Roll of Attorneys No. _____ PTR No. __, [date issued], [place issued] IBP No. __, [date issued], [place issued]

Doc. No. ___ Page No. ___ Book No. ___ Series of ____.


Omnibus Sworn Statement

REPUBLIC OF THE PHILIPPINES )CITY/MUNICIPALITY OF ______ ) S.S.

A F F I D AV I T

I, [Name of Affiant], of legal age, [Civil Status], [Nationality], and residing at [Address of Affiant], after having been duly sworn in accordance with law, do hereby depose and state that:

1. Select one, delete the other:If a sole proprietorship: I am the sole proprietor or authorized representative of [Name of Bidder] with office address at [address of Bidder];

If a partnership, corporation, cooperative, or joint venture: I am the duly authorized and designated representative of [Name of Bidder] with office address at [address of Bidder];

2. Select one, delete the other:If a sole proprietorship: As the owner and sole proprietor, or authorized representative of [Name of Bidder], I have full power and authority to do, execute and perform any and all acts necessary to participate, submit the bid, and to sign and execute the ensuing contract for [Name of the Project] of the [Name of the Procuring Entity], as shown in the attached duly notarized Special Power of Attorney;

If a partnership, corporation, cooperative, or joint venture: I am granted full power and authority to do, execute and perform any and all acts necessary to participate, submit the bid, and to sign and execute the ensuing contract for [Name of the Project] of the [Name of the Procuring Entity], as shown in the attached [state title of attached document showing proof of authorization (e.g., duly notarized Secretary’s Certificate, Board/Partnership Resolution, or Special Power of Attorney, whichever is applicable;)];

3. [Name of Bidder] is not “blacklisted” or barred from bidding by the Government of the Philippines or any of its agencies, offices, corporations, or Local Government Units, foreign government/foreign or international financing institution whose blacklisting rules have been recognized by the Government Procurement Policy Board;

4. Each of the documents submitted in satisfaction of the bidding requirements is an authentic copy of the original, complete, and all statements and information provided therein are true and correct;

5. [Name of Bidder] I is authorizing the Head of the Procuring Entity or its duly au-thorized representative(s) to verify all the documents submitted;

6. Select one, delete the rest:If a sole proprietorship: The owner or sole proprietor is not related to the Head of the Procuring Entity, members of the Bids and Awards Committee (BAC), the Technical Working Group, and the BAC Secretariat, the head of the Project Management Office or the end-user unit, and the project consultants by consanguinity or affinity up to the third civil degree;


If a partnership or cooperative: None of the officers and members of [Name of Bidder] is related to the Head of the Procuring Entity, members of the Bids and Awards Committee (BAC), the Technical Working Group, and the BAC Secretariat, the head of the Project Management Office or the end-user unit, and the project consultants by consanguinity or affinity up to the third civil degree;

If a corporation or joint venture: None of the officers, directors, and controlling stockholders of [Name of Bidder] is related to the Head of the Procuring Entity, members of the Bids and Awards Committee (BAC), the Technical Working Group, and the BAC Secretariat, the head of the Project Management Office or the end-user unit, and the project consultants by consanguinity or affinity up to the third civil degree;

7. [Name of Bidder] complies with existing labor laws and standards; and

8. [Name of Bidder] is aware of and has undertaken the following responsibilities as a Bidder:

a) Carefully examine all of the Bidding Documents;

b) Acknowledge all conditions, local or otherwise, affecting the implementation of the Contract;

c) Made an estimate of the facilities available and needed for the contract to be bid, if any;

d) Inquire or secure Supplemental/Bid Bulletin(s) issued for the [Name of the Pro-ject]; and

e) Responsible for any erroneous interpretation or conclusion out of the data fur-nished by the PROCURING ENTITY.

9. [Name of Bidder] did not give or pay directly or indirectly, any commission, amount, fee, or any form of consideration, pecuniary or otherwise, to any person or official, personnel or representative of the government in relation to any procurement project or activity.

IN WITNESS WHEREOF, I have hereunto set my hand this __ day of ___, 20__ at ____________, Philippines.

_____________________________________Bidder’s Representative/Authorized Signatory


SUBSCRIBED AND SWORN to before me this ___ day of [month] [year] at [place of execution], Philippines. Affiant/s is/are personally known to me and was/were identified by me through competent evidence of identity as defined in the 2004 Rules on Notarial Practice (A.M. No. 02-8-13-SC). Affiant/s exhibited to me his/her [insert type of government identification card used], with his/her photograph and signature appearing thereon, with no. ________ and his/her Community Tax Certificate No. _______ issued on ____ at ______.

Witness my hand and seal this ___ day of [month] [year].

NAME OF NOTARY PUBLIC

Serial No. of Commission _______________

Notary Public for _______ until __________

Roll of Attorneys No. __________________

PTR No. ______ [date issued], [place issued]

IBP No. ______ [date issued], [place issued]

Doc. No. _______Page No. _______Book No. _______Series of _______

Bidding Form No. 4Bid Form

Date:

To: MR. BERNARDINE R. BELMONTEDuty Free Philippines CorporationFiestamall, Columbia Complex,Ninoy Aquino Avenue, Parañaque City

Gentlemen and/or Ladies:

Having examined the Bidding Documents including Bid Bulletin Numbers [insert numbers], the receipt of which is hereby duly acknowledged, we, the undersigned, offer to PROVISION OF DFPC HEALTHCARE SERVICES (HRMD1705) in conformity with the said Bidding Documents for the sum of [total bid amount in words and figures] or such other sums as may be ascertained in accordance with the Schedule of Prices attached herewith and made part of this Bid.

We undertake, if our Bid is accepted, to deliver the goods in accordance with the delivery schedule specified in the Schedule of Requirements.

If our Bid is accepted, we undertake to provide a performance security in the form, amounts, and within the times specified in the Bidding Documents.

We agree to abide by this Bid for the Bid Validity Period specified in BDS provision for ITB Clause 18.2 and it shall remain binding upon us and may be accepted at any time before the expiration of that period.

Until a formal Contract is prepared and executed, this Bid, together with your written acceptance thereof and your Notice of Award, shall be binding upon us.

We understand that you are not bound to accept the Lowest Calculated Bid or any Bid you may receive.

We certify/confirm that we comply with the eligibility requirements as per ITB Clause 5 of the Bidding Documents.

We likewise certify/confirm that the undersigned, [for sole proprietorships, insert: as the owner and sole proprietor or authorized representative of Name of Bidder , has the full power and authority to participate, submit the bid, and to sign and execute the ensuing contract, on the latter’s behalf for the Name of Project of the Name of the Procuring Entity] [for partnerships, corporations, cooperatives, or joint ventures, insert: is granted full power and authority by the Name of Bidder, to participate, submit the bid, and to sign and execute the ensuing contract on the latter’s behalf for Name of Project of the Name of the Procuring Entity].

We acknowledge that failure to sign each and every page of this Bid Form, including the attached Schedule of Prices, shall be a ground for the rejection of our bid.

Dated this ________________ day of ________________ 20______.

[signature] [in the capacity of]

Duly authorized to sign Bid for and on behalf of

Bidding Form No. 5

PRICE SCHEDULE

1 2 3 4 5 6

Description Quantity Unit Price Per Quarter Applicable Tax

Total Unit Price Per Quarter(Col. 3 + 4)

Total Cost Per Quarter

(Cols. 5 x 2)PRINCIPAL MEMBERS

A. Chief Operating Officer

1

B. Managers 66

C. Supervisors 274

D. Rank and File 583

TOTAL 924Total Bid per

Quarter (Principal Members)

DEPENDENTSA. Chief Operating Officer

2

B. Managers 88

C. Supervisors 422

D. Rank and File 959

TOTAL 1,471Total Bid per

Quarter (Dependents)

TOTAL BID PER QUARTER

(Principal + Dependents)

GRAND TOTAL (Total Bid per Quarter x 4)

__________________________________________________________________

Signature over printed name Position

Duly authorized to sign this Price Schedule for and on behalf of ___________________

Date: ___________________________

Bidding Form No. 6

CONTRACT AGREEMENT FORM

THIS AGREEMENT made the _____ day of __________ 20_____ between Duty Free Philippines Corporation (hereinafter called “the Entity”) of the one part and [name of Supplier] of [city and country of Supplier] (hereinafter called “the Supplier”) of the other part:

WHEREAS the Entity invited Bids for certain goods and ancillary services, viz., [brief description of goods and services] and has accepted a Bid by the Supplier for the supply of those goods and services in the sum of [contract price in words and figures] (hereinafter called “the Contract Price”).

NOW THIS AGREEMENT WITNESSETH AS FOLLOWS:

1. In this Agreement words and expressions shall have the same meanings as are respectively assigned to them in the Conditions of Contract referred to.

2. The following documents shall be deemed to form and be read and construed as part of this Agreement, viz.:

(a) the Supplier’s Bid, including the Technical and Financial Proposals, and all other documents/statements submitted (e.g. bidder’s response to clarifications on

the bid), including corrections to the bid resulting from the Procuring Entity’s bid evaluation;

(b) the Schedule of Requirements;(c) the Technical Specifications;(d) the General Conditions of Contract;(e) the Special Conditions of Contract; (f) the Performance Security; and(g) the Entity’s Notification of Award.

3. In consideration of the payments to be made by the Entity to the Supplier as hereinafter mentioned, the Supplier hereby covenants with the Entity to provide the goods and services and to remedy defects therein in conformity in all respects with the provisions of the Contract

4. The Entity hereby covenants to pay the Supplier in consideration of the provision of the goods and services and the remedying of defects therein, the Contract Price or such other sum as may become payable under the provisions of the contract at the time and in the manner prescribed by the contract.

IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed in accordance with the laws of the Republic of the Philippines on the day and year first above written.

Signed, sealed, delivered by the (for the Entity)

Signed, sealed, delivered by the (for the Supplier)

[ACKNOWLEDGEMENT]

Bidding Form No. 7

Motion for Reconsideration

Date of Issuance

Mr. Bernardine R. BelmonteDuty Free Philippines CorporationFiestamall, Columbia Complex,Ninoy Aquino Avenue, Parañaque City

Dear Madame:

In relation to the results of the Bid Opening/Post-Qualification conducted for the bidding of the ( Name of Project) held on (date and time) at (venue) , we would like to request for reconsideration the decision of “Ineligibility” of our of our firm on the following grounds:

We are hoping for your consideration.

Very truly yours,

Name of the Representative of the BidderPosition of the RepresentativeName of the Bidder

Received by the BAC:

__________________________

Date:______________________

IX. EMPLOYEE PAID DEPENDENTS 1. The PRINCIPAL MEMBERS- may opt to enrol additional dependents. These

dependents are those not included in the Matrix of Members (Principal and Dependents)

1.1 IMMEDIATE DEPENDENT- as described under 1.2, 1.3, and 1.4 of the Technical Specifications.

1.1.1 Immediate dependents of single principal member- who gets married during the contract period shall continue to be classified as immediate dependent/s of the former single principal members until the expiration of the contract, if he/she opts to continue coverage.

1.2 EXTENDED DEPENDENT– those who are financially dependent on the principal member, not categorized as immediate dependents, subject to the same limitations stated in the Technical Specifications.

1.2.1 Parents of married principal members- who were covered by our previous HMOs for the last three (3) years.

2. The premiums of these members shall be paid by the principal member through the PROCURING ENTITY and are not included as part of the Approved Budget for the Contract (ABC).

3. A separate agreement shall be entered into by the SUPPLIER and PROCURING ENTITY to cover this Section. The bidding documents shall be supplementary to the said agreement unless specifically provided otherwise in this Section.

4. Proposed rates for this Section shall be prepared by the SUPPLIER as a required submission under 13.1(a) of the Instruction to Bidders (ITB).

5. Proposed rates for immediate dependents shall follow the same rate as indicated in the submitted Price Schedule of SUPPLIER’s Financial Proposal.

6. The utilization under this section shall not be considered in computing the utilization of company paid members.

Annex 1 of Section IX

PROPOSED RATES FOREMPLOYEE PAID DEPENDENTS

Name of Bidder _________________

For Employee-Paid Dependents

1 2 3 4 5 6

Description Quantity Unit Price

Per Quarter

Applicable Tax

Total Price(Cols. 3 + 4)

Total Annual Price

(Col. 5 x 4)IMMEDIATE DEPENDENTS

A. Managers

Age Bracket 00 – 65 1

B. Supervisors


C. Rank and File


Proposed rates for immediate dependents shall follow the same rate as indicated in the submitted Price Schedule of the SUPPLIER’s Financial Proposal

1 2 3 4 5 6

Description Quantity Unit Price

Per Quarter

Applicable Tax

Total Price(Cols. 3 + 4)

Total Annual Price

(Col. 5 x 4)EXTENDED DEPENDENTS

A. Managers


B. Supervisors


C. Rank and File


________________________________ ________________________________Signature over printed name PositionDuly authorized to sign this Proposed Rates for Employee Paid Dependents for and on behalf of __________________________