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: 03/2018/HP/IR Belgium (Package # 03) Please complete, sign and return to PR No: 02/2018 Islamic Relief Worldwide BangladeshDate: January 04, 2018 Tel: 9893458, 8819392, 8859128, 8859128

To

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

1 Deep Set Pump As per attached BOQ and

Design of Deep Tube Well

No's 100

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 100 units of Deep Set Pump under HP Program of IR Belgium Project at Modhupur Upazila,

Tangail.

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 150 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 Fulbag Chala and Sholakori Union

of Modhupur Upazila of Tangail.

Page 1 of 1

Reference Purchase Order# Dated#

Qty/

TW

Tube

well

Unit Rate Total

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

1 Mobilization Ls 1 100

Mobilization of human resources, materials, equipments and

boring tools at spot to accomplish the assignment as design

and direction of the Engineer-in-charges (EIC).

2 Tube well Head Set 1 100

Supply of No.6 hand pump (RFL heavy duty with weight

minimum 28±1 kg with 900 mm Handle, which excludes of

Base plate & Piston assemble; should be free from any kind of

defect) and painting by 1 coat anticrossive paint and 3 coats

synthetic enamel paint of green colour etc.all complete as per

instruction of Engineer-in-Charge 3 Bottom Flange Assembly (alternativbe Base Plate) Set 1 100

Supply of MS Pipe: Ø-112mm (4"-NB) x 900mm long 4mm

thicker MS pipe, welded with ø170mm 11-12mm thick MS

flange. MS Rod: 4 nos. ø 10mm diameter 235±5mm long MS

rod welded with pipe.(hot deep galvanized) -Rubber Cone

Grommet: Rubber(soft uPVC) cone grommet (55-70 shores)

with gasket (Brand: MAWTS/Kazi/RFL/Hatim/KRP, Any other

quivalent approved brand (approved by Islamic Relief,

Bangladesh) ), all set as per design/instruction of Engineer In

Charge. 4 Round Top Rod Set 1 100

Supply of Ø12mm x 382mm long SS round Holder Rod Hanger

with one M10 MS bolt (electro-plated) (Brand: Indian/ chaina

type, Any other quivalent approved brand (approved by

Islamic Relief, Bangladesh)) as per design/ direction of

Engineer In Charge.5 Piston Assembly -  Set 1 100

Supply of 55mm double-cup seal to maximize the water

quantity; nitrile rubber made cup seal, polyamide/nylon cup

seal holder; SS shaft with M12 thread; nut washer and grapple

hook (Brand: MAWTS/Kazi/KRP,Any other quivalent approved

brand(approved by Islamic Relief, Bangladesh)) as per

design/direction of Engineer In Charge.

6 Cylinder Assembly Set 1 100

Supply of Cylinder Assembly HDPE foot valve body with M-6 SS

bolt, nitrile rubber flap valve and 10-12mm SS guide rod and

rubber O-ring to ensure water sealing, OD 60 ± 2 mm x ID

55±1.0mm x 0.6±0.05M (1.2 mm SS lining) fitted with ø50mm

male coupler and rubber bottom seat;(Brand:

MAWTS/Kazi/RFL/KRP, Any other quivalent approved brand

(approved by Islamic Relief, Bangladesh)) and fitting-fixing as

ISLAMIC RELIEF BANGLADESH

WaSH facilities for the Targeted Communities living in North Central part of Bangladesh 2017

Scope of Work: Supply of materials with necessary equipments/tools and mobilization of manpower and

Installation of Deep-set types Tube-wells (TW) at Fulbagchala and Solakur union of madhupur of tangail.

Bill of Qunatities (BOQ)

SL Description Unit

Qty/

TW

Tube

well

Unit Rate Total

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

SL Description Unit

7 Foot Valve Assembly Set 1 100

Supply of Foot Valve Assembly - HDPE foot valve body with M-

6 SS bolt, nitrile rubber flap valve and 10-12mm SS T-guide

rod and rubber O-ring to ensure water sealing. (Brand:

MAWTS/Kazi/KRPAny other quivalent approved brand(approved

by Islamic Relief, Bangladesh)) and fitting-fixing as per

design/direction of Engineer In Charge.

8 Pump Rod Assembly -  Rft 100 100

Supply of Pump Rod Assembly - Ø9mm SS (Stainless Steel)

pump rod x 3.6±0.15M long with M/F M12 threaded connector

and centralizer at each joint (Indian/ Chaina Type, Any other

quivalent approved brand(approved by Islamic Relief,

Bangladesh)) and fitting-fixing as per design/direction of

Engineer In Charge.9 Main Rising PVC pipe 50mm dia Rft 100 100

Supplying Main Rising Main - Ø50mm (NB) Class D (BS-3505 x

3.0±0.05M/ 4.5±0.05 M long uPVC pipe Thickness 3.10-

3.70mm with both end joint by 2 additional socket Shoket and

two ring od rubber.(Brand: NPoly/Partex/RFL/Madina, Any

other quivalent approved brand(approved by Islamic Relief,

Bangladesh)) with fitting-fixing as per design/direction of

Engineer In Charge.10 uPVC Blind Pipe (3" dia) Casing pipe Rft 100 100

Supply of Casing pipe- 3” dia upvc pipe -Ø75mm (NB) Class C

grade water class (BS-3505 x 6.0±0.05M long Thickness 3.50-

4.10mm uPVC pipe with both end male and female plain

socketjoint with solvent cement as per BSTI approved

manufacturer such as RFL/Partex/National Polymer/Madina or

any approved brand (approved by Islamic Relief, Bangladesh),

lowering and fiting-fixing as per design and instruction of 11 uPVC Blind Pipe (1.5" dia) Rft 90 100

Supply of 1.5” dia uPVC pipe -Ø38mm (NB) Class D (BS-3505 x

4.5.0±0.05M long uPVC pipe ( Thickness 2.5-3.0 MM) with both

end male and female plain socketjoint with solvent cement as

per BSTI approved manufacturer such as

RFL/Bashundhara/National Polymer/Madina or any approved

brand (approved by Islamic Relief, Bangladesh) 12 uPVC Reducer (1.5"x3") No. 1 100

Supplying & lowering of uPVC pipe reducer of dia 1.5"x 3" (D

Grade-Water Class; Brand- RFL/Bashundhara/National Polymer

/Partex or any Islamic Relief approved brand including

required Solvent Cement (Adhesive Glue))with necessary fitting

and fixing.13 PVC Strainer Rft 13 100

Supplying, fixing and lowering the PVC Robo screen (uPVC

Pipe Strainer (water grade) of 38 mm dia with uniform

thickness ( 2.5- 3.00mm) without any defect. Length may vary

based on the requirement of under ground aquifer and as per

the written direction of Engineer In charge.

14 Coarse Sylhet sand (FM-2.00) Cft 4 100

Supplying & Filling up the space between bore hole & the tube

well by coarse Sylhet sand (FM-2.00) from bottom of the bore

hole up to 6 meter from top of the filter.

Qty/

TW

Tube

well

Unit Rate Total

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

SL Description Unit

15 Tube well installation Rft 200 100

Boring/Drilling by using 150 mm dia cutter and 40mm dia GI

pipes and another materials such as betonies, 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) and ensuring safe water through

fresh aquifer while boring, all complete as per direction of

Engineer In Charge.

16 Construction of RCC Platform(6'-0"x6'-0"x1'-6") No. 1 100

Earth cutting and Earth filling and Construction of concrete

platform (6'-0"x6'-0"x1'-6") including stair and Tube well GI

pipe pase using 19 mm downgraded brick chips (1st class),

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

proportion of 1:2:4 as per attached design and specification

including plastering (12 mm thick, 1:4) & neat cement

finishing (NCF) including 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). Used Brick

chips and Sand should be netted and washed accordingly.

Inside will be compacted enough and 9 inch sand will be

provided on the compacted earth, all complete as per design

and specification and as per direction of Engineer In Charge.

Detail design is attached herewith.17 Drainage System Rft 15 100

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

Brand: RFL/Bashundhara/National Polymer/Partex/Madina (

Thickness 3.5-4.10 )or any approved brand by IR) with

necessary earth cutting, earth filling, stainless steel screen and

fittings such as bend, elbow, 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. 18 Locking Arrangement Set 1 100

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

4'-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.

19 Tube-wells Name Plate Supply No. 1 100

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

6"x1'-0"x 17±1 mm thickness) with Islamic Relief logos and

written text (Bangla/English/Arabic/all), 4 color, all complete as

per given sample and instruction of Engineer In Charge.

In Words: Only Taka…………………………………………………………………………………………………………….

Working Area:

________________________________

Total Amount (BDT) =

(Signature of the Contractor with Seal)

fulbag chala and Sholakori union of Madhupur Upzila of Tangail

W1 W2 W3 W4 W9 W10 W11 W12 W13 W14 W15 W16 W17 W18 W19 W20 W21 W22

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

___________________

Signature (with seal)

I, the following signatory have the capacity to maintain the proposed action flow and signed below

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

ISLAMIC RELIEF BANGLADESH

Humanitarian Programmes

WaSH facilities for the Targeted Communities living in North Central part of Bangladesh 2017

Annex-1: Action Plan of Wdeep set pump Installation

SL Activity Breakdown Work Accomplishing period (Week wise)

Month-1