GPSU.SF-19.

IOM Libya Mission

REQUEST FOR QUOTATIONS (RFQ)

AND
GENERAL INSTRUCTION TO SUPPLIERS (GIS)1

To : All eligible interested suppliers.

Project: Medicines and medical supplies for medical operations in the east of Libya.
Ref. No.: LY21-300
Date : 14 NOV 2021

The International Organization for Migration (IOM) is an intergovernmental organization

established in 1951 and is committed to the principle that humane and orderly migration
benefits both migrants and society.

In the framework of MHD Program, the IOM invites interested eligible Suppliers to submit
Quotations for the supply and delivery of Medicines and medical supplies for medical
operations in the east of Libya.

Item Item Description Quantity Unit

No.
1. Adrenalin 1mg/ml ampule - Pack of 10 Amp 5 Pack
2. Albendazol 400mg Tablets - Pack of 1 Tab 50 Pack
3. Amiodarone 150mg/3ml - Pack of 5 Amp 1 Pack
4. Amlodipine 5mg Tablet - Pack of 28 Tab 100 Pack
5. Amoxicillin 250mg Syrup - Bottle 100 ml 60 Bottl
e
6. Amoxicillin 500mg Capsule - Pack of 21 Cap 325 Pack
7. Amydramine Syrup - Bottle 120 ml 240 Bottl
e
8. Antacid syrup - Bottle 200 ml 350 Bottl
e
9. Aspirin 75 mg Tablet - Pack of 56 Tab 75 Pack
10. Atorvastatin 20mg Tablet - Pack of 30 Tab 100 Pack
11. Augmentin 156 mg/5ml - Bottle 100 ml 55 Bottl
e
12. Augmentin 1g Tablet - Pack of 15 Tab 250 Pack
13. Augmentin 457 mg/5ml - Bottle 100 ml 140 Bottl
e
14. Augmentin 625 mg Tablet - Pack of 20 Tab 235 Pack
15. Azithromycin 200mg/5ml - Bottle 15 ml 140 Bottl
e
16. Azithromycin 500mg Tablet - Pack of 3 Tab 400 Pack
17. Beclomethasone Dipropionate 250mcg inhaler - Inhaler 8 EA

1
18. Benzyl Benzoate lotion (Ascalol) - 125 ml Bottle 300 Bottl
e
19. Betamethasone valerate 0.1% cream - 15 g Tube 250 EA
20. Bisoprolol fumarate 5mg Tablet - Pack of 28 Tab 90 Pack
21. Budesonide 0.5mg/2ml nebulizer suspension - Pack of 20 8 Pack
Nebules
22. Calamin Lotion - Bottle 200 ml 300 Bottl
e
23. Carbamazepine 400 mg CR Tablet - Pack of 30 Tab 25 Pack
24. Cefixime 100 mg/5 ml suspension - Bottle 30 ml 85 Bottl
e
25. Cefixime 400 mg Capsule - Pack of 5 Cap 125 Pack
26. Ceftriaxone 1g IM - Pack of 1 Vial 135 Pack
27. Chloramphenicol 1% eye Ointment - 5g Tube 150 EA
28. Chlorpheniramine Syrup 2mg/5ml - Bottle 100 ml 100 Bottl
e
29. Ciprofloxacin 500mg Tablet - Pack of 10 Tab 275 Pack
30. Ciprofloxacin hydrochloride 0.3% eye/ear drops - Bottle 5 ml 150 Bottl
e
31. Clotrimazole 1% spray - Spray 40 ml 150 EA
32. Clotrimazole skin cream 1% - 20 g Tube 75 EA
33. Clotrimazole Vaginal Tab 100mg+Applicator - Pack of 6 Tab 75 Pack
34. Depakine 500 mg (Sodium Valproate ) Tablet - Pack of 40 Tab 10 Pack
35. Dewax ear drops (0.5% Docusate Sodium) - Bottle 10 ml 150 Bottl
e
36. Dexamethasone 0.5mg/5ml - Bottle 100 ml 150 Bottl
e
37. Dexamethasone 4mg/ml - Pack of 10 Amp 35 Pack
38. Dextromethorphan Syrup 15mg/5ml - Bottle 120 ml 300 Bottl
e
39. Dextrose 5% injectable solution - 500 ml Bag 100 EA
40. Dextrose 50% injection - Amp of 10ml 15 EA
41. Diamicron (Gliclazide) 60mg MR Tablet - Pack of 30 Tab 20 Pack
42. Diclofenac Sodium 1% Gel - 30 g Gel Tube 500 EA
43. Diclofenac Sodium 50 mg Tablet - Pack of 20 Tab 500 Pack
44. Diclofenac Sodium 75mg/3ml Injection - Pack of 5 Amp 100 Pack
45. Doxycycline 200mg Tablet - Pack of 8 Tab 100 Pack
46. Eucarbon Tablet - Pack of 20 Tab 140 Pack
47. Ferrous Sulphate 200 mg Tablet - Pack of 30 Tab 160 Pack
48. Fluconazol Tab 150mg - Pack of 1 Tab 100 Pack
49. Folic Acid 5mg Tablet - Pack of 28 Tab 160 Pack
50. Fucicort Cream - 15 g Tube 375 EA
51. Furosemide 20mg/2ml - Pack of 10 20 Pack
52. Fybogel sachet - Pack of 10 Sach 300 Pack
53. Gentamicin 0.3% eye drops - Singel Pack 225 Pack
54. Glibenclamide 5mg Tablet - Pack of 60 Tab 115 Pack
55. Glycerin Suppository Adult - Pack of 10 Supp 280 Pack
56. Glycerin Suppository Childern - Pack of 10 Supp 150 Pack
57. Hydrochlorothiazide 25 mg Tablet - Pack of 20 Tab 20 Pack
58. Hydrocortisone 100mg Vial - Vial 100 EA
59. Hydrocortisone Acetate Ointment 1% - 15 g Tube 250 EA
2
60. Hyoscine Butylbromide 10 mg Tablet - Pack of 20 Tab 375 Pack
61. Hyoscine Butylbromide 20 mg/ml - Pack of 6 Amp 75 Pack
62. Ibuprofen 100mg/5ml - Bottle 100 ml 50 Bottl
e
63. Ibuprofen 400mg Film Coated - Pack of 24 Tab 550 Pack
64. Lactulose Syrup - Bottle 200 ml 125 Bottl
e
65. Levothyroxine 50 mcg Tablet - Pack of 28 Tab 20 Pack
66. Librax Tablet (5 mg chlordiazepoxide /2.5 clidinium bromide - 75 Pack
Pack of 30 Tab
67. Lidocain 2% injection - Single Vial 75 EA
68. Lisinopril 10mg Tablet - Pack of 28 Tab 100 Pack
69. Loperamide 2mg Capsule - Pack of 10 Cap 140 Pack
70. Loratadine 10mg Tablet - Pack of 10 Tab 400 Pack
71. Mebo Cream (25%w/w B-sitosterol) - 15 g Tube 150 EA
72. Metformin 1000 mg Tablet - Pack of 30 Tab 150 Pack
73. Metformin 500 mg Tablet - Pack of 30 Tab 210 Pack
74. Metformin 850 mg Tablet - Pack of 30 Tab 210 Pack
75. Metoclopramaide 10mg Injection - Pack of 10 Amp 35 Pack
76. Metoclopramaide 10mg Tablet - Pack of 40 Tab 90 Pack
77. Metronidazole 125 mg/5ml Suspension - Bottle 100 ml 60 Bottl
e
78. Metronidazole 500mg Tablet - Pack of 30 Tab 100 Pack
79. Miconazole Vaginal Cream 2% - 78 g Tube 150 EA
80. Mixtard 70/30 Suspension for Injection 100IU/ml - Vial 10 ml 100 EA
81. Multivitamins Childern Syrup - Bottle 100 ml 75 Bottl
e
82. Multivitamins Tablet - Pack of 30 Tab 500 Pack
83. Muscadol Tablet - Pack of 20 Tab 300 Pack
84. Nifedipine Retard 20 mg Tablet - Pack of 30 Tab 50 Pack
85. Normal Salin 0.9% IV solution - 500 ml Bag 150 EA
86. Normal Salin 0.9% nasal drops - 10 ml dropper 300 EA
87. Nystatin suspension 100 000 IU/ mL - Bottle of 30 ml 125 Bottl
e
88. Omeprazol 40 mg Capsule - Pack of 28 Cap 525 Pack
89. Omeprazol 40 mg Vial - Pack of 1 vial 70 Pack
90. ORS (oral rehydration salt) - Pack of 10 sach 200 Pack
91. Otipax ear drops (Lidocaine hydrochloride+Phenazone) - 150 Bottl
Drppper Bottle 15 ml e
92. Paracetamol 1000mg /100ml infusion - Singel Pack 150 Pack
93. Paracetamol 150mg Suppository - Pack of 10 Supp 150 Pack
94. Paracetamol 250mg Syrup - Bottle 100 ml 225 Bottl
e
95. Paracetamol 500 mg Tablet - Pack of 100 Tab 500 Pack
96. Prednisolone 5 mg Tablet - Pack of 20 Tab 100 Pack
97. Prisoline eye drops - Dropper Bottle 220 Bottl
e
98. Rhinostop Tablet - Pack of 20 Tab 325 Pack
99. Ringer Lactate IV solution - 500 ml Bag 70 EA
100. Salbutamol 0.1 mg/dose Inhaler 200 doses - Inhaler 125 EA
101. Salbutamol nebules 2.5mg/2.5 ml - Pack of 20 Nebules 8 Pack
3
102. Salicylic acid ointment 40% - Jar of 30g 30 EA
103. Silver sulfadiazine cream 1% - 50 g Tube 125 EA
104. Sudocream - 60 gm Jar 175 EA
105. Sulphur Ointment 3% - 30 gm Jar 200 EA
106. Sulphur Soap - Single Pack 300 Pack
107. Supraproct-S cream (antihemorroidal cream) - 20 g Tube 175 EA
108. Thiocolchicoside 4mg/2ml - Pack of 6 Amp 75 Pack
109. Trifed Syrup - Bottle 100 ml 250 Bottl
e
110. Uricol Sachet - Pack of 12 sach 400 Pack
111. Vitamin B complex Tablet - Pack of 30 Tab 220 Pack
112. Vitamin B6 25mg Tablet - Bottle of 30 Tab 100 Bottl
e
113. Vitamin C (Ascorbic Acid) 500mg - Pack of 30 Tab 450 Pack
114. Water for injection 10ml - Pack of 100 Amp 10 Pack
115. Xylometazoline 0.05% nasal drops - Singel Pack 90 Pack
116. Absorbent Cotton wool - Single unit 100 EA
117. Adhesive non woven wound dressing Roll 15 cm X 10 M - 75 EA
Single unit
118. Alcohol hand gel sanitizer 70% - Bottle 500 ml 260 Bottl
e
119. Alcohol swabs ‐3mm X 3mm - Pack of 100 60 Pack
120. Biohazard Bags 10 L - Pack of 100 20 Pack
121. Blood Lancet for Glucometer - Pack of 100 30 Pack
122. Cannula, IV short, 18G (1.3 x 32 mm) sterile,disposable - Single 500 EA
unit
123. Cannula, IV short, 20G (1.1 x 32 mm) sterile,disposable - Single 500 EA
unit
124. Cannula, IV short, 22G (0.9 x 25 mm) sterile,disposable - Single 500 EA
unit
125. Disposable sharp bin container - Single unit 30 EA
126. Disposable Bed sheets - Single unit 1,000 EA
127. Elastic Crepe Bandages 10 cmX 4m - Roll 2,000 EA
128. Foley Catheter sizeFoley Catheter size 18 - 200 200 EA
129. Face masks Surgical Type IIR - Pack of 50 250 Pack
130. Glucometer test strips (Accu check ) - Pack of 50 test strips 75 Pack
131. Gauze bandage roll 10 cm cmx 4.5 m - Single unit 500 EA
132. Infusion Set - Single set 400 EA
133. Nebulizer masks ( adult size) - Single set 50 EA
134. Nebulizer masks ( Pediatric size) - Single set 50 EA
135. Nitrile Examination Gloves Size L (AQL 1.5) - Box of 100 200 Box
136. Non Sterile Gauze Pads 7.5cm X 7.5cm - Pack of 100 Pad 200 Pack
137. Non woven adhesive wound dressing 10cm x 10cm - Pack of 50 50 Pack
PCS
138. N95 mask (3M-1860) - Singel Mask 200 EA
139. Oxygen Mask (Adult size) - Singel unit 50 EA
140. Parafine Dressing Gauze 10cm X10 cm - Pack of 10 225 Pack
141. Povidone Iodine 10% - 1 Liter 50 EA
142. Covid-19 Rapid Antigen Test Kit - Single unit 400 EA
143. Syringes Insulin U-100 1ml - Singel Unit 2,000 EA
144. Sterile Disposable Syringes 5 ml - Singel Unit 1,000 EA
4
 145. Sterile Disposable Syringes 10 ml - Single Unit 2,500 EA
146. Sputum collection conatiner 60 ml - Single unit 400 EA
147. Sterile Surgical Gloves Size 7.5 - Box of 50 pair 12 Box
148. Surgical Sterile Gloves Size 8 - Box of 50 pair 12 Box
149. Sterile Gauze Swab 10 cmX 10 cm - Pack of 100 150 Pack
150. Surgical Vicryl Stitches ( Size 0-6 ) - Pack of 12 35 Pack
151. Surgical Vicryl Stitches ( Size 0-3 ) - Pack of 12 35 Pack
152. Surgical gown reinforced sterile size L and XL - Single pack 500 Pack
153. Urine Collection Bag 2000 ml - Single unit 200 EA
154. Transport and Handling (unloading of medicines and medical 1 EA
supplies) to IOM storage in Benghazi City.

Important information to Vendors and suppliers:

- Deadline of RFQ: 24 November 2021

- Bid offer currency: USD
- Submission of bid: by email (signed and stamped) to iomlibyaproposal@iom.int
- Delivery location will be at Benghazi City.
- Price of transportation, packing and labeling costs should be input on last item No.154 on
Price list.
- All Medicines must have min 18 Months Shelf life; expiration date must exceed 18 months
at the date of delivery.
- All Medical equipment must have at least 1-year warranty.
- Eligible Interested vendors and suppliers who will pass the shortlist will be asked to
present a physical sample delivered to IOM-Libya office (Hal Alkuwait , Janzour).

With this RFQ is the GIS which include the Instructions to Suppliers, Technical
Specifications and administrative requirements that Suppliers will need to follow in order to
prepare and submit their quotation for consideration by IOM.

IOM reserves the right to accept or reject any quotation, and to cancel the procurement process
and reject all quotations at any time prior to award of Purchase Order or Contract, without
thereby incurring any liability to the affected Supplier/s or any obligation to inform the affected
Supplier/s of the ground for IOM’s action.

Very truly yours,

IOM Procurement Unit
Procurement Staff/Focal Point

IOM is encouraging companies to use recycled materials or materials coming from

sustainable resources or produced using a technology that has lower ecological footprints.

5
 GENERAL INSTRUCTION TO SUPPLIERS (GIS)

1. Description of Goods

IOM request prospective suppliers to submit quotation for the supply and delivery of
Medicines and medical supplies for medical operations in the east of Libya at Benghazi.
As per the above table

2. Corrupt, Fraudulent, and Coercive Practices

IOM requires that all IOM Staff, manufacturers, suppliers or distributors, observe the
highest standard of ethics during the procurement and execution of all contracts. IOM shall
reject any proposal put forward by Suppliers, or where applicable, terminate their contract,
if it is determined that they have engaged in corrupt, fraudulent, collusive or coercive
practices. In pursuance of this policy, IOM defines for purposes of this paragraph the terms
set forth below as follows:

 Corrupt practice means the offering, giving, receiving or soliciting, directly or

indirectly, of any thing of value to influence the action of the Procuring/Contracting
Entity in the procurement process or in contract execution;

 Fraudulent practice is any act or omission, including a misrepresentation, that

knowingly or recklessly misleads, or attempts to mislead, the Procuring/Contracting
Entity in the procurement process or the execution of a contract, to obtain a
financial gain or other benefit to avoid an obligation;

 Collusive practice is an undisclosed arrangement between two or more bidders

designed to artificially alter the results of the tender procedure to obtain a financial
gain or other benefit;

 Coercive practice is impairing or harming, or threatening to impair or harm, directly

or indirectly, any participant in the tender process to influence improperly its
activities in a procurement process, or affect the execution of a contract

3. Conflict of Interest

All Suppliers found to have conflicting interests shall be disqualified to participate in the
procurement at hand. A Supplier may be considered to have conflicting interest under any
of the circumstances set forth below:

 A Supplier has controlling shareholders in common with another Supplier;

 A Supplier receives or has received any direct or indirect subsidy from another
Supplier;

 A Supplier has the same representative as that of another Supplier for purposes of this
quotation;

 A Supplier has a relationship, directly or through third parties, that puts them in a
position to have access to information about or influence on the Quotation of another
or influence the decisions of the Mission/Procuring Entity regarding this quotation
process;
6
  A Supplier submits more than one Quotation in this Quotation process;

 A Supplier who participated as a consultant in the preparation of the design or

technical specifications of the Goods and related services that are subject of this
quotation process.

4. Eligible Suppliers

Only Suppliers that are determined to be qualified shall be considered for award. The
Supplier shall fill up and submit the standard IOM Vendor Information Sheet (VIS)
(Annex D) to establish their eligibility together with the Quotation.

5. Cost of Preparing the Quotation

The Supplier shall bear all costs associated with the preparation and submission of his
Quotation and IOM will not in any case be responsible and liable for the costs incurred.

6. Errors, omissions, inaccuracies and clarifications

The documents and forms requested for the purpose of soliciting Quotations shall form
part of the Contract; hence care should be taken in completing these documents.

Suppliers shall not be entitled to base any claims on errors, omissions, or inaccuracies
made in the Quotation Documents.

Suppliers requiring any clarifications on the content of this document may notify the
IOM in writing at the following address.

iomlibyaproposal@iom.int
IOM will respond to any request for clarification received on or before 18 NOV 2021.
Copies of the response including description of the clarification will be given to all
Suppliers who received this General Instruction, without identifying the source of the
inquiry.

7. Confidentiality and Non-Disclosure

All information given in writing to or verbally shared with the Supplier in connection with
this General Instruction is to be treated as strictly confidential. The Supplier shall not share
or invoke such information to any third party without the prior written approval of IOM.
This obligation shall continue after the procurement process has been completed whether
or not the Supplier is successful.

8. IOM’s Right to Accept any Quotation and to Reject any and all Quotations

IOM reserves the right to accept or reject any Quotation, and to cancel the procurement
process and reject all Quotations, at any time prior to award of contract, without thereby
incurring any liability to the affected Supplier/s or any obligation to inform the affected
Supplier/s of the ground for IOM’s action.

9. Requirements

7
 9.1 Quotation Documents

The following shall constitute the Quotation Documents to be submitted by the

Suppliers:

a.) Quotation Form (Annex A)

b.) Price Schedule Form (Annex B)
c.) Vendor Information Sheet (Annex D)

Suppliers are required to use the forms provided as Annexes in this document.

9.2 Quotation Form

The Quotation Form (Annex A) and other required documents shall be duly
signed and accomplished and typewritten or written in indelible ink. Any
correction made to the prices, rates or to any other information shall be rewritten
in indelible ink and initialed by the person signing the Quotation Form.

The language of the Quotation shall be in English and prices shall be quoted in
USD, exclusive of VAT.

Prices quoted by the Supplier shall be fixed during Supplier performance of the
contract and not subject to price escalation and variation on any account, unless
otherwise approved by IOM. A submitted quotation with an adjustable price
quotation will be treated as non responsive and will be rejected.

9.3 Validity of Quotation Price

The Quotation shall remain valid for a minimum period of 45 calendar days, after
the deadline for submission.

In exceptional circumstances, prior to expiry of the period of validity of

quotations, IOM may request that the Suppliers extend the period of validity for a
specified additional period. The request and the response there to shall be made in
writing. A supplier agreeing to the request will not be required or permitted to
modify its quotation.

9.4 Documents Establishing Supplier’s Eligibility and Qualification

The Supplier shall furnish, as part of its Quotation, documents establishing the
Supplier’s eligibility to submit Quotation and its qualifications to perform the
contract if its Quotation is accepted. The IOM’s standard Vendors Information
Sheet (Annex D) shall be used for this purpose.

In the case of a Supplier not doing business within the Mission’s country, the
Supplier is or will be (if awarded the contract) represented by an Agent in that
country equipped, and be able to carry out the Supplier’s maintenance, repair and
spare parts-stocking obligations prescribed in the Conditions of Contract and/or
Technical Specifications [include this clause only if relevant-usually for high
value equipment].

10. Submission of Quotation Documents

8
 Quotation shall be submitted by email to: iomlibyaproposal@iom.int on or before 24 NOV
2021. Late2 Quotations will not be accepted.

11. Opening of Quotations.

At the indicated time and place, the opening of Quotations shall be carried out by IOM in
the presence of the Contractors who wish to attend. IOM reserve the right to conduct
opening of Quotations in public or not.

12. Acceptance of Quotations.

IOM is not bound to take an immediate decision on the acceptability or unacceptability of

Quotations at the time of their opening.

13. Rejection of Quotations

Quotation can be rejected for the following reasons:

(a) The Quotation is not presented in accordance with this General Instruction;
(b) The Quotation Form or any document which is part of the Quotation
Document is not signed;
(d) The Supplier is currently under list of blacklisted suppliers;
(e) The Supplier offer imposes certain basic conditions unacceptable to IOM
(f) The offered price is above the approved budget
(g) Failure to present physical sample upon IOM request and shortlist.

IOM is not bound to accept any offer received and reserves the right to waive any
minor defect in an offer, provided, however, that such minor defect (i) does not modify
the substance of the offer and (ii) does not change the relative ranking of the Suppliers.

14. Evaluation of Quotations

IOM shall evaluate and compare the Quotations on the basis of the following:

(a) Completeness and responsiveness of the documents mentioned in 9.1

(b) Compliance with technical specifications including delivery requirement
(c) Price
(d) Technical Evaluation

Arithmetical errors will be corrected on the following basis. If there is a discrepancy

between the unit price and the total price that is obtained by multiplying the unit price
and quantity, the unit price shall prevail, and the total price shall be corrected. If the
Supplier does not accept the correction of the errors, its Quotation will be rejected. If
there is a discrepancy between words and figures, the amount in words will prevail.

15. Post Qualification

2
Quotation delivered beyond the prescribed date and time shall be considered late, the envelope shall be
immediately returned to the Supplier unopened. The date and time of submission of the Quotation shall be
recorded. A quotation submission log shall be prepared for the purpose.
9
 Prior to award, post-qualification will be carried out by IOM to further determine the
selected Supplier’s technical and financial capability to perform the contract. IOM shall
verify and validate any documents/information submitted and shall conduct ocular
inspection of the office, plant and equipment.

16. Award of Contract

The Supplier that has submitted the lowest evaluated Price, substantially responsive to the
requirements of this General Instruction and who has been determined to be qualified to
perform the contract shall be selected and awarded the contract.

IOM shall notify the selected Supplier through a Notice of Award. IOM shall also notify in
writing, the other Suppliers who were not selected without disclosing the reason for
rejection.

17. Delivery Site and Period of Delivery

The goods should be delivered at the following delivery site/s:

Benghazi City, Full address and contact details will be forwarded to awarded vendors
and suppliers upon delivery and conformation of awarding and contract.

Delivery period shall be within approved and accepted delivery time on proposal of
awarding vendor and suppliers upon signing of the Purchase Order or Contract.

18. Liquidated Damages

If the Supplier fails to deliver any or all of the goods within the period specified in
Clause 17 above, a penalty payment of 0.1% of the price of the undelivered goods for
every day of breach of the delivery schedule by the Supplier will be requested.

19. Payment

Payment shall be made only upon IOM’s acceptance of the goods, and upon IOM’s
receipt of invoice describing the goods delivered 3.

20. Warranty

Warranty shall be quoted based on the standard warranties provided by the

manufacturer unless specified in the Technical Specifications of this General
Instruction. A Warranty Certificate shall be provided by the Supplier.

21. Settlement of Dispute

The United Nations Commission on International Trade Law (UNCITRAL) arbitration

rules will apply for any dispute, controversy or claim that will arise in relation to the
procurement process.

10
 Annex A

QUOTATION FORM

Date : _______________________

To : _______________________
_______________________
_______________________

Having examined the General Instruction for the Supply and Delivery of [insert description
of goods], the receipt of which is hereby duly acknowledge, I, representing [name of
company] offer to supply and deliver the requested goods in conformity with the General
Instruction for the total amount of [total bid amount in words and figures and currencies] in
accordance with the Price Schedule (Annex B) which is herewith attached and form part of
this Quotation.

I undertake if my offer is accepted, to deliver the goods in accordance with the delivery
schedule set out in the Price Schedule.

I agree to abide by this Quotation for the Validity Period specified in the General Instruction
which may be accepted at any time before the expiration of that period.

Until a formal contract is prepared and executed, this Quotation Form, together with your
Notice of Award shall constitute a binding agreement between us.

I hereby certify that this Quotation complies with the requirements stipulated in the General
Instruction.

Dated this______________day of____________20_____.

________________________ ________________________________
[signature over printed name] [in the capacity of]

Duly authorized to sign Quotation for and on behalf of

____________________________________ [name of company]

11
 Annex B

PRICE SCHEDULE FORM

PROJECT TITLE : Medicines and medical supplies for medical operations in the east of Libya
LOCATION : Benghazi City
REF NO. : LY21-300
Lot 1 :
COUNTRY DELIVERY
ITEM UNIT TOTAL DELIVERY
ITEM DESCRIPTION OF QUANTITY UNIT SITE /FINAL
NO. PRICE PRICE SCHEDULE
ORIGIN DESTINATION
Adrenalin 1mg/ml ampule - Pack of 10 5 Pack
1. Amp
2. Albendazol 400mg Tablets - Pack of 1 Tab 50 Pack
3. Amiodarone 150mg/3ml - Pack of 5 Amp 1 Pack
4. Amlodipine 5mg Tablet - Pack of 28 Tab 100 Pack
5. Amoxicillin 250mg Syrup - Bottle 100 ml 60 Bottle
Amoxicillin 500mg Capsule - Pack of 21 325 Pack
6. Cap
7. Amydramine Syrup - Bottle 120 ml 240 Bottle
8. Antacid syrup - Bottle 200 ml 350 Bottle
9. Aspirin 75 mg Tablet - Pack of 56 Tab 75 Pack
10. Atorvastatin 20mg Tablet - Pack of 30 Tab 100 Pack
11. Augmentin 156 mg/5ml - Bottle 100 ml 55 Bottle
12. Augmentin 1g Tablet - Pack of 15 Tab 250 Pack
13. Augmentin 457 mg/5ml - Bottle 100 ml 140 Bottle
Augmentin 625 mg Tablet - Pack of 20 235 Pack
14. Tab
15. Azithromycin 200mg/5ml - Bottle 15 ml 140 Bottle

12
 Azithromycin 500mg Tablet - Pack of 3 400 Pack
16. Tab
Beclomethasone Dipropionate 250mcg 8 EA
17. inhaler - Inhaler
Benzyl Benzoate lotion (Ascalol) - 125 ml 300 Bottle
18. Bottle
Betamethasone valerate 0.1% cream - 15 g 250 EA
19. Tube
Bisoprolol fumarate 5mg Tablet - Pack of 90 Pack
20. 28 Tab
Budesonide 0.5mg/2ml nebulizer 8 Pack
21. suspension - Pack of 20 Nebules
22. Calamin Lotion - Bottle 200 ml 300 Bottle
Carbamazepine 400 mg CR Tablet - Pack 25 Pack
23. of 30 Tab
Cefixime 100 mg/5 ml suspension - Bottle 85 Bottle
24. 30 ml
25. Cefixime 400 mg Capsule - Pack of 5 Cap 125 Pack
26. Ceftriaxone 1g IM - Pack of 1 Vial 135 Pack
Chloramphenicol 1% eye Ointment - 5g 150 EA
27. Tube
Chlorpheniramine Syrup 2mg/5ml - Bottle 100 Bottle
28. 100 ml
Ciprofloxacin 500mg Tablet - Pack of 10 275 Pack
29. Tab
Ciprofloxacin hydrochloride 0.3% eye/ear 150 Bottle
30. drops - Bottle 5 ml
31. Clotrimazole 1% spray - Spray 40 ml 150 EA
32. Clotrimazole skin cream 1% - 20 g Tube 75 EA
33. Clotrimazole Vaginal Tab 75 Pack
13
 100mg+Applicator - Pack of 6 Tab
Depakine 500 mg (Sodium Valproate ) 10 Pack
34. Tablet - Pack of 40 Tab
Dewax ear drops (0.5% Docusate Sodium) 150 Bottle
35. - Bottle 10 ml
36. Dexamethasone 0.5mg/5ml - Bottle 100 ml 150 Bottle
37. Dexamethasone 4mg/ml - Pack of 10 Amp 35 Pack
Dextromethorphan Syrup 15mg/5ml - 300 Bottle
38. Bottle 120 ml
Dextrose 5% injectable solution - 500 ml 100 EA
39. Bag
40. Dextrose 50% injection - Amp of 10ml 15 EA
Diamicron (Gliclazide) 60mg MR Tablet - 20 Pack
41. Pack of 30 Tab
Diclofenac Sodium 1% Gel - 30 g Gel 500 EA
42. Tube
Diclofenac Sodium 50 mg Tablet - Pack of 500 Pack
43. 20 Tab
Diclofenac Sodium 75mg/3ml Injection - 100 Pack
44. Pack of 5 Amp
45. Doxycycline 200mg Tablet - Pack of 8 Tab 100 Pack
46. Eucarbon Tablet - Pack of 20 Tab 140 Pack
Ferrous Sulphate 200 mg Tablet - Pack of 160 Pack
47. 30 Tab
48. Fluconazol Tab 150mg - Pack of 1 Tab 100 Pack
49. Folic Acid 5mg Tablet - Pack of 28 Tab 160 Pack
50. Fucicort Cream - 15 g Tube 375 EA
51. Furosemide 20mg/2ml - Pack of 10 20 Pack
52. Fybogel sachet - Pack of 10 Sach 300 Pack
53. Gentamicin 0.3% eye drops - Singel Pack 225 Pack
14
 Glibenclamide 5mg Tablet - Pack of 60 115 Pack
54. Tab
Glycerin Suppository Adult - Pack of 10 280 Pack
55. Supp
Glycerin Suppository Childern - Pack of 150 Pack
56. 10 Supp
Hydrochlorothiazide 25 mg Tablet - Pack 20 Pack
57. of 20 Tab
58. Hydrocortisone 100mg Vial - Vial 100 EA
Hydrocortisone Acetate Ointment 1% - 15 250 EA
59. g Tube
Hyoscine Butylbromide 10 mg Tablet - 375 Pack
60. Pack of 20 Tab
Hyoscine Butylbromide 20 mg/ml - Pack 75 Pack
61. of 6 Amp
62. Ibuprofen 100mg/5ml - Bottle 100 ml 50 Bottle
Ibuprofen 400mg Film Coated - Pack of 24 550 Pack
63. Tab
64. Lactulose Syrup - Bottle 200 ml 125 Bottle
Levothyroxine 50 mcg Tablet - Pack of 28 20 Pack
65. Tab
Librax Tablet (5 mg chlordiazepoxide /2.5 75 Pack
66. clidinium bromide - Pack of 30 Tab
67. Lidocain 2% injection - Single Vial 75 EA
68. Lisinopril 10mg Tablet - Pack of 28 Tab 100 Pack
69. Loperamide 2mg Capsule - Pack of 10 Cap 140 Pack
70. Loratadine 10mg Tablet - Pack of 10 Tab 400 Pack
Mebo Cream (25%w/w B-sitosterol) - 15 g 150 EA
71. Tube
72. Metformin 1000 mg Tablet - Pack of 30 150 Pack
15
 Tab
73. Metformin 500 mg Tablet - Pack of 30 Tab 210 Pack
74. Metformin 850 mg Tablet - Pack of 30 Tab 210 Pack
Metoclopramaide 10mg Injection - Pack of 35 Pack
75. 10 Amp
Metoclopramaide 10mg Tablet - Pack of 90 Pack
76. 40 Tab
Metronidazole 125 mg/5ml Suspension - 60 Bottle
77. Bottle 100 ml
Metronidazole 500mg Tablet - Pack of 30 100 Pack
78. Tab
Miconazole Vaginal Cream 2% - 78 g 150 EA
79. Tube
Mixtard 70/30 Suspension for Injection 100 EA
80. 100IU/ml - Vial 10 ml
Multivitamins Childern Syrup - Bottle 100 75 Bottle
81. ml
82. Multivitamins Tablet - Pack of 30 Tab 500 Pack
83. Muscadol Tablet - Pack of 20 Tab 300 Pack
Nifedipine Retard 20 mg Tablet - Pack of 50 Pack
84. 30 Tab
Normal Salin 0.9% IV solution - 500 ml 150 EA
85. Bag
Normal Salin 0.9% nasal drops - 10 ml 300 EA
86. dropper
Nystatin suspension 100 000 IU/ mL - 125 Bottle
87. Bottle of 30 ml
Omeprazol 40 mg Capsule - Pack of 28 525 Pack
88. Cap
89. Omeprazol 40 mg Vial - Pack of 1 vial 70 Pack
16
 ORS (oral rehydration salt) - Pack of 10 200 Pack
90. sach
Otipax ear drops (Lidocaine 150 Bottle
hydrochloride+Phenazone) - Drppper
91. Bottle 15 ml
Paracetamol 1000mg /100ml infusion - 150 Pack
92. Singel Pack
Paracetamol 150mg Suppository - Pack of 150 Pack
93. 10 Supp
94. Paracetamol 250mg Syrup - Bottle 100 ml 225 Bottle
Paracetamol 500 mg Tablet - Pack of 100 500 Pack
95. Tab
96. Prednisolone 5 mg Tablet - Pack of 20 Tab 100 Pack
97. Prisoline eye drops - Dropper Bottle 220 Bottle
98. Rhinostop Tablet - Pack of 20 Tab 325 Pack
99. Ringer Lactate IV solution - 500 ml Bag 70 EA
Salbutamol 0.1 mg/dose Inhaler 200 doses 125 EA
100. - Inhaler
Salbutamol nebules 2.5mg/2.5 ml - Pack of 8 Pack
101. 20 Nebules
102. Salicylic acid ointment 40% - Jar of 30g 30 EA
103. Silver sulfadiazine cream 1% - 50 g Tube 125 EA
104. Sudocream - 60 gm Jar 175 EA
105. Sulphur Ointment 3% - 30 gm Jar 200 EA
106. Sulphur Soap - Single Pack 300 Pack
Supraproct-S cream (antihemorroidal 175 EA
107. cream) - 20 g Tube
Thiocolchicoside 4mg/2ml - Pack of 6 75 Pack
108. Amp
109. Trifed Syrup - Bottle 100 ml 250 Bottle
17
110. Uricol Sachet - Pack of 12 sach 400 Pack
Vitamin B complex Tablet - Pack of 30 220 Pack
111. Tab
Vitamin B6 25mg Tablet - Bottle of 30 100 Bottle
112. Tab
Vitamin C (Ascorbic Acid) 500mg - Pack 450 Pack
113. of 30 Tab
Water for injection 10ml - Pack of 100 10 Pack
114. Amp
Xylometazoline 0.05% nasal drops - Singel 90 Pack
115. Pack
116. Absorbent Cotton wool - Single unit 100 EA
Adhesive non woven wound dressing Roll 75 EA
117. 15 cm X 10 M - Single unit
Alcohol hand gel sanitizer 70% - Bottle 260 Bottle
118. 500 ml
Alcohol swabs ‐3mm X 3mm - Pack of 60 Pack
119. 100
120. Biohazard Bags 10 L - Pack of 100 20 Pack
Blood Lancet for Glucometer - Pack of 30 Pack
121. 100
Cannula, IV short, 18G (1.3 x 32 mm) 500 EA
122. sterile,disposable - Single unit
Cannula, IV short, 20G (1.1 x 32 mm) 500 EA
123. sterile,disposable - Single unit
Cannula, IV short, 22G (0.9 x 25 mm) 500 EA
124. sterile,disposable - Single unit
Disposable sharp bin container - Single 30 EA
125. unit
126. Disposable Bed sheets - Single unit 1,000 EA
18
127. Elastic Crepe Bandages 10 cmX 4m - Roll 2,000 EA
Foley Catheter sizeFoley Catheter size 18 - 200 EA
128. 200
129. Face masks Surgical Type IIR - Pack of 50 250 Pack
Glucometer test strips (Accu check ) - 75 Pack
130. Pack of 50 test strips
Gauze bandage roll 10 cm cmx 4.5 m - 500 EA
131. Single unit
132. Infusion Set - Single set 400 EA
133. Nebulizer masks ( adult size) - Single set 50 EA
Nebulizer masks ( Pediatric size) - Single 50 EA
134. set
Nitrile Examination Gloves Size L (AQL 200 Box
135. 1.5) - Box of 100
Non Sterile Gauze Pads 7.5cm X 7.5cm - 200 Pack
136. Pack of 100 Pad
Non woven adhesive wound dressing 50 Pack
137. 10cm x 10cm - Pack of 50 PCS
138. N95 mask (3M-1860) - Singel Mask 200 EA
139. Oxygen Mask (Adult size) - Singel unit 50 EA
Parafine Dressing Gauze 10cm X10 cm - 225 Pack
140. Pack of 10
141. Povidone Iodine 10% - 1 Liter 50 EA
Covid-19 Rapid Antigen Test Kit - Single 400 EA
142. unit
143. Syringes Insulin U-100 1ml - Singel Unit 2,000 EA
Sterile Disposable Syringes 5 ml - Singel 1,000 EA
144. Unit
Sterile Disposable Syringes 10 ml - Single 2,500 EA
145. Unit
19
 Sputum collection conatiner 60 ml - Single 400 EA
146. unit
Sterile Surgical Gloves Size 7.5 - Box of 12 Box
147. 50 pair
Surgical Sterile Gloves Size 8 - Box of 50 12 Box
148. pair
Sterile Gauze Swab 10 cmX 10 cm - Pack 150 Pack
149. of 100
Surgical Vicryl Stitches ( Size 0-6 ) - Pack 35 Pack
150. of 12
Surgical Vicryl Stitches ( Size 0-3 ) - Pack 35 Pack
151. of 12
Surgical gown reinforced sterile size L and 500 Pack
152. XL - Single pack
153. Urine Collection Bag 2000 ml - Single unit 200 EA
Transport and Handling (unloading of 1 EA
medicines and medical supplies) to IOM
154. storage in Benghazi

__________________________________________
Suppliers authorized signature over printed name

20
 Annex D
VENDORS INFORMATION SHEET (VIS)

[insert here IOM Standard Vendors Information Sheet (VIS) and other required eligibility
requirement if any]

VENDOR INFORMATION SHEET (VIS)

Name of the Company __________________________________________________________

Address Leased Owned Area: _______sqm

House No _____________________________________________________
Street Name _____________________________________________________
Postal Code _____________________________________________________
City _____________________________________________________
Region _____________________________________________________
Country _____________________________________________________

Contact Numbers/Address
Telephone Nos. __________________ Contact Person: ___________________
Fax No. ____________________
E mail Address ____________________ Website: ___________________

Location of Plant/Warehouse Leased Owned Area: ______sqm

__________________________________________________________________
__________________________________________________________________
__________________________________________________________________

Business Organization Corporation Partnership Sole Proprietorship

Business License No.: __________ Place/Date Issued:_________ Expiry Date ________

No. of Personnel ___________ Regular ___________ Contractual/Casual ____________

Nature of Business/Trade

Manufacturer Authorized Dealer Information Services

Wholesaler Retailer Computer Hardware

Trader Importer Service Bureau

Site Development/ Consultancy Others ____________

Construction __________________

Number of Years in business: _________

21
Complete Products & Services
__________________________________________________________________
__________________________________________________________________

Payment Details

Payment Method Cash Check Bank Transfer Others

Currency Loc.Currency USD EUR Others

Terms of Payment 30 days 15 days 7 days upon receipt of

invoice

Advance Payment Yes No % of the Total PO/Contract

Bank Details:

Bank Name ________________________________________________

Bldg and Street ________________________________________________
City ________________________________________________
Country ________________________________________________
Postal Code ________________________________________________
Country ________________________________________________
Bank Account Name ________________________________________________
Bank Account No. ________________________________________________
Swift Code ________________________________________________
Iban Number ________________________________________________

Key Personnel & Contacts (Authorized to sign and accept PO/Contracts & other commercial
documents)

Name Title/Position Signature

_______________________ _______________________ _______________________

_______________________ _______________________ _______________________

_______________________ _______________________ _______________________

_______________________ _______________________ _______________________

Companies with whom you have been dealing for the past two years with approximate value in
US Dollars:

Company Name Business Value Contact Person/Tel. No.

22
_______________________ _______________________ _______________________

_______________________ _______________________ _______________________

_______________________ _______________________ _______________________

_______________________ _______________________ _______________________

Have you ever provided products and/or services to any mission/office of IOM?

Yes No

If yes, list the department and name of the personnel to whom you provided such goods and/or
services.

Name of Person Mission/Office Items Purchased

_______________________ _______________________ _______________________

_______________________ _______________________ _______________________

_______________________ _______________________ _______________________

_______________________ _______________________ _______________________

Do you have any relative who worked with us at one time or another, or are presently employed
with IOM? If yes, kindly state name and relationship.

_______________________ _______________________ _______________________

_______________________ _______________________ _______________________

_______________________ _______________________ _______________________

_______________________ _______________________ _______________________

Trade Reference

Company Contact Person Contact Number

_______________________ _______________________ _______________________

_______________________ _______________________ _______________________

_______________________ _______________________ _______________________

23
_______________________ _______________________ _______________________

Banking Reference

Bank Contact Person Contact Number

_______________________ _______________________ _______________________

_______________________ _______________________ _______________________

_______________________ _______________________ _______________________

_______________________ _______________________ _______________________

24
 REQUIREMENTS CHECK LIST

Please submit the following documents together with the Information Sheet:

For IOM use only

No. Document Not
Submitted
Applicable
Company Profile (including the names of owners, key
1
officers, technical personnel)
Company's Articles of Incorporation, Partnership or
2 Corporation, whichever is applicable, including
amendments thereto, if any.
Certificate of Registration from host country's Security
3 & Exchange Commission or similar government
agency/department/ministry
4 Valid Government Permits/Licenses

5 Audited Financial Statements for the last 3 years*

Certificates from the Principals (e.g. Manufacturer's
Authorization, Certificate of Exclusive Distributorship,
6
Any certificate for the purpose, indicating name,
complete address and contact details)
7 Catalogues/Brochures

8 List of Plants/Warehouse/Service Facilities

9 List of Offices/Distribution Centers/Service Centers

10 Quality and Safety Standard Document / ISO 9001

List of all contracts entered into for the last 3 years
11
(indicate whether completed or ongoing ) *
Certification that Non-performance of contract did not
occur within the last 3 years prior to application for
12
evaluation based on all information on fully settled
disputes or litigation
For Construction Projects: List of machines &
13 equipment (include brand, capacity and indication if
the equipment are owned or leased by the Contractor)

* For Competitive Biddings, number of years may increase depending on the estimated contract
amount.
** Indicate if an item is not applicable. Failure to provide any of the documents mentioned above
will result in automatic "failed" rating.

25
 I hereby certify that the information above are
true and correct. I am also authorizing IOM to
validate all claims with concerned authorities.

Received by:

_______________________ _______________________
Signature Signature

_______________________ _______________________
Printed Name Printed Name

_______________________ ______________________
Position/Title Position/Title

_______________________ _______________________
Date Date

__________________________FOR IOM USE ONLY_________________________

Purchasing Organization ___________________

Account Group ___________________

Industry 001 002 003

where 001 - Transportation related to movement of migrants

002 - Goods (e.g. supplies, materials, tools)
003 - Services (e.g. professional services, consultancy, maintenance)

Vendor Type Global Loca

26