| [613] | 1 | PRCHQM2 ;WISC/KMB-MANUAL PRINT OF RFQ ;7/23/99 15:58
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| 2 | ;;5.1;IFCAP;;Oct 20, 2000
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| 3 | ;Per VHA Directive 10-93-142, this routine should not be modified.
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| 4 | S P=1 U IO D HEADER^PRCHQM3
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| 5 | ;print RFQ, vendor, PA, delivery info
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| 6 | U IO W ! F I=1:1:90 W "_"
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| 7 | W !,"REQUEST FOR MANUAL QUOTATIONS | The Notice of Small Business-Small Purchase Set-Aside"
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| 8 | W !," (this is not an order)",?31,"| on the last page of this form"
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| 9 | W !,?31,"| _____is _____is not applicable."
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| 10 | W ! F I=1:1:31 W "_"
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| 11 | W "|" F I=1:1:58 W "_"
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| 12 | W !,"1. REQUEST NO. |2.DATE ISSUED |3.REQUISITION/PURCHASE REQUEST |4.CERT.FOR.NAT. |RATING"
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| 13 | W !,?15,"|",?31,"| NO.",?63,"| DEF. UNDER BDSA |"
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| 14 | W !,?15,"|",RDATE,?31,"|",?33,RFQNUM,?63,"| REG.2 AND/OR DMS|"
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| 15 | W !,?15,"|",?31,"|",?63,"| REG.1->",?81,"|"
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| 16 | W ! F I=1:1:15 W "_"
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| 17 | W "|" F I=1:1:15 W "_"
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| 18 | W "|" F I=1:1:31 W "_"
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| 19 | W "|" F I=1:1:17 W "_"
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| 20 | W "|" F I=1:1:8 W "_"
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| 21 | W !,"5A.ISSUED BY ",ISS(1),?63,"|6.DELIVER BY (Date)"
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| 22 | W !,?15,ISS(2),?63,"|"
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| 23 | W !,?15,ISS(4),",",ISS(5)," ",ISS(6),?63,"|",?65,ADATE
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| 24 | W !,?63,"|" F I=1:1:26 W "_"
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| 25 | W ! F I=1:1:63 W "_"
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| 26 | DELIV ;
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| 27 | W "|7.DELIVERY"
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| 28 | W !,"5B.FOR INFORMATION CALL:(Name & phone no.) (No collect calls) |(unless otherwise"
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| 29 | W !,?63,"| specified)"
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| 30 | W !?4,PA,?31,"PHONE: ",PPHONE,?63,"| FOB",?83,"OTHER"
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| 31 | W !?33,"FAX: ",$G(PAFAX),?63,"|",FOB1," DESTINATION",?81,FOB2,"(See",!
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| 32 | W:$G(PRCEMAIL)'="" ?4,"E-MAIL: ",PRCEMAIL W ?63,"|",?81,"schedule)"
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| 33 | W ! F I=1:1:63 W "_"
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| 34 | W "|" F I=1:1:26 W "_"
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| 35 | W !,"8.TO: NAME AND ADDRESS, INCLUDING ZIP CODE",?63,"|9.DESTINATION (Consignee"
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| 36 | W !,?10,SRC(1),?63,"| and address, using ZIP)"
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| 37 | W !,?10,SRC(2),?63,"| ",$E(FDES1,1,21)
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| 38 | W !,?10,SRC(3),?63,"| ",FDES2
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| 39 | W !,?10,SRC(6),",",SRC(7)," ",SRC(8),?63,"| ",FDES3
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| 40 | W !,"PHONE: ",VENPH,?33,"FAX: "_$G(VENFAX),?63,"| ",FDES4,!
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| 41 | F I=1:1:63 W "_"
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| 42 | W "|" F I=1:1:26 W "_"
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| 43 | W !,"10.PLEASE FURNISH QUOTATIONS TO",?32,"|11.BUSINESS CLASSIFICATION (check appropriate boxes)"
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| 44 | W !," THE ISSUING OFFICE ON OR BE-",?32,"|",?34,BC1,?36,"_SMALL",?58,BC2,?60,"_OTHER THAN SMALL"
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| 45 | W !," FOR CLOSE OF BUSINESS (date)",?32,"|",?34,BC3,?36,"_VIETNAM VETERAN-OWNED",?58,BC4,?60,"_WOMEN-OWNED"
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| 46 | W !,?5,CBDATE,?32,"|",?34,BC5,?36,"_DISADVANTAGED",?58,BC6,?60,"_DISABLED VETERAN-OWNED"
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| 47 | W ! F I=1:1:32 W "_"
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| 48 | W "|" F I=1:1:57 W "_"
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| 49 | W !!,"IMPORTANT: This is a request for information, and quotations furnished are"
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| 50 | W !,"not offers. If you are unable to quote, please so indicate on this form and"
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| 51 | W !,"return it. This request does not commit the Government to pay any costs "
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| 52 | W !,"incurred in the preparation of the submission of this quotation or to "
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| 53 | W !,"contract for supplies or services. Supplies are of domestic origin unless "
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| 54 | W !,"otherwise indicated by quoter. Any representations and/or certifications"
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| 55 | W !,"attached to this Request for Quotations must be completed by the quoter."
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| 56 | W ! F I=1:1:90 W "_"
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| 57 | SCH ;
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| 58 | W !,?10,"12.SCHEDULE (Include applicable Federal, State and local taxes)",!
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| 59 | F I=1:1:90 W "_"
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| 60 | ;
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| 61 | W !,"ITEM #",?7,"| DELIVERY LOCATION &",?35,"|"," QTY ",?42,"| UNIT ",?47,"| UNIT PRICE ",?54,"| AMOUNT ",?62,"| DEL. DATE "
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| 62 | W !,?7,"| DESCRIPTION",?35,"|",?42,"|",?49,"|",?62,"|",?75,"|"
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| 63 | W !,"__(a)__",?7,"|_____________(b)___________",?35,"|_(c)__",?42,"|_(d)__",?47,"|_____(e)____",?54,"|_____(f)____",?62,"|_____(g)_____"
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| 64 | S LN="" F S LN=$O(^TMP($J,LN)) Q:LN="" D
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| 65 | .S LD=0 F S LD=$O(^TMP($J,LN,LD)) Q:LD="" D
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| 66 | ..I $Y>60 D HEADER^PRCHQM3
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| 67 | ..W ! I LD=1 W $P(^TMP($J,LN,LD),"^")
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| 68 | ..W ?7,"|",$P(^TMP($J,LN,LD),"^",2),?35,"|",$P(^TMP($J,LN,LD),"^",3),?42,"|",$P(^TMP($J,LN,LD),"^",4)
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| 69 | ..W ?49,"|",?62,"|",?75,"|",$P(^TMP($J,LN,LD),"^",6)
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| 70 | .D ITEMS^PRCHQM3
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| 71 | D HEADER^PRCHQM3,METRIC^PRCHQM3
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| 72 | DISC ;
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| 73 | W !,"13.DISCOUNT FOR PROMPT",?22,"|10 CALENDAR DAYS",?40,"|20 CALENDAR DAYS",?58,"|30 CALENDAR DAYS",?76,"|CALENDAR DAYS"
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| 74 | W !,?6,"PAYMENT--->",?22,"|",?39,"%|",?57,"%|",?75,"%| %"
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| 75 | W !,?22,"|",?40,"|",?58,"|",?76,"|"
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| 76 | W ! F I=1:1:90 W "_"
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| 77 | W !,"NOTE: Last page must also be completed by the quoter."
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| 78 | W ! F I=1:1:90 W "_"
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| 79 | W !,"14.NAME AND ADDRESS OF QUOTER (Street, |15.SIGNATURE OF PERSON AUTHORIZED |16.QUOTATION"
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| 80 | W !," city,county, State and ZIP code)",?40,"| TO SIGN QUOTATION",?76,"| DATE"
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| 81 | W !,?40,"|",?76,"|",!,?40,"|"
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| 82 | F I=1:1:35 W "_"
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| 83 | W "|_____________"
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| 84 | W !,?40,"|17.NAME AND TITLE OF SIGNER (Type |18.PHONE NO."
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| 85 | W !,?40,"| or print)",?76,"| (area code)"
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| 86 | W !,?40,"|",?76,"|"
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| 87 | W ! F I=1:1:40 W "_"
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| 88 | W "|" F I=1:1:35 W "_"
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| 89 | W "|_____________"
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| 90 | Q
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