Bid Initiation Form

Please provide the following documentation:

Department:
Name of Requestor:
Phone:
Email:
Date:
Description (equipment type, product name):
Specifications for above (both general and technical):
Recommended Suppliers: (to be included in bid)
Supplier Name:
Address:
Contact/Rep Name:
Phone and/or Cell:
Fax:
Email Address:
Supplier's Catalog#(s):
   
Supplier Name:
Address:
Contact/Rep Name:
Phone and/or Cell:
Fax:
Email Address:
Supplier's Catalog#(s):
   
Supplier Name:
Address:
Contact/Rep Name:
Phone and/or Cell:
Fax:
Email Address:
Supplier's Catalog#(s):
   
Supplier Name:
Address:
Contact/Rep Name:
Phone and/or Cell:
Fax:
Email Address:
Supplier's Catalog#(s):

Other department(s) and/or contacts that should be part of the process (to develop specs, i.e. Clinical Engineering, UTD, ISD/ITS, Facilities, PPM)

Select Appropriate Corporate Purchasing Commodity Group: