JADUAL PENENTUAN/SPESIFIKASI TEKNIKAL SEBUTHARGA BAGI MEMBEKAL, MENGHANTAR, MEMASANG DAN MENGUJI WIRELESS EOG AND ECG TRANSMITTER AND RECEIVERS UNTUK NAMA iKOHZA BAGI MALAYSIA-JAPAN INTERNATIONAL INSTITUTE OF TECHNOLOGY (MJIIT), UNIVERSITI TEKNOLOGI MALAYSIA KUALA LUMPUR NO. SEBUTHARGA : 3.2 On site hands-on training at MJIIT, UTMKL must be provided to make sure the instrument is in good condition according to the theoretical principle. 3.3 The basic troubleshooting and maintenance procedure shall be provided to the Biomedical Engineering staffs. 3.4 UTM reserves the right to accept or reject any extension of the period required for the delivery. 3.5 The manufacturer warranty of the instrument shall be at least 24 months.

____________________________ Nama (Dekan) Fakulti Cop Tarikh

______________________________ Nama (Timbalan Dekan) Fakulti Cop Tarikh

SAMPLE

_______________________________ Nama (Ketua Jabatan/ikohza) Fakulti Cop Tarikh

Lampiran 1 PERMOHONAN PEROLEHAN BARANGAN IMPORT BIL

NAMA BARANGAN/ MODEL/JENAMA

KEGUNAAN BARANGAN

KUANTITI

ANGGARAN KOS SEUNIT (RM)

JUMLAH (RM)

HASIL SEMAKAN* MSC

SIRIM

e-P

MATR ADE

SME

MIDA

*Hasil semakan: / Ada pengilang tempatan; X Tiada pengilang tempatan; NA Tiada berkaitan

Perakuan Pemohon i. ii. iii.

Saya memperakukan bahawa semakan telah dibuat melalui portal MSC Malaysia/ SIRIM/ Sistem ePerolehan/MATRADE/ SME CORP/ MIDA dan mendapati barangan-barangan yang dinyatakan diatas TIDAK dikeluarkan oleh Pengilang tempatan. Saya memahami tindakan sewajarnya boleh diambil ke atas saya jika gagal mematuhi peraturan-peraturan dan tindakan surcaj boleh dikenakan ke atas saya menurut SPP Bil. 7 tahun 2002. Disertakan spesifikasi teknikal/gambar/katalog barangan dan dokumen berkaitan penetapan harga anggaran.

Disediakan oleh:

Disahkan oleh:

Diluluskan oleh JKPBIU

................................... (T/tangan dan cop pemohon)

.................................... (T/tangan dan cop Ketua PTJ)

............................................ (T/tangan dan cop Urus Setia JKPBIU)

1

Lampiran 2 SENARAI PEROLEHAN BARANGAN IMPORT (SEBENAR)

Bil.

Butiran Perolehan

Nama Pembekal Tempatan

Nama Pembekal Asing

Negara Asal Barangan

Nilai Kontrak (RM)

Perolehan Secara FOB/CIF

No. Rujukan Surat kelulusan JPBIU

NOTA: 1. Perolehan Barangan Import bermaksud perolehan yang dibuat oleh pemohon sama ada menggunakan pembekal/agen tempatan atau pembekal/agen luar negara. 2. Sila kembalikan borang ini kepada Urus Setia JK Perolehan Barangan Import Universiti dalam tempoh dua minggu selepas barangan diterima. Disediakan oleh:

............................... (Nama dan cop jawatan) 2

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