Work/Purchase Order Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. About YouPosition *Executive DirectorDirector of Learning and Humanitarian Relief – Port SudanHumanitarian Relief Coordinator – GedarifHumanitarian Relief Coordinator – White NileManager of Grants and ProgramsGraphic Design OfficerSudan office, internProgram *Food Security ProgramOutbreaks/Epidemic ResponseUS related programs/eventsMoney transfer to SudanOtherProgram *Full Name *Email Address *ProcurementPurpose of Procurement (Briefly describe the purpose and context) * Item Description Item *The common name or title of the product being procured. Be specific, e.g., “Oral Rehydration Salts (ORS)” or “Latex Gloves.”Size & Unit *Refers to the individual item’s measurement or dose (what you’re actually using or administering). It’s the smallest usable or consumable unit. – 500 mg tablet – 250 mL bottle – Size M gloves (1 pair)Quantity *Quantity refers to the total number of individual usable units being requested for procurement. It represents the actual count of single items that will be used, administered, or distributed during the outbreak response — not the number of boxes, cartons, or packages.Packaging (Quantity and type) * Refers to how the units are grouped together for transport or delivery. It’s the outer form used for shipping, storing, or counting bulk items. – Box of 100 tablets – Carton with 24 bottles – Pack of 10 glove pairs Vendor Quotations (Attach copies of all quotations) Vendor Name *Contact Info *Quotation Amount * Vendor 1 (Upload Copy of Government ID (passport or driver’s license), Business License, Sanctions Check Report, Quotations) * Drag & Drop Files, Choose Files to Upload You can upload up to 10 files. Vendor 2 (Upload Copy of Government ID (passport or driver’s license), Business License, Sanctions Check Report, Quotations) * Drag & Drop Files, Choose Files to Upload You can upload up to 10 files. Vendor 3 (Upload Copy of Government ID (passport or driver’s license), Business License, Sanctions Check Report, Quotations) * Drag & Drop Files, Choose Files to Upload You can upload up to 10 files. Request details Amount requested in US$ * Amount requested in SDG * Quotations of Work/Purchase Order Drag & Drop Files, Choose Files to Upload You can upload up to 10 files. .pdf, .png, .jpg formatDescribe the work/order planned * Money transfer from US office Name of transferring entity *al-mahfzaotherType of money transfer entity *IndividualBusinessName of transferring entity *Address of transferring entity *Address Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip Codescreenshot of OFAC crosscheck * Drag & Drop Files, Choose Files to Upload How will the funds be spent ? define an amount for each category where applicable. This information will be used for book keeping. *Visual Code break down the funds into the following categories: 1. Humanitarian Relief 2. Dr. Isam Osman Mission 3. Bushra Ibnauf Center for Learning 4. salaries 5. administrative 6. fundraising if unsure about category, contact the secretary general.Submit Work/Purchase Order
