DRUG CONSIGNMENT AGREEMENT

This Consignment Agreement is entered into by and between:

xxxxxxxxxxxxxxxxx with principal address at xxxxxxxxxxxxxxxxxxxxxxxxx, represented
by xxxxxxxxxxxxxxxxxxx, hereinafter referred to as the CONSIGNOR/SUPPLIER;
-and-
xxxxxxxxxxxxxxxxxxxxxxxxxxx, with principal address at
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxx represented by xxxxxxxxxxxxxxxxxxxxxxxxx,
hereinafter referred to as the CONSIGNEE/RECIPIENT;
WITNESSETH THAT:
WHEREAS, in view of the high procurement cost of drugs, medicines and other
hospital supplies and items, access to the same by patients and other members of the
population in need has been limited;
WHEREAS, the Supplier desires to offer its products by making stocks available, at
reasonable costs, without disbursement of government funds, but payable upon sale of the
same by the XXXXXXXXX Satellite Pharmacy or by the forward-stocking or consignment
scheme;
WHEREAS, the Supplier possesses all the qualifications and none of the
disqualification as an entity allowed to supply/consign products according to the DOH rules
and regulations;
WHEREAS, the Supplier was among those who qualified during the latest bidding
conducted by the XXXXXXXXX for drugs and medicines;
WHEREAS, both parties are fully aware of the guidelines set forth for this purpose
specifically the DOH Administrative Order No. 2006-0039, dated December 8, 2006; DOH
Memorandum No. 2017-0033-A, dated February 22, 2017, among other relevant orders and
memoranda;
NOW THEREFORE, for and in consideration of the foregoing premises, and the terms
and conditions hereunder enumerated, the parties to this CONSIGNMENT Agreement hereby
agree that:
1. The Supplier shall undertake to supply Drugs and Medicines for sale which will be
payable after consumption of the XXXXXXXXX Satellite Pharmacy;
2. XXXXXXXXX shall undertake to sell the delivered drugs and medicines to the
public at a reasonable and affordable price;
3. The specific description of the goods and their quantities shall be covered by a
Supply Order Form;
4. The Supply Order Form for the initial stocking shall be based at the time a
Consignment Agreement is perfected; A copy of the Supply Order Form is made
an integral part of this Agreement;
5. A Supply Order Form shall be issued by the XXXXXXXXX Satellite Pharmacy at any
time the inventory of delivered goods reaches its reorder point;
6. Prices shall be competitively determined in order to arrive at the cheapest and
reasonable price but the initial stock shall in no way higher than the bid offer of
the Supplier during the latest bidding or that of the price of retail drugstores
within the area of the XXXXXXXXX;
7. The Supplier shall be bound to maintain the price of the delivered goods for at
least seven (7) months from the date of delivery; However, it can be adjusted
subject to periodic determination of the prevailing market price;
8. Deliveries will be made directly to the Satellite Pharmacy in the presence of the
Pharmacist-in-Charge or her/his designated representative AND all members of
the XXXXXXXXX Inspection and Acceptance Committee. A representative from the
Commission on Audit shall be invited to act as witness.
9. A Delivery Receipt shall be issued by the Supplier for every delivery made to the
XXXXXXXXX and shall bear the following information:
a. Name of the Supplier as Heading
b. Date of the Delivery Receipt;
c. Delivery Receipt Number;
d. Consignment Order Number;
e. Name of the Authorized Representative of the Supplier effecting the Delivery
with the necessary Special Power of Attorney;
f. Item Number;
 g. Description of the Requested Goods
1. Generic Name
2. Dosage Form
3. Strength
4. Batch Number/Lot Number;
5. Manufacturing Date
6. Expiration Date
7. Sub-packing Unit
h. Quantity
i. Unit
j. Unit Price
k. Total price
10. A Delivery Receipt must be supported with a Certificate of Analysis coming from
the Quality Control Department of the manufacturer reflecting therein the same
batch/lot numbers covered in the Delivery Receipt. The same batch/lot numbers
must appear on the invoices for billing purposes.
11. Delivery of the items should be done within seven (7) working days from the
receipt of the Supply Order Form;
12. No items shall be received which have expiration dates of less than 12 months
from the date of delivery, EXCEPT:
a. Biologicals
b. In instances where the Satellite Pharmacy is in urgent need of the item
requested and the supplier has stocks, but with expiration dates of less
than 12 months
13. In cases of items with expiration dates of less than 12 months from date of
delivery, these has to be immediately invoiced back to the Supplier for immediate
replacement. A Return Invoice Receipt shall be issued to this effect stating the
specific description and quantity of the items, and the reason for the return;
14. XXXXXXXXX Satellite Pharmacy shall conduct an inventory of goods supplied
every end of the month or at the last working day of the month as the case may
be. Inventory may also be done at any time upon the determination of the
Pharmacist-in-Charge. The Supplier shall observe the inventory taking at all times.
15. CONSIGNEE shall apply the zero inventory concept by turning over all unused
stocks to the CONSIGNOR within seven (7) days after each of the quarters
covered in the Agreement or within the following day from the receipt of the
Replenishment Goods, to avoid stock availability gaps. The drugs and medicines
returned shall be covered with the appropriate invoices;
16. XXXXXXXXX shall be bound to pay only for the drugs and medicines sold. Any
expired or unsold stocks shall be returned to the Supplier every quarter. Payments
shall be made within thirty (30) days after the inventory taking;
17. Ownership and title to the delivered goods shall remain with the Supplier. The
delivered goods shall not be removed from the Satellite Pharmacy without prior
consent of the Supplier;
18. The CONSIGNOR shall hold the CONSIGNEE free and harmless from, and shall be
solely responsible, for any claim, action, suit, cost of expenses, damages and
liabilities arising out of, in connection with, or resulting from the use of the
consigned goods;
19. Supplied goods may be subjected to random sampling and testing by the Food
and Drugs Administration through an authorized DOH representative or FDA
inspector during deliveries and the corresponding items retained tested by the
FDA/DOH shall be promptly replaced by the Supplier at no cost to the
Government.
20. Any loss arising from fortuitous events shall relieve the XXXXXXXXX from any
responsibility. However, in case of loss arising from pilferage and theft, the
XXXXXXXXX shall be liable for the monetary value of the goods lost or stolen, if
the latter is proved to be negligent;
21. This Agreement shall have a validity duration of six (6) months from the signing of
this Contract, unless extended with reasonable cause as shall be justified by the
Head/Chief of the CONSIGNEE;
22. Upon the expiration or earlier termination for breach of any term or condition, the
CONSIGNEE may upon previous notice/demand, require the CONSIGNOR to
remove from the Hospital the consigned goods and medicines;

IN VIEW THEREOF, the parties have hereunto set their hands this _________ day of
______________, 2017.
xxxxxxxxxxxxxx xxxxxxxxxxxxxxxxxx
 xxxxxxxxxxxxxxxxxxxxxx xxxxxxxxxxxxxxxxxxx
xxxxxxxxxxxxxxxxx xxxxxxxxxxxxxxxxxxxx
ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES }

xxxxxxxxxxxxxx } S.S.

X - - - - - - - - - - - - - - - - - - - - - - -X

BEFORE ME, a Notary Public for and in the City of Iloilo, Philippines this __________________,
personally appeared xxxxxxxxxxxxxxxxxxx who is personally known to me and presented
to me her TIN Card No. xxxxxxxxxxxxxxxxxxx and to me known to be the same person who
executed the foregoing instrument and he acknowledged to me that the same is her own
free and voluntary act and deed.

Doc. No. ___;

Page No. ___;
Book No. ___;
Series of 2017.