Certification for Compliance of
            Equipment Purchased/To be Purchased
                                                                              Date: ___________________
           To: Controller’s Department, Loan Administration Division
           TA. No._____ – Country: TA Title__________________
           With reference to our endorsement for advance / reimbursement / liquidation of equipment cost, we 
           certify the following:
                  Quotations of equipment obtained from at least three (3) suppliers
                  ADB Procurement Guidelines were followed 
                  List of equipment to be purchased with corresponding prices as follows: 
                       Equipment    Supplier's    Origin of    Unit Price    Quantity    Total Cost
                                    Nationality    Goods
                   1
                   2
                   3
                   4
            
                                                           _______________________________
                                                           Printed Name and Signature
                                                           TASU Specialist: ___________
                                                           Division: ________________________
                                                           Department: _____________________
           ADB Form No. 690/01                                                                                                                                                                                          Revised April 2010