质疑函范本

一、质疑供应商基本信息

质疑供应商：                                        

地址：                          邮编：                                                   

联系人：                      联系电话：                              

授权代表：                                          

联系电话：                                            

地址：                         邮编：                                               

二、质疑项目基本情况

质疑项目的名称：                                     

质疑项目的编号：               包号：                

采购人名称：                                        

采购文件获取日期：                                          

三、质疑事项具体内容

质疑事项1：                                        

事实依据：                                         

法律依据：                                         

质疑事项2

……

四、与质疑事项相关的质疑请求

请求：                                              

签字(签章)：                   公章：                     

日期：