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* 個資使用聲明：本平台個人資訊僅供承辦單位使用。

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日期 Date:

09/16/2024

基本資料 Basic Information

執行單位 Implementing Unit *

執行單位 Implementing Unit 其他

補充說明 Supplementary Explanation

若為行政單位，請補充處室組別。 If it is an admin unit, please specify the department or division.

工作主持人 Project Leader *

職員編號 Employee ID *

連絡電話 Phone *

E-mail *

請購時間(起) Requisition Date (Start) *

月份

日

年

114年08月31日前完成核銷 The verification process must be completed by August 31, 2025

聯絡窗口 Contact Window

請填寫協助執行/核銷窗口 Please fill out the assistance in execution/verification window.

聯絡窗口分機 Contact Window Extension

聯絡窗口職員編號 Contact Window Employee ID

聯絡窗口Email Contact Window Email

實驗室資料 Laboratory Information

實驗室名稱 Laboratory Name *

建置地點 Location *

預計採購設備 Expected Equipment to Be Purchased

設備1 Equipment 1

品名1 Item Name 1 *

單價1 Unit Price 1 *

數量1 Quantity 1 *

小計1 Subtotal 1 *

設備為新增(請寫用途說明)或汰換(請註明財編及年限)1 Is the equipment new (please provide a purpose explanation) or a replacement (please specify finance code and lifespan)1 *

目前現有設備數量1 Current Quantity of Existing Equipment 1 *

用途說明1 Purpose Explanation 1 *

估價單(超過5萬元需三張估價單)1 Estimated Cost (for items exceeding 50,000 NT dollars, three estimates are required)1

設備2 Equipment 2

品名2 Item Name 2

單價2 Unit Price 2

數量2 Quantity 2

小計2 Subtotal 2

設備為新增(請寫用途說明)或汰換(請註明財編及年限)2 Is the equipment new (please provide a purpose explanation) or a replacement (please specify finance code and lifespan)2

目前現有設備數量2 Current Quantity of Existing Equipment 2

用途說明2 Purpose Explanation 2

估價單(超過5萬元需三張估價單)2 Estimated Cost (for items exceeding 50,000 NT dollars, three estimates are required)1

設備3 Equipment 3

品名3 Item Name 3

單價3 Unit Price 3

數量3 Quantity 3

小計3 Subtotal 3

設備為新增(請寫用途說明)或汰換(請註明財編及年限)3 Is the equipment new (please provide a purpose explanation) or a replacement (please specify finance code and lifespan)3

目前現有設備數量3 Current Quantity of Existing Equipment 3

用途說明3 Purpose Explanation 3

估價單(超過5萬元需三張估價單)3 Estimated Cost (for items exceeding 50,000 NT dollars, three estimates are required)1

設備4 Equipment 4

品名4 Item Name 4

單價4 Unit Price 4

數量4 Quantity 4

小計4 Subtotal 4

設備為新增(請寫用途說明)或汰換(請註明財編及年限)4 Is the equipment new (please provide a purpose explanation) or a replacement (please specify finance code and lifespan)4

目前現有設備數量4 Current Quantity of Existing Equipment 4

用途說明4 Purpose Explanation 4

估價單(超過5萬元需三張估價單)4 Estimated Cost (for items exceeding 50,000 NT dollars, three estimates are required)1

設備5 Equipment 5

品名5 Item Name 5

單價5 Unit Price 5

數量5 Quantity 5

小計5 Subtotal 5

設備為新增(請寫用途說明)或汰換(請註明財編及年限)5 Is the equipment new (please provide a purpose explanation) or a replacement (please specify finance code and lifespan)5

目前現有設備數量5 Current Quantity of Existing Equipment 5

用途說明5 Purpose Explanation 5

估價單(超過5萬元需三張估價單)5 Estimated Cost (for items exceeding 50,000 NT dollars, three estimates are required)1

設備6 Equipment 6

品名6 Item Name 6

單價6 Unit Price 6

數量6 Quantity 6

小計6 Subtotal 6

設備為新增(請寫用途說明)或汰換(請註明財編及年限)6 Is the equipment new (please provide a purpose explanation) or a replacement (please specify finance code and lifespan)6

目前現有設備數量6 Current Quantity of Existing Equipment 6

用途說明6 Purpose Explanation 6

估價單(超過5萬元需三張估價單)6 Estimated Cost (for items exceeding 50,000 NT dollars, three estimates are required)1

設備7 Equipment 7

品名7 Item Name 7

單價7 Unit Price 7

數量7 Quantity 7

小計7 Subtotal 7

設備為新增(請寫用途說明)或汰換(請註明財編及年限)7 Is the equipment new (please provide a purpose explanation) or a replacement (please specify finance code and lifespan)7

目前現有設備數量7 Current Quantity of Existing Equipment 7

用途說明7 Purpose Explanation 7

估價單(超過5萬元需三張估價單)7 Estimated Cost (for items exceeding 50,000 NT dollars, three estimates are required)1

設備8 Equipment 8

品名8 Item Name 8

單價8 Unit Price 8

數量8 Quantity 8

小計8 Subtotal 8

設備為新增(請寫用途說明)或汰換(請註明財編及年限)8 Is the equipment new (please provide a purpose explanation) or a replacement (please specify finance code and lifespan)8

目前現有設備數量8 Current Quantity of Existing Equipment 8

用途說明8 Purpose Explanation 8

估價單(超過5萬元需三張估價單)8 Estimated Cost (for items exceeding 50,000 NT dollars, three estimates are required)1

設備9 Equipment 9

品名9 Item Name 9

單價9 Unit Price 9

數量9 Quantity 9

小計9 Subtotal 9

設備為新增(請寫用途說明)或汰換(請註明財編及年限)9 Is the equipment new (please provide a purpose explanation) or a replacement (please specify finance code and lifespan)9

目前現有設備數量9 Current Quantity of Existing Equipment 9

用途說明9 Purpose Explanation 9

估價單(超過5萬元需三張估價單)9 Estimated Cost (for items exceeding 50,000 NT dollars, three estimates are required)1

設備10 Equipment 10

品名10 Item Name 10

單價10 Unit Price 10

數量10 Quantity 10

小計10 Subtotal 10

設備為新增(請寫用途說明)或汰換(請註明財編及年限)10 Is the equipment new (please provide a purpose explanation) or a replacement (please specify finance code and lifespan)10

目前現有設備數量10 Current Quantity of Existing Equipment 10

用途說明10 Purpose Explanation 10

估價單(超過5萬元需三張估價單)10 Estimated Cost (for items exceeding 50,000 NT dollars, three estimates are required)1

申請總金額 Total Application Amount *

請加總所提出全部設備的總金額 Please sum up the total amount for all proposed equipment.

預期成效(請填寫績效指標，非過程活動型指標) Expected Achievements (Please specify performance indicators, not process-oriented indicators) *

請具體詳述足以證明學生之學習成效，如證照、專題、產學成果等。 Please provide specific details that demonstrate student learning outcomes, such as certifications, projects, industry achievements, etc.

說明其所對應永續發展目標SDGs之原因 Reasons for Corresponding to SDGs *

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