Cover letter
A letter from VA saying it is submitted to secure an estimate and is not a purchase order, and that a purchase order will be prepared and forwarded if the purchase is approved. It notes Attachment: VA Form FL 10-90.
FL-10-90
Request to Submit Quotation
- Agency
- VA
- Revision
- September 2008
- Fillable fields
- 28
- Pages
- 2
- Official source
- VA form page
- Checked
- October 20, 2026
VA Form FL-10-90: Request to Submit Quotation
VA Form FL-10-90 is the U.S. Department of Veterans Affairs Request to Submit Quotation. VA's page lists it as related to VHA. A requesting VA facility sends it to a vendor to get an estimate for the item(s) or service(s) it lists for a Veteran. It is not a Veterans benefit application and not a purchase order: the form says the quotation is not to be considered as authority for delivery or work to be started.
The PDF is two pages. Page 1 is a cover letter from VA. Page 2 is the form: Section I is completed by the requesting VA facility with the vendor, facility and Veteran information and the items wanted, and Section II is the vendor's itemized estimate. The form says to return it via facsimile to the VA facility. You can fill out the PDF free in your browser on this page and download the result without an account.
What's on VA Form FL-10-90
Privacy Act and burden notice
The information is solicited under Title 38, U.S.C., and the form says it will be used to determine the cost effective company. OMB Number 2900-0188, with an estimated burden of 5 minutes.
Section I: vendor, facility and Veteran
Name, address, phone number and fax number for the vendor and for the requesting VA facility, and a Veteran Information block.
Section I: items requested
Space for the items the firm is being considered as a possible source for, the estimate request text, and the VA Approving Official's name, title and date.
Section II: vendor's estimate
An itemized table with HCPCS (if known), item(s) or service(s), quantity, unit, unit cost and total cost, then sub total, less discount (if applicable) and total. The form says to separate materials from labor costs.
How VA Form FL-10-90 is completed
- 1
VA fills in Section I
The requesting VA facility enters the vendor, facility and Veteran information and lists the items or services wanted.
- 2
The approving official is named
The name and title of the VA Approving Official and the date go at the end of Section I.
- 3
The vendor evaluates the request
The form says the request authorizes the vendor to contact the named Veteran for additional information and/or to schedule an appointment for evaluation.
- 4
The vendor itemizes the estimate
Section II is filled in line by line, separating materials from labor costs, with any discount and the total, then the company official's name, title and date.
- 5
Fax it back
The form says to return it via facsimile to the VA facility indicated in Section I, and that the estimate is expected within 5 business days from the date of the request unless you notify the VA Approving Official.
Why fill Form FL-10-90 on indox
You get the real form, filled in a browser tab, with nothing standing between you and the finished PDF.
- Fill the form right in your browser, no software to install
- Free to fill and free to download, with no account
- The official blank straight from the VA, not a copy someone retyped
- Works on a phone, tablet or computer
Returning the quotation
Return by fax
The form says to return the estimate via facsimile to the Department of Veterans Affairs facility indicated in Section I. It prints no central address or fax number.
Timing
The cover letter says your estimate is expected within five (5) business days from the date of this letter unless you notify the VA Approving Official.
Not a purchase order
The form says the quotation does not constitute a purchase order nor is it to be considered as authority for delivery or work to be started. If approved, a purchase order will be prepared and forwarded to the vendor.
Copies
The cover letter says the vendor may retain one copy of the letter and the attached form for its files.
Edition
The PDF footer reads VA FORM SEP 2008 FL 10-90, with OMB Number 2900-0188. VA's page lists a form revision date of June 2008.
Related forms
Who completes VA Form FL-10-90?
The form splits the work between a requesting VA facility and a vendor.
Official sources and the blank
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Questions about Form FL-10-90
What is VA Form FL-10-90?
It is VA's Request to Submit Quotation. A requesting VA facility uses it to ask a vendor for an itemized estimate for the items or services listed in Section I.
Is the request a purchase order?
No. The form says it does not constitute a purchase order nor authority for delivery or work to be started. The cover letter says that if the purchase is approved, a purchase order will be prepared and forwarded, and at that time the vendor is authorized to start work.
Who fills in Section II?
The vendor. Section II, Vendor's Estimate, is marked To be completed by Vendor, and the form says the estimate should be itemized, separating materials from labor costs.
How soon is the estimate expected?
The form says the estimate is expected within 5 business days from the date of the request unless you notify the VA Approving Official.
How is VA Form FL-10-90 returned?
The form says to return it via facsimile to the Department of Veterans Affairs facility indicated in Section I.
Can the vendor contact the Veteran?
The form says the request authorizes the vendor to contact the named Veteran for additional information and/or to schedule an appointment for evaluation.