2 - T1057 Price Schedule_Infant Formula Rebate Tab Sheet 092017~1.xlsx
XLSX spreadsheet 34 KB Posted
- Attached to
- T1057 - WIC Infant Formula Rebate:DOH
- Solicitation number
- 18DPP00157
- Issued by
- New Jersey
About this file
This document is a price schedule and tabulation sheet related to a Request for Proposal (RFP) issued by the New Jersey Department of Health (DOH) for a WIC Infant Formula Rebate contract, solicitation number 18DPP00157. The contract covers the provision of milk-based, iron-fortified infant formula in powdered, liquid concentrate, and ready-to-feed physical forms to serve the WIC program's needs across the state of New Jersey. The RFP requests that bidders provide their lowest wholesale full truckload price per unit and rebate bid per unit for each formula type and physical form. The estimated monthly reconstituted ounce volumes and average number of participating infants are provided for each age category and formula type. The contract is for an unspecified term, and there is no assurance of minimum or maximum purchase quantities.
The price schedule requires bidders to provide detailed pricing information, including the product name, UPC code, unit size, reconstituted ounces per unit, lowest wholesale price per unit, and rebate bid per unit. The rebate bid per unit is used to calculate the net cost per unit and total net cost per month. Bidders must certify that their products comply with federal regulations and that they can supply 100% of the WIC program's needs across all geographic areas in New Jersey.
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Bid Sheet T0157 - WIC Infant Formula Rebate: DOH Bid Solicitation {RFP} 18DPP00157 Price Schedule/Infant Formula Rebate Tabulation Sheet
CARRY ALL FIGURES TO THREE (3) DECIMAL PLACES
Instructions: Enter Vendor {Bidder} Name, product name, UPC code, unit size, reconstituted ounce per unit, lowest national wholesale price per unit for a full truckload of the Vendor’s {Bidder's} milk-based iron-fortified Primary Rebate-Eligible Formula, and rebate bid per unit in the chart below. The Vendor {Bidder} must carry all figures to three (3) decimal places.
| Fields where the Vendor {Bidder} must provide data are highlighted yellow. |
| Calculations will be performed automatically within the spreadsheet in Page 2. |
| The Vendor {Bidder} shall sign and notarize this form. |
Vendor {Bidder} Name:
| Physical Form | Product Name Being Bid | Total Monthly Reconstituted Ounces - Estimated Volumes | UPC Code | Unit Size (in Ounces) | Reconstituted Ounce Per Unit | Lowest Wholesale Full Truckload Price Per Unit | Rebate Bid Per Unit | Net Cost | Percent Rebate |
| Powdered | 0.000 | ERROR:#DIV/0! | |||||||
| Liquid Concentrate | 0.000 | ERROR:#DIV/0! | |||||||
| Ready-to-Feed | 0.000 | ERROR:#DIV/0! |
**No assurance is given as to any minimum or maximum number of infant participants. Likewise, no assurances are provided on the quantity, type, or physical forms that will be issued under the agreement that will become a result of this Invitation to Bid
| Certification |
| The Vendor {Bidder} hereby certifies that it is registered under the Food, Drug and Cosmetic Act with the United States Department of Health & Human Services and its products are in compliance with Federal regulations issued pursuant to P.L. 100-237. Bids for all physical forms of formula must meet the requirements of 246.10 (e) (l)(iii) and 246.10(e)(2)(iii) and be suitable for the routine issuance to the majority of generally healthy, full term infants. |
| Each infant formula product to be supplied under the terms of the contract complies with the Federal Food, Drug, and Cosmetic Act. |
| The Bidder certifies that the company can and will supply the quantities of infant formula offered to meet one hundred percent (100%) of the WIC Program’s needs in all geographic areas. |
Signature Date
| Notarized Signature: |
| Seal/Date |
Eval Model T0157 - WIC Infant Formula Rebate: DOH Bid Solicitation {RFP} 18DPP00157 Price Schedule/Infant Formula Rebate Tabulation Sheet-Evaluation Model
ALL FIGURES MUST BE AT LEAST THREE (3) DECIMAL PLACES
All highlighted cells containing information will automatically populate from Vendor's {Bidder's} data entered into Page 1
| Physical Form, Product Brand Name, and Unit Size | Reconstituted Ounces Per Unit | Infant Age Categories | Number of Reconstituted Ounces Issued per Month (based on Max)** | Estimated Average # Infants by Form Based on 6 Months Average* | Total Monthly Reconstituted Ounces to Bid | Total Monthly Units | Lowest Wholesale Full Truckload Price Per Unit | Rebate Per Unit | Net Cost Per Unit | Total Net Cost | |||
| Type: | Powdered | FF | PBF | FF | PBF | ||||||||
| Name: | 0 | 0.000 | 0-3 months | 870 | 435 | 4,250 | 3,974 | 17,020,020 | ERROR:#DIV/0! | 0.000 | 0.000 | 0.000 | ERROR:#DIV/0! |
| Ounces: | 0.000 | 4-5 months | 960 | 522 | 2,496 | 2,107 | |||||||
| 6-11 months | 696 | 384 | 9,269 | 4,288 | |||||||||
| Type: | Liquid Concentrate | FF | PBF | FF | PBF | ||||||||
| Name: | 0 | 0.000 | 0-3 months | 823 | 388 | 117 | 110 | 425,925 | ERROR:#DIV/0! | 0.000 | 0.000 | 0.000 | ERROR:#DIV/0! |
| Ounces: | 0.000 | 4-5 months | 896 | 460 | 69 | 58 | |||||||
| 6-11 months | 630 | 315 | 256 | 118 | |||||||||
| Type: | Ready-to-Feed | FF | PBF | FF | PBF | ||||||||
| Name: | 0 | 0.000 | 0-3 months | 832 | 384 | 23 | 22 | 86,959 | ERROR:#DIV/0! | 0.000 | 0.000 | 0.000 | ERROR:#DIV/0! |
| Ounces: | 0.000 | 4-5 months | 913 | 474 | 14 | 12 | |||||||
| 6-11 months | 643 | 338 | 51 | 24 | |||||||||
| Total Net | ERROR:#DIV/0! | ||||||||||||
| Cost Per Month | |||||||||||||
| * Based on six months of the most recent data available | |||||||||||||
| * Excludes those infants exclusively breastfed or issued exempt infant formula | |||||||||||||
| **Based on WIC Program Regulations (§246.10(e)(9)(Table 1) and §246.16a(c)(5)(i)) |
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