2 - T1057 Revised Price Sheet 110317.xlsx
XLSX spreadsheet 35 KB Posted
- Attached to
- T1057 - WIC Infant Formula Rebate:DOH
- Solicitation number
- 18DPP00157
- Issued by
- New Jersey
About this file
This document is a revised price sheet for a solicitation (RFP 18DPP00157) issued by the New Jersey Department of Health (DOH) for WIC Infant Formula Rebate. The solicitation requests bids from vendors to provide milk-based, iron-fortified primary rebate-eligible infant formula products in powdered, liquid concentrate, and ready-to-feed physical forms. The bid sheet requires vendors to provide product details, including UPC codes, unit sizes, reconstituted ounces per unit, lowest national wholesale prices, and rebate bids per unit. The contract will have no assurances on minimum or maximum number of infant participants or quantity, type, or physical forms to be issued.
The price sheet includes an evaluation model that calculates the total monthly reconstituted ounces and units to be bid based on estimated average number of infants by form and age category. Vendors must meet federal regulations and be able to supply 100% of the WIC program's needs in all geographic areas. The contract is for the state of New Jersey, specifically Mercer County.
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Text version
Bid Sheet T0157 - WIC Infant Formula Rebate: DOH Bid Solicitation {RFP} 18DPP00157 Revised Price Schedule/Infant Formula Rebate Tabulation Sheet 11/04/17
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 | 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
| 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 | 6,613 | 2,378 | 19,732,614 | ERROR:#DIV/0! | 0.000 | 0.000 | 0.000 | ERROR:#DIV/0! |
| Ounces: | 0.000 | 4-5 months | 960 | 522 | 4,089 | 917 | |||||||
| 6-11 months | 696 | 384 | 11,325 | 1,715 | |||||||||
| Type: | Liquid Concentrate | FF | PBF | FF | PBF | ||||||||
| Name: | 0 | 0.000 | 0-3 months | 823 | 388 | 157 | 11 | 361,560 | ERROR:#DIV/0! | 0.000 | 0.000 | 0.000 | ERROR:#DIV/0! |
| Ounces: | 0.000 | 4-5 months | 896 | 460 | 91 | 7 | |||||||
| 6-11 months | 630 | 315 | 220 | 15 | |||||||||
| Type: | Ready-to-Feed | FF | PBF | FF | PBF | ||||||||
| Name: | 0 | 0.000 | 0-3 months | 832 | 384 | 23 | 1 | 55,246 | ERROR:#DIV/0! | 0.000 | 0.000 | 0.000 | ERROR:#DIV/0! |
| Ounces: | 0.000 | 4-5 months | 913 | 474 | 15 | 1 | |||||||
| 6-11 months | 643 | 338 | 33 | 1 | |||||||||
| 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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