25-10009_Attach_1_Milk_Based_Formula_Bid_Form_CAPS_1.22.25.xls

XLS spreadsheet 51 KB Posted

Attached to
Milk-Based Infant Formula Rebate
Solicitation number
25-10009
Issued by
California

About this file

This is a bid form attachment for the California WIC Infant Formula Rebate IFB 25-10009, specifically for milk-based infant formula. The form requires manufacturers to provide detailed product information including product name, UPC code, unit size, reconstituted ounce per unit, and lowest national wholesale price per unit for full truckload delivery across three physical forms: powdered, liquid concentrate, and ready-to-feed formula. The form specifies that no minimum or maximum number of infant participants is guaranteed, and no assurances are provided regarding quantity, type, or physical forms that will be issued under the agreement.

The pricing structure requires bidders to submit rebate amounts per unit, with calculations automatically performed to determine net costs and percent rebates. The form includes detailed monthly usage estimates based on infant age categories (0-3 months, 4-5 months, and 6-11 months) for both fully formula-fed and partially breastfed infants. The estimated monthly volume shows approximately 93 million reconstituted ounces for powdered formula, 370,465 for liquid concentrate, and 4,960 for ready-to-feed formula, based on six months of the most recent data available.

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California WIC Infant Formula RebateIFB 25-10009 Attachment 1 Page 1 of 2
Bid Form for Milk-Based Infant Formula
CARRY ALL FIGURES TO THREE (3) DECIMAL PLACES
Instructions:Enter manufacturer's name, product name, UPC code, unit size, reconstituted ounce per unit, lowest national wholesale price per unit for a full truckload, and rebate bid per unit in the chart below.
Data entry fields are yellow sections.
Calculations will be performed automatically within the spreadsheet in Page 2.
Sign and Notarize this page.
Manufacturer:
Physical FormProduct Name Being BidUPC CodeUnit Size (in Ounces)Reconstituted Ounce Per UnitLowest Wholesale Full Truckload Price Per UnitRebate Bid Per UnitNet CostPercent Rebate
Powdered$0.0000.000%
Liquid Concentrate$0.0000.000%
Ready-to-Feed$0.0000.000%
**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 bidder hereby certifies that the company 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.
SignatureDate
Notarized Signature:
Seal/Date

&RAttachment 2

California WIC Infant Formula RebateIFB 25-10009 Attachment 1 Page 2 of 2
Bid Form for Milk-Based Infant Formula
ALL FIGURES MUST BE AT LEAST THREE (3) DECIMAL PLACES
All cells highlighted salmon will automatically populate from bidder's data entered into Page 1
Physical Form, Product Brand Name, and Unit SizeReconstituted Ounces Per UnitInfant Age CategoriesNumber of Reconstituted Ounces Issued per Month (based on Max)**Estimated Average # Infants by Form Based on 6 Months Average*Total Monthly Reconstituted Ounces to BidTotal Monthly UnitsLowest Wholesale Full Truckload Price Per UnitRebate Per UnitNet Cost Per UnitTotal Net Cost
Form:PowderedFFPBFFFPBF
Name:00.00-3 months87043538,2295,19593,058,9810$0.000$0.000$0.000$0.000
Ounces:0.04-5 months96052219,9561,778
6-11 months69638449,8197,240
Form:Liquid ConcentrateFFPBFFFPBF
Name:00.00-3 months82338818320370,4650$0.000$0.000$0.000$0.000
Ounces:0.04-5 months896460769
6-11 months63031520926
Form:Ready-to-FeedFFPBFFFPBF
Name:00.00-3 months832384104,9600$0.000$0.000$0.000$0.000
Ounces:0.04-5 months91347410
6-11 months64333850
Total Net$0.000
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))
FF means fully-formula fed.
PBF means partially breastfed.

&RAttachment 2

File details come from the government source that posted it. Updated .