25-10121_Attach_1_Soy_Based_Formula_Bid_Forms_CAPS_1.22.25.xls
XLS spreadsheet 52 KB Posted
- Attached to
- Soy-Based Infant Formula Rebate
- Solicitation number
- 25-10121
- Issued by
- California
About this file
This is a bid form attachment for the California WIC Infant Formula Rebate IFB 25-10121, specifically for soy-based infant formula submissions. The form requires manufacturers to provide detailed information about their soy-based infant formula products in three physical forms: powdered, liquid concentrate, and ready-to-feed. Manufacturers must submit product names, UPC codes, unit sizes, reconstituted ounces per unit, and wholesale pricing information. The form includes certification requirements confirming compliance with the Food, Drug and Cosmetic Act and federal regulations under P.L. 100-237.
The pricing structure requires bidders to submit their lowest national wholesale price per unit for full truckload quantities and their rebate bid per unit, carried to three decimal places. The form includes calculations for estimated usage based on infant age categories (0-3 months, 4-5 months, and 6-11 months) and feeding types (fully formula-fed and partially breastfed). The document includes a calculation sheet that automatically determines total monthly reconstituted ounces and total net costs based on estimated average infant numbers over a six-month period. No minimum or maximum quantity guarantees are provided for infant participants or formula types.
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Other files
| File | Type | Posted |
|---|---|---|
| IFB_25-10121_-_Soy-Based_Infant_Formula_Rebate.pdf |
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Text version
| California WIC Infant Formula Rebate | IFB 25-10121 Attachment 1 Page 1 of 2 | |||||||||
| Bid Form for Soy-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 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 | 0.000% | ||||||||
| Liquid Concentrate | $0.000 | 0.000% | ||||||||
| Ready-to-Feed | $0.000 | 0.000% | ||||||||
| **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. | ||||||||||
| Signature | Date | |||||||||
| Notarized Signature: | ||||||||||
| Seal/Date |
&RAttachment 2
| California WIC Infant Formula Rebate | IFB 25-10121 Attachment 1 Page 2 of 2 | |||||||||||||
| Bid Form for Soy-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 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 | ||||
| Form: | Powdered | FF | PBF | FF | PBF | |||||||||
| Name: | 0 | 0.0 | 0-3 months | 870 | 435 | 632 | 126 | 1,860,756 | 0 | $0.000 | $0.000 | $0.000 | $0.000 | |
| Ounces: | 0.0 | 4-5 months | 960 | 522 | 420 | 49 | ||||||||
| 6-11 months | 696 | 384 | 1,128 | 110 | ||||||||||
| Form: | Liquid Concentrate | FF | PBF | FF | PBF | |||||||||
| Name: | 0 | 0.0 | 0-3 months | 823 | 388 | 12 | 2 | 30,663 | 0 | $0.000 | $0.000 | $0.000 | $0.000 | |
| Ounces: | 0.0 | 4-5 months | 896 | 460 | 6 | 1 | ||||||||
| 6-11 months | 630 | 315 | 22 | 1 | ||||||||||
| Form: | Ready-to-Feed | FF | PBF | FF | PBF | |||||||||
| Name: | 0 | 0.0 | 0-3 months | 832 | 384 | 0 | 0 | 0 | 0 | $0.000 | $0.000 | $0.000 | $0.000 | |
| Ounces: | 0.0 | 4-5 months | 913 | 474 | 0 | 0 | ||||||||
| 6-11 months | 643 | 338 | 0 | 0 | ||||||||||
| 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 .