S02_Pricing Schedule_Q0273.xlsx
XLSX spreadsheet 15 KB Posted
- Attached to
- 761-24-2-015-0563 -Chelmsford CMOP OTC PHARM
- Solicitation number
- 36C77024Q0273
About this file
This document is a pricing schedule template for a Request for Quote (RFQ) related to the Chelmsford VA Community-Based Outpatient Clinic (CMOP). The RFQ number is 36C77024Q0273. The required delivery is within 10 days of award. Vendors must submit the following documents: a signed SF1449 Solicitation cover page, a completed quote spreadsheet, a valid state wholesale distributor license, OEM authorization documentation, and a BAA certificate for any non-domestic quotes.
The pricing schedule lists 6 line items for various pharmaceutical and medical/surgical products such as eye drops, vaginal gel, multivitamins, and wound therapy solution. Vendors must provide pricing, packaging details, and any comments on expiration dates or other considerations. This is a Small Business Set-Aside procurement, and the Buy American Act (BAA) applies. Quotes are due by 4:00 PM CST on 5/14/24 and should be emailed to the POC.
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Other files
| File | Type | Posted |
|---|---|---|
| S02 RFQ 36C77024Q0273_.pdf |
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Text version
Quote Spreadsheet
| CMOP - Chelmsford CMOP | ||||||
| RFQ: 36C77024Q0273 | Delivery on or before: 10 days ARO | Required documents: | ||||
| Solicitation - Quote Spreadsheet | Posted Date: | 5/7/24 | 1. SF1449 - Solicitation cover page (signed) | |||
| Vendor shall complete all areas in orange | Closing Date: | 5/14/24 | 2. Quote - excel spreadsheet | |||
| Vendor Name: | Closing Time: | 4:00PM Central Standard Time (CST) | 3. Vaild State Wholesale Distributor License | |||
| ueiSAM: | 4. OEM Authorzation documentation for all (Over the Counter) | |||||
| POC Name: | (OTC) products. | |||||
| POC E-Mail: | * If vendor is proposing NDC with count other than CMOP listed NDC, | 5. BAA Certificate - for non-domestic quotes | ||||
| Phone: | QTY shall be adjusted for that count and this should be noted in "Vendor Comments" | Email quotes to: sarah.fry2@va.gov | ||||
| * Per the Statement of Requirements, expiration dates of all pharmaceuticals and/or medical surgical supplies | ||||||
| shall be no less than one (1) year of date of delivery. Please provide expiration in "Vendor Comments" if short-dated | ||||||
| Line | ||||||
| Item | File | |||||
| Number | CMOP | |||||
| Facility | Description | Local Stock Number | Quoted | |||
| NDC | Mfr | Country of | ||||
| Origin | Packaging | |||||
| Multiple | Unit | QTY | Unit | |||
| Price | Total | |||||
| Price | Vendor |
Comments
| 0001 | 13707 | VA CMOP Chelmsford - 761 | CARBOXYMETHYLCELLULOSE NA 0.25% OPH SOLN 15ML | 58790000115 | 15 ML | BT | 2400 | $ - 0 | $0.00 |
| 0002 | 14532 | VA CMOP Chelmsford - 761 | CARBOXYMETHYL 0.5/GLYCERIN 0.9% OPH SOLN 15ML (C1472) | 00023324015 | 15 ML | BT | 2400 | $ - 0 | $0.00 |
| 0003 | 2752 | VA CMOP Chelmsford - 761 | MOISTURIZER VAG GEL APPLIC (EQV-REPLENS) M1024 | 22600000104 | 8 CT | BX | 3600 | $ - 0 | $0.00 |
| 0004 | 18090 | VA CMOP Chelmsford - 761 | MULTIVIT/OPHTH AREDS2/LUTE/ZEAX CHEW TAB (M1255) | 32420869763 | 60 CT | BT | 720 | $ - 0 | $0.00 |
| 0005 | 15410 | VA CMOP Chelmsford - 761 | NURSING TOP CREAM W/LANOLIN (N0650) | 44677010020 | 40 GM | TU | 3600 | $ - 0 | $0.00 |
| 0006 | 13129 | VA CMOP Chelmsford - 761 | VASHE WOUND THERAPY TOP SOLN (V0261) | 51383000313 | 250 ML | BT | 3600 | $ - 0 | $0.00 |
| Total Small Business Set-aside | $0.00 | ||||||||
| Buy American Act Applies (BAA) |
File details come from the government source that posted it. Updated .