S02 - Pricing Schedule_Q0022 - ACAMPROSATE - HINES - FINAL.xlsx
XLSX spreadsheet 14 KB Posted
- Solicitation number
- 36C77025Q0022
About this file
This is a pricing quote spreadsheet template for RFQ 36C77025Q0022 from the VA Veterans Health Administration Network 15 for Acamprosate CA 333MG EC tablets in 180-count bottles. The solicitation requests quotes for 1,728 bottles to be delivered to the Hines CMOP facility within 10 days after receipt of order.
Vendors must submit required documents including a signed SF1449, completed quote spreadsheet, valid state wholesale distributor license, and Buy American Act certificate by January 10, 2025 at 3:00 PM Central Time. Quotes should be emailed to Jennifer.Coleman4@va.gov. All pharmaceuticals must have at least one year until expiration at time of delivery. The template requires vendors to specify NDC numbers, manufacturer, country of origin, unit pricing, and total pricing, with space for additional comments regarding alternate NDCs or expiration dates.
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| File | Type | Posted |
|---|---|---|
| S02 - RFQ - 36C77025Q0022 - ACAMPROSATE - FINAL.pdf |
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Text version
Quote Spreadsheet
| CMOP - Hines | ||||||||||||
| RFQ: 36C77025Q0022 | Delivery 10 days After Receipt of Order (ARO) | Required documents: | ||||||||||
| Solicitation - Quote Spreadsheet | Posted Date: | 1/3/25 | 1. SF1449 - Solicitation cover page (signed) | |||||||||
| Vendor shall complete all areas in orange | Closing Date: | 1/10/25 | 2. Quote - excel spreadsheet | |||||||||
| Vendor Name: | Closing Time: | 3:00PM Central Time (CT) | 3. State Wholesale Distributor License, valid and unexpired | |||||||||
| ueiSAM: | 4. Buy American Act (BAA) Certificate | |||||||||||
| POC Name: | * Vendors shall submit no more than (1) one quote per vendor | |||||||||||
| POC E-Mail: | * If vendor is proposing NDC with count other than CMOP listed NDC, | Email quotes to: Jennifer.Coleman4@va.gov | ||||||||||
| Phone: | QTY shall be adjusted for that count and this should be noted in "Vendor Comments" | |||||||||||
| * 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 | CMOP Facility | Description | NDC# | Alternate NDCs | Mfr | Country of Origin | Packaging Multiple | Unit | QTY | Unit Price | Total Price | Vendor Comments |
| 0001 | Hines | ACAMPROSATE CA 333MG EC TAB 180CT BT (A1222) | 68462-0435-18 | 180 | BT | 1728 | $0.00 | |||||
| Grand Total Price | $0.00 |
File details come from the government source that posted it. Updated .