S02 - Pricing Schedule_Q0022 - ACAMPROSATE - HINES - FINAL.xlsx

XLSX spreadsheet 14 KB Posted

Attached to
6505--765-25-1-021-0009 -Hines CMOP ACAMPROSATE -(VA-25-00012693)
Solicitation number
36C77025Q0022
Issued by

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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S02 - RFQ - 36C77025Q0022 - ACAMPROSATE - FINAL.pdf PDF

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Text version

Quote Spreadsheet

CMOP - Hines
RFQ: 36C77025Q0022Delivery 10 days After Receipt of Order (ARO)Required documents:
Solicitation - Quote SpreadsheetPosted Date:1/3/251. SF1449 - Solicitation cover page (signed)
Vendor shall complete all areas in orangeClosing Date:1/10/252. 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 ItemCMOP FacilityDescriptionNDC#Alternate NDCsMfrCountry of OriginPackaging MultipleUnitQTYUnit PriceTotal PriceVendor Comments
0001HinesACAMPROSATE CA 333MG EC TAB 180CT BT (A1222)68462-0435-18180BT1728$0.00
Grand Total Price$0.00

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