Attachment 3 - Quote Sheet.xlsx
XLSX spreadsheet 23 KB Posted
- Solicitation number
- HT941026Q2067
- Issued by
-
Defense Health Agency
About this file
This is a Quote Sheet template for solicitation HT941026Q2067, a Request for Quote issued by the Defense Health Agency's Healthcare Contracting Division-West for pharmacy fingertip testing services at 374 MDSS, Yokota Air Base, Japan. The requirement covers a five-year period of performance from September 1, 2026, through August 31, 2031, consisting of a base period plus four option periods. Quotations must be received no later than 11:00 am PDT/PST on August 19, 2026.
The quote sheet provides line items for the base period and four option periods (CLINs 0001, 1001, 2001, 3001, and 4001), with columns for quantity, unit price, and total price to be completed by offerors. Offerors must provide company information including name, address, Unique Entity ID, CAGE code, business size designation, and primary point of contact. The template requires acknowledgment of any solicitation amendments, agreement to all terms and conditions, commitment to hold prices firm for 30 calendar days from the quote receipt date, authorized signature, and payment terms information. This non-personal services requirement must comply with The Joint Commission (TJC) and USP 797 standards for sterile intravenous compounding, with the Performance Work Statement provided as Attachment 2.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Q and A HT941026Q2067.pdf | ||
| CSS HT941026Q2067 Rev.1 (8-19-2026).pdf | ||
| CSS HT941026Q2067.pdf | ||
| Attachment 2 - Past Performance Questionnaire.docx | DOCX document | |
| PWS - FY27 Pharmacy Services (updated 8 Jul 26).pdf |
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Text version
Quote Sheet
| Attachment 3 - Quote Sheet | |
| Solicitation Number: | HT941026Q2067 |
| Requirement: | Pharmacy fingertip testing, 374 MDSS Yokota Airbase Japan |
| Period of Performance (POP): | From 9/1/2026 - To 8/31/2031 |
| Contracting Office: | DHA Healthcare Contracting Division-West |
| Quotations must be received by: | no later than 11:00 am PDT/PST on Aug 19, 2026 |
| CLIN | Description of Services | Quantity | Unit Price | Total Price |
| 0001 | Description of Services - Base Period | 0 | $ - 0 | $ - 0 |
| 1001 | Description of Services - Option Period 1 | 0 | $ - 0 | $ - 0 |
| 2001 | Description of Services - Option Period 2 | 0 | $ - 0 | $ - 0 |
| 3001 | Description of Services - Option Period 3 | 0 | $ - 0 | $ - 0 |
| 4001 | Description of Services - Option Period 4 | 0 | $ - 0 | $ - 0 |
| TOTAL EVALUATED PRICE (Base + Options 1 through 4) | $0.00 |
| Offeror Name: |
| Street Address: |
| City, State, ZIP: |
| Unique Entity ID: |
| CAGE Code: |
| Business Size: |
| Point of Contact: |
| Phone Number: |
| Email Address: |
| The Offeror acknowledges receipt of the following amendments to the solicitation: | |||
| Amendment No.: | Date: | Amendment No.: | Date: |
| Amendment No.: | Date: | Amendment No.: | Date: |
| Amendment No.: | Date: | Amendment No.: | Date: |
| Amendment No.: | Date: | Amendment No.: | Date: |
| Amendment No.: | Date: | Amendment No.: | Date: |
| Amendment No.: | Date: | Amendment No.: | Date: |
The Offeror agrees with all terms, conditions, and provisions included in the solicitation and agrees to furnish any or all items set forth or otherwise identified above subject to the terms and conditions specified in the solicitation.
The Offeror agrees to hold the prices in its quote firm for 30 calendar days from the date specified for receipt of quotes.
| Person Authorized to Sign Quote: |
| Signature: |
| Date: |
Payment Terms:
GSA Contract Number, if applicable:
File details come from the government source that posted it. Updated .