Copy of S02_Pricing Schedule_Q0252.xlsx
XLSX spreadsheet 16 KB Posted
- Solicitation number
- 36C77023Q0252
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| File | Type | Posted |
|---|---|---|
| 36C77023Q0252_2.docx | DOCX document |
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Quote Spreadsheet
| CMOP - Leavenworth | |||||||||||||
| RFQ: 36C77023Q0252 | Delivery on or before: 6/05/2023 | Required documents: | |||||||||||
| Solicitation - Quote Spreadsheet | Posted Date: | 5/9/23 | 1. SF1449 - Solicitation cover page (signed) | ||||||||||
| Vendor shall complete all areas in orange | Closing Date: | 5/22/23 | 2. Quote - excel spreadsheet | ||||||||||
| Vendor Name: | Closing Time: | 5:00PM Central Standard Time (CST) | 3. State Wholesale Distributor License | ||||||||||
| ueiSAM: | |||||||||||||
| POC Name: | * Vendors shall submit no more than (1) one quote per vendor | Email quotes to: Latoyia.farley@va.gov | |||||||||||
| POC E-Mail: | * If vendor is proposing NDC with count other than CMOP listed NDC, | ||||||||||||
| 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 | File Number | CMOP Facility | Description | NDC# | Alternate NDCs | Mfr | Country of Origin | Packaging Multiple | Unit | QTY | Unit Price | Total Price | Vendor Comments |
| 0001 | 18089 | Leavenworth | ENTACAPONE 200MG TAB 100CT (E0294) | 27241-0049-10 | 100 | BT | 792 | $ - 0 | $0.00 | ||||
| 0002 | 19277 | Leavenworth | FESOTERODINE FUMARATE 8MG SA TAB 30CT (F0425) | 43598-0248-30 | 30 | BT | 1056 | $ - 0 | $0.00 | ||||
| 0003 | 2950 | Leavenworth | GALANTAMINE HYDRO 16MG SA CAP 30S | 65862-0745-30 | 30 | BT | 1008 | $ - 0 | $0.00 | ||||
| 0004 | 14341 | Leavenworth | HCTZ12.5/VALSARTAN 160MG TAB 90CT (H0337) | 00378-6322-77 | 90 | BT | 480 | $ - 0 | $0.00 | ||||
| 0005 | 13108 | Leavenworth | HCTZ 12.5/OLMESARTAN 20MG TAB 90CT, H0426 | 43547-0391-09 | 90 | BT | 288 | $ - 0 | $0.00 | ||||
| 0006 | 3801 | Leavenworth | OXAPROZIN 600MG TAB | 55111-0170-01 | 500 | BT | 168 | $ - 0 | $0.00 | ||||
| 0007 | 13679 | Leavenworth | ONDANSETRON 4MG ORAL DISINTEGRATING TAB, 30CT | 57237-0077-30 | 30 | BT | 11712 | $ - 0 | $0.00 | ||||
| 0008 | 644 | Leavenworth | PROMETHAZINE HCL 25MG | 00591-5307-10 | 1000 | BT | 108 | $ - 0 | $0.00 | ||||
| 0009 | 16682 | Leavenworth | PIOGLITAZONE HCL 30MG TAB 90CT, P0536 | 72606-0571-02 | 90 | BT | 2880 | $ - 0 | $0.00 | ||||
| 0010 | 16602 | Leavenworth | PIOGLITAZONE HCL 45MG TAB 500CT (P0537) | 72606-0572-03 | 500 | BT | 288 | $ - 0 | $0.00 | ||||
| 0011 | 18167 | Leavenworth | PRAMIPEXOLE DI-HCL 1.5MG 24HR SA TAB 30CT, P0951 | 16714-0918-01 | 30 | BT | 288 | $ - 0 | $0.00 | ||||
| 0012 | 16000 | Leavenworth | RIFAMPIN 300MG CAP 60CT, R0012 | 68180-0659-07 | 60 | BT | 288 | $ - 0 | $0.00 | ||||
| 0013 | 9147 | Leavenworth | SULFACETAMIDE NA 10%/SULFUR 5% TOP FOAM 60GM, S0530 | 42192-0143-60 | 60 | BT | 108 | $ - 0 | $0.00 | ||||
| 0014 | 5501 | Leavenworth | SULFACETAMIDE NA 10%/SULFUR 5% TOP WASH 180ML--S0531 | 42192-0136-06 | 180 | BT | 1320 | $ - 0 | $0.00 | ||||
| Grand Total Price | $0.00 |
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