DJD-17-Q-0147_NARCAN_(Naloxone_Hcl)(correction)v2.pdf

PDF 16 KB Posted

Attached to
NARCAN (Naloxone Hcl)
Solicitation number
DJD-17-Q-0147
Issued by

About this file

RFQ Corrected Version 2

View the file

Other files

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

Text version

REQUEST FOR QUOTATION

(THIS IS NOT AN ORDER) THIS RFQ IS IS NOT A SMALL BUSINESS SET-ASIDEX

1. REQUEST NO.

DJD-17-Q-0147

2. DATE ISSUED

08/16/2017

3. REQUISITION/PURCHASE REQUEST NO.

D-17-HO-0328

4. CERT. FOR NAT. DEF.

UNDER BDSA REG. 2

AND/OR DMS REG. 1

RATING

DEA

Attn: Office of Acq & Relo Mgmt (FA) 8701 Morrissette Drive Springfield, VA 22152

5a. ISSUED BY 6. DELIVER BY (Date) See Lines

7. DELIVERY

OTHER

(See Schedule)X FOB DESTINATION

9. DESTINATION

5b. FOR INFORMATION CALL (NO COLLECT CALLS) a. NAME OF CONSIGNEE

DEA

NAME

Teresa Delgado

TELEPHONE NUMBER

AREA CODE NUMBER

Ext.:

8. TO:

Attn: Office of Forensic Sciences (SS) 8701 Morrissette Drive

b. STREET ADDRESS

c. CITY

Springfield

a. NAME b. COMPANY

c. STREET ADDRESS

d. CITY e. STATE f. ZIP CODE d. STATE

VA

e. ZIP CODE

22152

10. PLEASE FURNISH QUOTATIONS TO THE

ISSUING OFFICE IN BLOCK 5a ON OR BEFORE CLOSE OF BUSINESS (Date)

08/25/2017 17:00:00

IMPORTANT: This is a request for information, and quotations furnished are not offers. If you are unable to quote, please so indicate on this form and return it to the address in Block 5a. This request does not commit the Government to pay any costs incurred in the preparation of the submission of this quotation or to contract for supplies or service. Supplies are of domestic origin unless otherwise indicated by quoter. Any representations and/or certifications attached to this Request for Quotation must be completed by the quoter.

11. SCHEDULE (Include applicable Federal, State and local taxes)

ITEM NO.

(a)

SUPPLIES/SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

Attached please find the RFQ Guidelines;

Clauses; and Blanket Purchase Agreement

Note: Per RFQ, Questions should be sent via email to: teresa.a.roshau-delgado@usdoj.gov

See Continuation Sheet(s)

12. DISCOUNT FOR PROMPT PAYMENT

a. 10 CALENDAR DAYS (%)

0.00 %

b. 20 CALENDAR DAYS (%)

0.00 %

c. 30 CALENDAR DAYS (%)

0.00 %

d. CALENDAR DAYS

NUMBER

PERCENTAGE

0.00 NOTE: Additional provisions and representations [ ] are [ X ] are not attached.

13. NAME AND ADDRESS OF QUOTER 14. SIGNATURE OF PERSON AUTHORIZED TO SIGN

QUOTATION

15. DATE OF

QUOTATION

a. NAME OF QUOTER

b. STREET ADDRESS 16. SIGNER

a. NAME (Type or print) b. TELEPHONE

c. COUNTY AREA CODE

d. CITY e. STATE f. ZIP CODE c. TITLE (Type or print) NUMBER

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition not usable

STANDARD FORM 18 (REV. 6-95)

Prescribed by GSA-FAR (48 CFR) 53.215-1(a)

DJD-17-Q-0147 Page 1 of 6

Section 2 - Commodity or Services Schedule

SCHEDULE OF SUPPLIES/SERVICES

CONTINUATION SHEET

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 NARCAN (Naloxone Hcl) 4mg Nasal Spray - 2pk

Line Period of Performance: 09/30/2017 - 09/29/2018

0.000000 EA $____________ $___________________

0002 NARCAN (Naloxone Hcl) 2mg Nasal Spray - 2pk

Line Period of Performance: 09/30/2017 - 09/29/2018

0.000000 EA $____________ $___________________

0003 NARCAN (Naloxone Hcl) 2mg Pre-Filled Syringe- 1ea

Line Period of Performance: 09/30/2017 - 09/29/2018

0.000000 EA $____________ $___________________

0004 NARCAN (Naloxone Hcl) KIT Kit Contains:

*(QTY: 1)Neoprene Accessory Pouch, black, zipper closure and carabineer clip. 5"W x 3"H *(QTY: 2) IMS3369/ Naloxone l mg/ mL 2mL Needleless PFS (Narcan) *(QTY: 2) WTMAD300/ Nasal Atomization Device w/o 3cc Syringe *(QTY: 1)MDI70-150/ Shield CPR Microshield *(QTY: 1)RU123128/ Nasal Airway 28FR *(QTY: 1)837168/ Surgical Lubricant Packet *(QTY: 1)KC55083/ Purple Nitrile Gloves, Large, pair

Line Period of Performance: 09/30/2017 - 09/29/2018

0.000000 EA $____________ $___________________

0005 NARCAN (Naloxone Hcl) 4mg Nasal Spray - 2pk

Line Period of Performance: 09/30/2018 - 09/29/2019

0.000000 EA $____________ $___________________

0006 NARCAN (Naloxone Hcl) 2mg Nasal Spray - 2pk

Line Period of Performance: 09/30/2018 - 09/29/2019

0.000000 EA $____________ $___________________

0007 NARCAN (Naloxone Hcl) 2mg Pre-Filled Syringe- 1ea

Line Period of Performance: 09/30/2018 - 09/29/2019

0.000000 EA $____________ $___________________

0008 NARCAN (Naloxone Hcl) KIT Kit Contains:

*(QTY: 1)Neoprene Accessory Pouch, black, zipper closure and carabineer clip. 5"W x 3"H *(QTY: 2) IMS3369/ Naloxone l mg/ mL 2mL Needleless PFS (Narcan) *(QTY: 2) WTMAD300/ Nasal Atomization Device w/o 3cc Syringe *(QTY: 1)MDI70-150/ Shield CPR Microshield *(QTY: 1)RU123128/ Nasal Airway 28FR *(QTY: 1)837168/ Surgical Lubricant Packet *(QTY: 1)KC55083/ Purple Nitrile Gloves, Large, pair

Line Period of Performance: 09/30/2018 - 09/29/2019

0.000000 EA $____________ $___________________

0009 NARCAN (Naloxone Hcl) 4mg Nasal Spray - 2pk

Line Period of Performance: 09/30/2019 - 09/29/2020

0.000000 EA $____________ $___________________

0010 NARCAN (Naloxone Hcl) 2mg Nasal Spray - 2pk

Line Period of Performance: 09/30/2019 - 09/29/2020

0.000000 EA $____________ $___________________

0011 NARCAN (Naloxone Hcl) 2mg Pre-Filled Syringe- 1ea

Line Period of Performance: 09/30/2019 - 09/29/2020

0.000000 EA $____________ $___________________

0012 NARCAN (Naloxone Hcl) KIT Kit Contains:

Syringe

*(QTY: 1)Neoprene Accessory Pouch, black, zipper closure and carabineer clip. 5"W x 3"H *(QTY: 2) IMS3369/ Naloxone l mg/ mL 2mL Needleless PFS (Narcan) *(QTY: 2) WTMAD300/ Nasal Atomization Device w/o 3cc Syringe

0.000000 EA $____________ $___________________

DJD-17-Q-0147 Page 2 of 6

*(QTY: 1)MDI70-150/ Shield CPR Microshield *(QTY: 1)RU123128/ Nasal Airway 28FR *(QTY: 1)837168/ Surgical Lubricant Packet *(QTY: 1)KC55083/ Purple Nitrile Gloves, Large, pair

Line Period of Performance: 09/30/2019 - 09/29/2020

0013 NARCAN (Naloxone Hcl) 4mg Nasal Spray - 2pk

Line Period of Performance: 09/30/2020 - 09/29/2021

0.000000 EA $____________ $___________________

0014 NARCAN (Naloxone Hcl) 2mg Nasal Spray - 2pk

Line Period of Performance: 09/30/2020 - 09/29/2021

0.000000 EA $____________ $___________________

0015 NARCAN (Naloxone Hcl) 2mg Pre-Filled Syringe- 1ea

Line Period of Performance: 09/30/2020 - 09/29/2021

0.000000 EA $____________ $___________________

0016 NARCAN (Naloxone Hcl) KIT Kit Contains:

*(QTY: 1)Neoprene Accessory Pouch, black, zipper closure and carabineer clip. 5"W x 3"H *(QTY: 2) IMS3369/ Naloxone l mg/ mL 2mL Needleless PFS (Narcan) *(QTY: 2) WTMAD300/ Nasal Atomization Device w/o 3cc Syringe *(QTY: 1)MDI70-150/ Shield CPR Microshield *(QTY: 1)RU123128/ Nasal Airway 28FR *(QTY: 1)837168/ Surgical Lubricant Packet *(QTY: 1)KC55083/ Purple Nitrile Gloves, Large, pair

Line Period of Performance: 09/30/2020 - 09/29/2021

0.000000 EA $____________ $___________________

0017 NARCAN (Naloxone Hcl) 4mg Nasal Spray - 2pk

Line Period of Performance: 09/30/2021 - 09/29/2022

0.000000 EA $____________ $___________________

0018 NARCAN (Naloxone Hcl) 2mg Nasal Spray - 2pk

Line Period of Performance: 09/30/2021 - 09/29/2022

0.000000 EA $____________ $___________________

0019 NARCAN (Naloxone Hcl) 2mg Pre-Filled Syringe- 1ea

Line Period of Performance: 09/30/2021 - 09/29/2022

0.000000 EA $____________ $___________________

0020 NARCAN (Naloxone Hcl) KIT Kit Contains:

*(QTY: 1)Neoprene Accessory Pouch, black, zipper closure and carabineer clip. 5"W x 3"H *(QTY: 2) IMS3369/ Naloxone l mg/ mL 2mL Needleless PFS (Narcan) *(QTY: 2) WTMAD300/ Nasal Atomization Device w/o 3cc Syringe *(QTY: 1)MDI70-150/ Shield CPR Microshield *(QTY: 1)RU123128/ Nasal Airway 28FR *(QTY: 1)837168/ Surgical Lubricant Packet *(QTY: 1)KC55083/ Purple Nitrile Gloves, Large, pair

Line Period of Performance: 09/30/2021 - 09/29/2022

0.000000 EA $____________ $___________________

DJD-17-Q-0147 Page 3 of 6

Section 3 - Contract Clauses

This Section Is Intentionally Left Blank

DJD-17-Q-0147 Page 4 of 6

Section 4 - List of Attachments

Identifier Title Number of Pages

1 DEA-19, split info, quote 2 TRU Patient Svcs Quote 3 NARCAN Mountainside Medical quote 4 NARCAN - Adapt quote

DJD-17-Q-0147 Page 5 of 6

Section 5 - Solicitation Provisions

This Section Is Intentionally Left Blank

DJD-17-Q-0147 Page 6 of 6

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