ESBD_567618_1791984532438_Exhibit_D_Pricing Proposal FNS Bid Sheet.xlsx
XLSX spreadsheet 28 KB Posted
- Attached to
- WIC Infant Formula Rebate
- Solicitation number
- HHS0016707
- Issued by
- Texas
About this file
This is an Infant Formula Bid Sheet for WIC (Women, Infants, and Children) Program procurement involving the state agencies of Texas, Minnesota, Iowa, and the Choctaw Nation of Oklahoma. The document serves as a template for collecting competitive bids for primary contract infant formula in both milk-based and soy-based formulations across three physical forms: powdered, liquid concentrate, and ready-to-feed. Bidders must submit pricing for three infant age categories (0-3 months, 4-5 months, and 6-11 months), with separate bid sheets for milk-based and soy-based formula products. The bid sheet requires bidders to provide detailed product information including UPC codes, unit sizes, reconstituted ounces per unit, and pricing data to at least three decimal places. The document includes estimated infant population data based on six months of recent usage averages, distinguishing between fully formula-fed and partially breastfed infants to establish baseline volume projections.
Bidders must submit rebate bids per unit and certify compliance with federal regulations under the Food, Drug and Cosmetic Act and WIC Program Regulations (7 C.F.R. 246.10(e)(9) and 246.16a). The bid sheet calculates net price per unit, percent rebate, total monthly reconstituted ounces, standardized number of units, and total monthly pricing. Bidders must certify their registration with the U.S. Department of Health & Human Services, product suitability for routine issuance to healthy full-term infants, federal compliance for each formula product, and capacity to supply 100 percent of the WIC Program's needs across all geographic areas. The template is designed for single-supplier competitive bid solicitations and explicitly notes that no quantity assurances are provided, and estimated infant populations represent approximations excluding exclusively breastfed infants or those issued exempt formula.
View the file
Other files
Show all 22
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
Infant Formula Bid Sheet
| WIC Infant Formula Rebate Bid Sheet Template for Separate Bid Solicitations: Milk-based Infant Formula |
| Purpose: Template for WIC State agencies to use in order to collect bids for primary contract infant formula as part of its single-supplier competitive bid solicitation to meet the federal requirements outlined in 7 C.F.R. 246.10(e)(9)(Table 1) and §246.16a(c)(2, 4-7). |
| Instructions for the WIC State agency: Please complete all fillable cells in this template highlighted in pink (i.e., cells K8:L16; B27:E27). |
| Instructions for the Bidder: Please complete all fillable cells in this template highlighted in gray (i.e., cells B8:G16; B28:E28; K27:Q28) and read through the certification statements below. Please provide data to at least 3 decimal places when possible. Once complete, please sign and reference procurement instructions provided in the State agency's bid solicitation. |
| Physical Form | Product Name | UPC Code | Unit Size (in ounces) | Reconstituted Ounce Per Unit | Lowest Wholesale Full Truckload Price Per Unit | Rebate Bid Per Unit | Infant Age Categories | Number of Reconstituted Ounces Issued per Month Based on Max* | Estimated Average Number of Infants by Form Based on 6 Months Average** | Net Price Per Unit | Percent Rebate | Total Monthly Reconstituted Ounces to Bid | Standardized Number of Units of Infant Formula | Total Cost | |||
| Fully Formula Fed Infants | Partially Breastfed Infants | Fully Formula Fed Infants | Partially Breastfed Infants | ||||||||||||||
| Powdered | |||||||||||||||||
| (milk-based) | 0-3 months | 870 | 435 | 21,721 | 33,583 | $0.000 | ERROR:#DIV/0! | 94,430,553 | ERROR:#DIV/0! | ERROR:#DIV/0! | |||||||
| 4-5 months | 960 | 522 | 12,180 | 14,291 | |||||||||||||
| 6-11 months | 696 | 384 | 39,967 | 36,341 | |||||||||||||
| Liquid Concentrate | |||||||||||||||||
| (milk-based) | 0-3 months | 823 | 388 | 59 | 63 | $0.000 | ERROR:#DIV/0! | 166,850 | ERROR:#DIV/0! | ERROR:#DIV/0! | |||||||
| 4-5 months | 896 | 460 | 24 | 21 | |||||||||||||
| 6-11 months | 630 | 315 | 66 | 67 | |||||||||||||
| Ready-to-Feed | |||||||||||||||||
| (milk-based) | 0-3 months | 832 | 384 | 29 | 34 | $0.000 | ERROR:#DIV/0! | 116,484 | ERROR:#DIV/0! | ERROR:#DIV/0! | |||||||
| 4-5 months | 913 | 474 | 18 | 16 | |||||||||||||
| 6-11 months | 643 | 338 | 66 | 38 | |||||||||||||
| *Based on WIC Program Regulations (§246.10(e)(9)(Table 1) and §246.16a(c)(5)(i)) | Total Monthly Price | ERROR:#DIV/0! | |||||||||||||||
| **Based on six months of the most recent data available. Excludes infants that are exclusively breastfed or issued exempt infant formula and includes infants that are issued milk-based infant formula. |
Please Note: No assurances are provided on the quantity, type, or physical forms that will be issued under the agreement that will become a result of this bid solicitation. Additionally, the estimated average number of infants provided on this bid sheet is an approximation and excludes infants that are exclusively breastfed or issued exempt infant formula.
| Certification: |
| The bidder hereby certifies that: |
1. The bidder is registered under the Food, Drug and Cosmetic Act with the U.S. Department of Health & Human Services and its products are in compliance with Federal regulations issued pursuant to P.L. 100-237.
2. Bids for all physical forms of formula meet the requirements of 246.10 (e) (l)(iii) and 246.10(e)(2)(iii) and are suitable for the routine issuance to the majority of generally healthy, full term infants.
3. Each infant formula product to be supplied under the terms of this contract complies with the Federal Food, Drug, and Cosmetic Act.
4. The bidder can and will supply the quantities of infant formula offered to meet one hundred percent (100%) of the WIC Program’s needs in all geographic areas as outlined in the bid solicitation.
| State Agency Name: | Texas, Minnesota, Iowa and Choctaw Nation of Oklahoma | Manufacturer's Signature: |
| Manufacturer Name: | ||
| WIC Infant Formula Rebate Bid Sheet Template for Separate Bid Solicitations: Soy-based Infant Formula | ||
| Purpose: Template for WIC State agencies to use in order to collect bids for primary contract infant formula as part of its single-supplier competitive bid solicitation to meet the federal requirements outlined in 7 C.F.R. 246.10(e)(9)(Table 1) and §246.16a(c)(2, 4-7). | ||
| Instructions for the WIC State agency: Please complete all fillable cells in this template highlighted in pink (i.e., cells K36:L44; B55:E55). | ||
| Instructions for the Bidder: Please complete all fillable cells in this template highlighted in gray (i.e., cells B36:G44; B56:E56; K55:Q56) and read through the certification statements below. Please provide data to at least 3 decimal places when possible. Once complete, please sign and reference procurement instructions provided in the State agency's bid solicitation. |
| Physical Form | Product Name | UPC Code | Unit Size (in ounces) | Reconstituted Ounce Per Unit | Lowest Wholesale Full Truckload Price Per Unit | Rebate Bid Per Unit | Infant Age Categories | Number of Reconstituted Ounces Issued per Month Based on Max* | Estimated Average Number of Infants by Form Based on 6 Months Average** | Net Price Per Unit | Percent Rebate | Total Monthly Reconstituted Ounces to Bid | Standardized Number of Units of Infant Formula | Total Cost | |||
| Fully Formula Fed Infants | Partially Breastfed Infants | Fully Formula Fed Infants | Partially Breastfed Infants | ||||||||||||||
| Powdered (soy- based) | 0-3 months | 870 | 435 | 528 | 538 | $0.000 | ERROR:#DIV/0! | 2,366,058 | ERROR:#DIV/0! | ERROR:#DIV/0! | |||||||
| 4-5 months | 960 | 522 | 368 | 290 | |||||||||||||
| 6-11 months | 696 | 384 | 1,255 | 767 | |||||||||||||
| Liquid Concentrate | |||||||||||||||||
| (soy-based) | 0-3 months | 823 | 388 | 7 | 3 | $0.000 | ERROR:#DIV/0! | 21,775 | ERROR:#DIV/0! | ERROR:#DIV/0! | |||||||
| 4-5 months | 896 | 460 | 5 | 2 | |||||||||||||
| 6-11 months | 630 | 315 | 13 | 4 | |||||||||||||
| Ready-to-Feed (soy-based) | 0-3 months | 832 | 384 | 3 | 1 | $0.000 | ERROR:#DIV/0! | 7,515 | ERROR:#DIV/0! | ERROR:#DIV/0! | |||||||
| 4-5 months | 913 | 474 | 1 | 1 | |||||||||||||
| 6-11 months | 643 | 338 | 4 | 2 | |||||||||||||
| *Based on WIC Program Regulations (§246.10(e)(9)(Table 1) and §246.16a(c)(5)(i)) | Total Monthly Price | ERROR:#DIV/0! | |||||||||||||||
| **Based on six months of the most recent data available. Excludes infants that are exclusively breastfed or issued exempt infant formula and includes infants that are issued soy-based infant formula. |
Please Note: No assurances are provided on the quantity, type, or physical forms that will be issued under the agreement that will become a result of this bid solicitation. Additionally, the estimated average number of infants provided on this bid sheet is an approximation and excludes infants that are exclusively breastfed or issued exempt infant formula.
| Certification: |
| The bidder hereby certifies that: |
1. The bidder is registered under the Food, Drug and Cosmetic Act with the U.S. Department of Health & Human Services and its products are in compliance with Federal regulations issued pursuant to P.L. 100-237.
2. Bids for all physical forms of formula meet the requirements of 246.10 (e) (l)(iii) and 246.10(e)(2)(iii) and are suitable for the routine issuance to the majority of generally healthy, full term infants.
3. Each infant formula product to be supplied under the terms of this contract complies with the Federal Food, Drug, and Cosmetic Act.
4. The bidder can and will supply the quantities of infant formula offered to meet one hundred percent (100%) of the WIC Program’s needs in all geographic areas as outlined in the bid solicitation.
| State Agency Name: | Texas, Minnesota, Iowa and Choctaw Nation of Oklahoma | Manufacturer's Signature: |
| Manufacturer Name: |
&"Arial,Bold"HHS0010510 Exhibit E - Pricing Proposal
File details come from the government source that posted it. Updated .