M5-Q50A-03-R8 0003_Part3of3_PricPropsl_65IB_R8_42-2aAllOtherSINs_Oct2019.xlsx

XLSX spreadsheet 635 KB Posted

Attached to
M5-Q50A-03-R8: 65IB Drugs, Pharmaceuticals & Hematology Related Products Solicitation Refreshment
Solicitation number
M5Q50A03R8
Issued by

About this file

This is a pricing proposal template for the GSA Federal Supply Schedule 65IB (Drugs, Pharmaceuticals & Hematology Related Products) solicitation M5-Q50A-03-R8. The template is used by vendors to submit pricing information for pharmaceutical and hematology-related products under FSC Groups 6505 and 6508.

The pricing proposal requires vendors to provide detailed commercial and government pricing data for each proposed line item, including the Schedule Identification Number (SIN), unique item number, product generic name, trade name, package size, unit of sale, FDA application number, and country of origin. Vendors must establish pricing tiers based on three customer categories: the Most Favored Customer (MFC) representing the lowest upfront guaranteed discount, a proposed Tracking Customer (TC) whose pricing will determine future price adjustment obligations, and the proposed Federal Supply Schedule (FSS) price without and with the Industrial Funding Fee (IFF currently at 0.5%). The template requires vendors to document prior fiscal year sales data (quantity and dollar volume) for commercial and government customers, as well as sales specifically to the proposed TC. All commercial list prices must correspond to vendors' current catalogs or pricelists, and the FSS price must be F.O.B. destination. This multiple-award, fixed-price, indefinite delivery-indefinite quantity (IDIQ) contract includes Economic Price Adjustment provisions and is issued on an open and continuous basis with no closing date; contract performance runs for five years from the award effective date unless canceled, terminated, or extended.

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ALL Other SINs - Proposal

Product InformationMFC InformationTC InformationFSS Information
SIN#
Lydia McKay: Carefully review the list of SINs provided in Document 02 (the Continuation of SF1449) and choose the category that matches your product’s attributes. If a product does not fit within one of the listed SIN categories, then it potentially does not fall within the scope of the Schedule.NDC 1

or Item # Lydia McKay: The item number must be listed for each proposed product and must be a unique identifier (i.e., you cannot list the same item number on more than one line). This item number should correspond to the item number listed in the commercial catalog/pricelist which you provide with your proposal.

NDC numbers must follow the prescribed format as follows, entering leading zeroes if necessary:

NDC1 = 5 digits NDC2 = 4 digits

NDC2 = 3 digitsNDC2
(4 digits only - Add leading 0 if necessary)NDC3Type "YES" if item is handled by Specialty Distrib.Generic Name / StrengthTrade Name / StrengthPackage SizeUnit of SaleQuantity in Unit of SaleUnit PkgQuantity in Unit PkgUnit of MeasureFDA Application NumberCountry of Origin

(See Country Codes Tab)

Lydia McKay: You must list the country of origin for each product, utilizing the two-letter country codes provided on a Country Code tab. Remember, the country of origin of the product is where the product was “substantially transformed”, not necessarily the country of manufacture or the country of export.Total (comm. & gov’t) units sold during Prior Fiscal Year (or a more recent 12-month period)Total (comm. & gov’t) sales ($) during Prior Fiscal Year (or a more recent 12-month period)Commercial List Price ($)
Lydia McKay: The commercial list price must be listed for each proposed line item. This should match the commercial pricelist/catalog provided with your proposal. The discount off of list price (for your Most Favored Customer, the Tracking Customer, and the Government) will be calculated based upon the information in this column.MFC Price ($)

VA Employee: Lowest upfront (guaranteed) discounted price.

List the lowest price you charge any customer (known as the Most Favored Customer) for each line item. This is specific to each line item; therefore, the Most Favored Customer (MFC) may vary from item to item. In determining your lowest price, you should be looking for the lowest price currently received by any customer for each line item based upon the upfront (guaranteed) discount received. This is not inclusive of “conditional” discounts, such as prompt payment discounts, annual rebates based on reaching a threshold, etc., which must be listed in Fig 515.4-2.MFC % Off Comm. List Price
Christine Szrom: Column auto-calculates the % discount off of list price.MFC Name
VA Employee: Name of Customer or category of customer that receives the lowest upfront (guaranteed) discounted price.Proposed Tracking Customer (TC) Name

VA Employee: Please enter the proposed Tracking Customer (TC) even if the proposed TC is the same as the stated MFC.

List the name of the customer or category of customers you wish to propose as the Tracking Customer (TC). You will need to complete this field for each proposed item. Be prepared to discuss your rationale for the TC you are proposing. The TC ratio (Government price without IFF divided by the TC price) will impact future price increases and decreases under your Government contract pursuant to clauses 552.238-75Price Reductions and 552.216-70 Economic Price Adjustment (located in Document 01 – Solicitation Document).Proposed TC Price ($)
Lydia McKay: List the price that the listed Tracking Customer (TC) pays for each line item. If you are proposing different TCs for different line items, then make sure that the price you list corresponds to the TC listed in the previous column.TC % Off Comm. List Price
Christine Szrom: Column auto-calculates the % discount off of list price.Total sales ($) to Proposed TC during Prior Fiscal Year (or a more recent 12-month period)Total Gov't sales (FSS & open market) ($) during Prior Fiscal Year (or a more recent 12-month period)Proposed FSS Price ($) without IFF
Christine Szrom: List the price you wish to offer the Government for each line item. This represents the price without IFF which will be added in Column P. This price must be F.O.B. destination (see clause F-FSS-202-G Delivery Prices in Document 02 – Vendor Response Document).Proposed FSS % Off Comm. List Price w/out IFF
Christine Szrom: Column auto-calculates the % off list price using the proposed FSS price without IFF.Proposed FSS Price ($) with IFF

Christine Szrom: Column autocalculates the price offered to FSS including the Industrial Funding Fee (currently 0.5%).

The correct method for calculating the IFF is:

Proposed FSS pricing / (1 minus the applicable IFF) = correct calculated proposed FSS price.

For more information on IFF, see clause 552.238-74 Industrial Funding Fee and Sales Reporting in Document 01 – Solicitation Document.TC<=MFC PriceProposed TC Ratio
TC Better Price
42-1TC Better Price
42-2BTC Better Price
42-3TC Better Price
42-5TC Better PriceAMEA
622TC Better Price42-2BBGF2
INPTC Better Price42-1BOGM
TC Better Price42-3BXIN
TC Better Price42-5CALT
TC Better Price622CHML
TC Better PriceINPCL
TC Better PriceCN
TC Better PriceCQ
TC Better PriceCT
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TC Better PriceEA
TC Better PriceKT
TC Better PricePC
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TC Better PriceRL
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&"Arial,Bold"&12Proposed Government Pricing &P of &N

&"Calibri,Regular"&11Version: Oct 2019 &"Calibri,Regular"&11 65 I B - Price Proposal &"Calibri,Regular"&11&P of &N

Definitions & Examples Column G - Package Size: Quantity in Unit of Sale x Quantity in Unit of Package

Columns H & J - Unit of Sale & Unit PackageColumn L - Unit of Measure
AMAmpuleEAEach
BGBagF2Square Feet
BOBottleGMGram
BXBoxINInch
CACaseLTLiter
CHContainerMLMilliliter
CLCylinder
CNCan
CQCartridge
CTCarton
DRDrum
EAEach
KTKit
PCPiece
PKPackage
RLRoll
TBTube
VIVial
EXAMPLES:
Note: There is no column for strength. It is to be included with the generic and trade names.
Generic Name / StrengthTrade Name / StrengthPackage SizeUnit of SaleUnit of PkgUnit of Measure
XXXXXX / 30mgXXXXXX / 30mg1 x 100BOBOEA
FSS Price is for one bottle containing 100 tablets of 30 mg each.
XXXXXX / 25mgXXXXXX / 25mg10 x 100CABOEA
FSS Price is for one case containing 10 boxes of bottles which contain 100 capsules of 25 mg each.
XXXXXX / 0.3%XXXXXX / 0.3%1 x 6VIVIML
FSS Price is for one vial containing 6 ml of 0.3% solution.
XXXXXX / 0.3%XXXXXX / 0.3%5 x 6BXVIML
FSS Price is for one box containing 5 vials, 6 ml each, of 0.3% solution.
XXXXXX / 0.2%XXXXXX / 0.2%1 x 150BOBOML
FSS Price is for one bottle containing 150 ml of 2% suspension.
XXXXXX / 0.1%XXXXXX / 0.1%50 x 150CABOML
FSS Price is for one case of 50 bottles containing 150ml each of 1% strength.
XXXXXX / 0.1%XXXXXX / 0.1%1 x 5TBTBGM
FSS Price is for one, 5 gram tube containing 1% strength.

Country Codes

CountryCode
AfghanistanAF
AlbaniaAL
AlbertaXA
AlgeriaDZ
American SamoaAS
AndorraAD
AngolaAO
AnguillaAI
Antigua & BarbudaAG
APO Customs Mail Entry OnlyAP
ArgentinaAR
ArmeniaAM
ArubaAW
AustraliaAU
AustriaAT
AzerbaijanAZ
BahamasBS
BahrainBH
BangladeshBD
BarbadosBB
BelarusBY
BelgiumBE
BelizeBZ
BeninBJ
BermudaBM
BhutanBT
BoliviaBO
Bosnia and HerceqovinaBA
BotswanaBW
Bouvet IslandBV
BrazilBR
British ColumbiaXC
British Columbia CoastalXD
British Columbia InteriorXE
British Indian Ocean TerritoryIO
British Virgin IslandsVG
BruneiBN
BulgariaBG
Burkina FasoBF
BurmaBU
Burma (Myanmar)MM
BurundiBI
CambodiaKH
CameroonCM
CanadaCA
Cape VerdeCV
Cayman IslandsKY
Central African RepublicCF
ChadTD
ChileCL
China (Mainland)CN
China (Taiwan)TW
Christmas IslandsCX
Cocos (Keeling) IslandsCC
ColombiaCO
ComorosKM
Congo (Brazzaville)CG
Congo, The Democratic Republic of the (Kinshasa)CD
Cook IslandsCK
Costa RicaCR
CroatiaHR
CubaCU
CuracaoCW
CyprusCY
Czech RepublicCZ
CzechoslavakiaCS
DenmarkDK
Djibouti,DJ
DominicaDM
Dominican RepublicDO
EcuadorEC
EgyptEG
El SalvadorSV
Equatorial GuineaGQ
EritreaER
EstoniaEE
EstoniaEN
EthiopiaET
Falkland Islands (Malvinas)FK
Faroe IslandsFO
FijiFJ
FinlandFI
FPO Customs Mail EntryFP
FranceFR
French GuianaGF
French PolynesiaPF
French Southern and Antarctic LandsTF
GabonGA
GambiaGM
Gaza StripGZ
GeorgiaGE
GeorgiaGG
GermanyDE
Germany, EastDD
GhanaGH
GibraltarGI
GreeceGR
GreenlandGL
GrenadaGD
GuadeloupeGP
GuamGU
GuatemalaGT
GuernseyGG
GuineaGN
Guinea BissauGW
GuyanaGY
HaitiHT
Heard Island and McDonald IslandsHM
HondurasHN
Hong KongHK
HungaryHU
IcelandIS
IndiaIN
IndonesiaID
Iran,IR
IraqIQ
IrelandIE
IsraelIL
ItalyIT
JamaicaJM
JapanJP
JordanJO
KazakhstanKZ
KazakhstanKK
KenyaKE
KiribatiKI
Korea, Republic OfKR
KuwaitKW
KyrgyzstanKG
Laos People's Democratic RepublicLA
LatviaLV
LebanonLB
LesothoLS
LiberiaLR
LibyaLY
LiechtensteinLI
LithuaniaLT
LuxembourgLU
MacaoMO
Macedonia, (Skopie)MK
MadagascarMG
MalawiMW
MalaysiaMY
MaliML
Malta and GozoMT
ManitobaXM
Marshall IslandsMH
MartiniqueMQ
MauritaniaMR
MauritiusMU
MayotteYT
MexicoMX
Micronesia, Federated StatesFM
Moldova, Republic ofMD
MonacoMC
MongoliaMN
MontenegroME
MontserratMS
MoroccoMA
MozambiqueMZ
NamibiaNA
NauruNR
NepalNP
NetherlandsNL
Netherlands AntillesAN
New BrunswickXB
New Foundland and LabradorXW
New CaledoniaNC
New ZealandNZ
NicaraguaNI
NigerNE
NigeriaNG
NiueNU
Norfolk IslandNF
Northern Mariana IslandsMP
NorwayNO
OmanOM
OntarioXO
PakistanPK
PalauPW
PanamaPA
Papua New GuineaPG
ParaguayPY
PeruPE
PhilippinesPH
Pitcairn IslandPN
PolandPL
PortugalPT
Prince Edward IslandXP
Puerto RicoPR
QatarQA
QuebecXA
Republic of MaldivesMV
Republic of South AfricaZA
Republic of YemenYE
ReunionRE
RomaniaRO
Russia FederationRU
RwandaRW
St. Kitts and Nevis IslandsKN
St. LuciaLC
Saint Pierre and MiquelonPM
Saint Vincent and The GrenadinesVC
SamoaWS
San MarinoSM
Sao Tomes and PrincipeST
Saudi ArabiaSA
SenegalSN
SerbiaRS
SeychellesSC
Sierra LeoneSL
SingaporeSG
Sint Maarten (Southern)SX
SlovakiaSK
SlovakiaSQ
SloveniaSI
Solomon IslandsSB
SomaliaSO
SpainES
Sri LankaLK
SudanSD
SurinamSR
Svalbard and Jan Mayen IslandsSJ
SwazilandSZ
SwedenSE
SwitzerlandCH
SyriaSY
TajikistanTJ
Tanzania, United Republic ofTZ
ThailandTH
Timor-LesteTL
TogoTG
TokelauTK
TongaTO
Trinidad and TobagoTT
TunisiaTN
TurkeyTR
TurkmenistanTM
Turks and Caicos IslandsTC
TuvaluTV
UgandaUG
UkraineUA
Union of Soviet Socialist RepublicsSU
United Arab EmiratesAE
United KingdomGB
United States of AmericaUS
United States Minor Outlying IslandsUM
UruguayUY
UzbekistanUZ
VanuatuVU
Vatican CityVA
VenezuelaVE
VietnamVN
Virgin Islands of the United StatesVI
Wallis and FutunaWF
West BankWE
Western SaharaEH
YemenYE
YugoslaviaYU
YukonXU
ZaireZR
ZambiaZM
ZimbabweZW

Figure 515.4-2 CSP-1

FIGURE 515.4-2
The Government expects you to provide information required by the format in accordance with the solicitation instructions for Figure 515.4-2 that is, to the best of your knowledge and belief, current, accurate, and complete as of 60 calendar days prior to its submission. The data provided in the price proposal tab and Figure 515.4-2 is current, accurate, and complete as of (enter date in cell to the right).Enter date in this cell based on instructions to the left.
Provide the date range which represents the start and end date of the transactional data and commercial agreements used to populate the MFC and TC columns on the Price Proposal tab as well as Figure 515.4-2 below (enter date in cell to the right).Enter date range (start and end date) in this cell based on instructions to the left.
Column 1 - Customer

VA Employee:

A "Customer" is any entity, except the Federal Gvmt, which acquires supplies or services from the Offeror.

In this column you should list the MFC as well as each customer or category of customers (e.g. wholesalers, GPOs, hospitals, etc.) who are receiving equal to or better pricing than that offered to the Government for any proposed item. Categories of customers for whom your discounting practices are the same (for all columns to the right, columns 2 – 5) may be grouped together in a single line. Each customer with different discounting practices must be listed on a separate line. Column 2 - Discount VA Employee: This column represents the best discount (as a percentage off of commercial list) at which you sell the offered products to the customer/category of customers listed in column 1. If the total discount is a combination of various discounts (upfront discount, prompt payment, quantity, etc.), then the percentage must be broken out for each type of discount. The “upfront” discount is that afforded to the customer at the time of order. Below are examples of different discounting configurations.

If your discount practices vary by individual line item and you are offering a large number of items and have numerous customers listed in this figure, then you may initially list the percentage discount range for each customer for the offered products. However, be aware that you may be asked by your Contract Specialist or the VA’s Office of Inspector General (OIG) to provide a breakdown by line item as this level of detail may be necessary for a determination of price reasonableness or a determination of the completeness and accuracy of your submission. Column 3 - Quantity/Volume VA Employee:

This column describes what is required of the customer in column 1 in order for them to be afforded the discount(s) listed in column 2. Be specific when listing the requirement (e.g.” 90% market share commitment contract” rather than “commitment contract”; “Minimum of $500,000 in purchases during calendar year” rather than “$500,000 in purchases”).Column 4 - FOB Terms
VA Employee: In the preformatted spreadsheet provided in Document 06, this column has a drop-down box for you to select FOB Origin or FOB Destination. FOB Origin means that the item is “free on board” at the point of origin; in other words, the customer pays for the shipping. FOB Destination means that the item is “free on board” to the point of destination; in other words, the customer does not pay a separate shipping charge and the price of the item is inclusive of shipping.Column 5 - Additional Discounts or Concessions

VA Employee: This column represents any additional concessions afforded to the listed customer, such as freight allowance, extended warranty, extended price guarantees, free installation and bonus goods, as identified in clause 553.212-70 Preparation of Offer (Multiple Award Schedule).

F.O.B. Origin
F.O.B. Destination
Please reference the instructions for this Figure in the CSP-1 section of the solicitation and in the "Contractor Guide to CSP"
found on our Training web page under the "Prospective Contractors - Solicitation Assistance" section at:
https://www.va.gov/opal/nac/fss/training.asp

&"Arial,Bold"&12CSP-1 COMMERCIAL SALES PRACTICE https://www.va.gov/opal/nac/fss/training.asp ManufPlaceOfPerf

Manufacturing Facilities / Place of Performance
Please complete the table below with information regarding each place of performance for the offered products.
Provide the Field Establishment Identifier (FEI) Number and the Facility Owner Name, Address, City, County, State and Zip Code)
You should provide information for the following (choose from the drop-down menu in column B):
1. Measured/Compounded: Location where ingredients are measured, weighed, mixed and compounded.
2. Sterilization: Location where product is sterilized.
3. Vaccines: Location where vaccine is produced.
4. Packaging: Location where intermediate containers will be fixed and labeled.
5. Packing: Location where products will be packed and prepared for shipment.

NDC 1

or Item # Lydia McKay: The item number must be listed for each proposed product and must be a unique identifier (i.e., you cannot list the same item number on more than one line). This item number should correspond to the item number listed in the commercial catalog/pricelist which you provide with your proposal.

NDC numbers must follow the prescribed format as follows, entering leading zeroes if necessary:

NDC1 = 5 digits NDC2 = 4 digits

NDC2 = 3 digitsNDC2
(4 digits only - Add leading 0 if necessary)NDC3Generic NameTrade NameFacility Location Type(FEI) NumberFacility Information
Facility Owner Name, Address, City, County, State and Zip CodePoint of Contact

Including Phone Number & Email Address

Facility Owner Name & Address:Measured/ Compounded
Facility Owner Name & Address:Sterilization
Facility Owner Name & Address:Vaccines
Facility Owner Name & Address:Packaging
Facility Owner Name & Address:Packing
Facility Owner Name & Address:
Facility Owner Name & Address:
Facility Owner Name & Address:
Facility Owner Name & Address:

Manufacturing Facilities / Place of Performance

NonManufacturers

SIN#

VA Employee: Special Item Number

This should match info provided in the price proposal tab. Manufacturer Name VA Employee: Manufacturer's Company Name

This should match info provided in price proposal tab Column E. Manuf.

NDC 1 or Item # Lydia McKay: The item number must be listed for each proposed product and must be a unique identifier (i.e., you cannot list the same item number on more than one line). This item number should correspond to the item number listed in the commercial catalog/pricelist which you provide with your proposal.

NDC numbers must follow the prescribed format as follows, entering leading zeroes if necessary:

NDC1 = 5 digits NDC2 = 4 digits

NDC2 = 3 digitsManuf. NDC2
(4 digits only - Add leading 0 if necessary)Manuf. NDC3Dealer/ Reseller

NDC 1 or Item # Lydia McKay: The item number must be listed for each proposed product and must be a unique identifier (i.e., you cannot list the same item number on more than one line). This item number should correspond to the item number listed in the commercial catalog/pricelist which you provide with your proposal.

NDC numbers must follow the prescribed format as follows, entering leading zeroes if necessary:

NDC1 = 5 digits NDC2 = 4 digits

NDC2 = 3 digitsDealer/ Reseller NDC2
(4 digits only - Add leading 0 if necessary)Dealer/ Reseller NDC3Product Description

Lydia McKay: Product Description

This should match the description provided in price proposal tab Column C.Mfr List Price
VA Employee: Manufacturer Commercial List PriceDealer/ Reseller % discount off Mfr. List Price

VA Employee:

The % discount your firm receives off of the Manufacturer's commercial list price.

This is not the % discount you are offering to the Government.

42-1
42-2A
42-2B
42-3
42-5
622
INP

&"Calibri,Bold"&11Dealer/Reseller Mfr. Disclosure

Price Analysis

MFC & TC Analysis
SIN#Item # / NDC1NDC2NDC3Commercial List Price ($)MFC Price ($)MFC Discount off Comm. List Price (%)Proposed TC NameProposed TC Price ($)TC Discount off Comm. List Price (%)Proposed FSS Price ($) without IFFProposed FSS Discount off Comm. Price w/out IFF (%)Is Proposed Gov't Price (w/out IFF) Less Than or Equal to MFC Price?Proposed TC Ratio

&"Calibri,Bold"65 I B - Price Analysis &"Calibri,Regular"Page &P of &N

Award

SIN# NDC1

or

Item #NDC2NDC3Specialty Distrib. Item?Generic Name / StrengthTrade Name / DescriptionPkg SizeUnit of SaleQnty in Unit of SaleUnit PkgQnty in Unit PkgUnit of MeasTracking Customer NameTracking RatioGov't Price without IFF(Copy FSS w/ IFF from PP Tab)Gov't Price with IFFRed "A" = Awarded
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