S01-Contract Review FormAREQ0516--.pdf

PDF 2 MB Posted

Attached to
6505--METFORMIN- Tucson CMOP Federal contract opportunity
Solicitation number
36C77020Q0516
Issued by
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 15

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Other files for this federal contract opportunity

Other files attached to 6505--METFORMIN- Tucson CMOP, newest first.
File Type Posted
S06-36C77020Q0516 0001.docx DOCX document
Pricing ScheduleAmend.xlsx XLSX spreadsheet
Pricing Schedule.xlsx XLSX spreadsheet
S02-36C77020Q0516_1.docx DOCX document

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Revised: 30-May-2019

Contract Review Form Print Form

Procurement Number: 762-20-3-040-1911

Dollar Value: $273,007.44

Description: 2 Line Pharm for Tucson

Review Requested:

Pre-Solicitation

Acquisition Type:

Commodity

Procurement Method:

FAR Part 13

Solicitation Method:

RFQ

Evaluation Type:

Trade Off

Contract Specialist: Jessica Hansroth Legal Review: No

MSO Review: No

Date: 6/8/20

Contracting Officer: Josie Manderscheid

Reviewer Position: Reviewer Name: Reviewer Signature and Date:

CO: Josie Manderscheid

Indicate Position and Name of Additional Applicable Reviewer above. By signing this review, I affirm the review relevant to this position is complete.

Clearance Authority:

By signing this review, I affirm that the action under review has received final clearance.

Branch Chief: John Fisher

Indicate Position and Name of Additional Applicable Reviewer above. By signing this review, I affirm the review relevant to this position is complete.

Position Enter Additional Reviewer's Name, if selected

Indicate Position and Name of Additional Applicable Reviewer above. By signing this review, I affirm the review relevant to this position is complete.

Position Enter Additional Reviewer's Name, if selected

Indicate Position and Name of Additional Applicable Reviewer above. By signing this review, I affirm the review relevant to this position is complete.

Position Enter Additional Reviewer's Name, if selected

Indicate Position and Name of Additional Applicable Reviewer above. By signing this review, I affirm the review relevant to this position is complete.

Reviewer Comments (mark each Mandatory or Advisory) & Contracting Officer Responses Comment Category Definitions (click here)

-+ Source: Page: Paragraph: Line:

Reviewer:

Item No.: Refer to Legal:

Completed:

Comment Category: Comment Type:

Reviewer Comment:

CO Response:

Reviewer Final Comment:

Page of Revised: 30-May-2019 Contract Review Form Reviewer Position:

Reviewer Name:

Reviewer Signature and Date:

Indicate Position and Name of Additional Applicable Reviewer above. By signing this review, I affirm the review relevant to this position is complete.

By signing this review, I affirm that the action under review has received final clearance.

Indicate Position and Name of Additional Applicable Reviewer above. By signing this review, I affirm the review relevant to this position is complete.

Indicate Position and Name of Additional Applicable Reviewer above. By signing this review, I affirm the review relevant to this position is complete.

Indicate Position and Name of Additional Applicable Reviewer above. By signing this review, I affirm the review relevant to this position is complete.

Indicate Position and Name of Additional Applicable Reviewer above. By signing this review, I affirm the review relevant to this position is complete.

Reviewer Comments (mark each Mandatory or Advisory) & Contracting Officer Responses Comment Category Definitions (click here) 8.2.1.4029.1.523496.503679 No No

CO:

Josie Manderscheid Branch Chief:

John Fisher

PrintButton1:
CurrentPage:
PageCount:
Enter Procurement ID number. : 762-20-3-040-1911
Enter total dollar value of contract for this action. The dollar sign and decimals will be added upon exit from the field. :
Enter description of the contract/procurement. Data entry space is limited to three lines. : 2 Line Pharm for Tucson
Select the Review Type requested. Users may add their own content by simply typing inside the drop down areas. : Pre-Solicitation
Select the Acquisition Type. Users may add their own content by simply typing inside the drop down areas. : Commodity
Select the Procurement Method for this contract/procurement. Users may add their own content by simply typing inside the drop down areas. : FAR Part 13
Select the Solicitation Method for this contract/procurement. Users may add their own content by simply typing inside the drop down areas. : RFQ
Select the Evaluation Type for this contract/procurement. Users may add their own content by simply typing inside the drop down areas. : Trade Off
Enter name of CO responsible for this contract. : Jessica Hansroth
Enter name of CO responsible for this contract. : Josie Manderscheid
Select Yes or No to indicate whether a legal review is needed. :
Select Yes or No to indicate whether a review by the Medical Sharing Office is needed. :
Enter date in MM/DD/YY format or select from calendar drop down.: 6/8/20
Select Not Applicable if no other additional reviewers are required. Simply Overwrite a Selection to create a unique value.:
Enter the name of the additional reviewer for the category selected. If no additional reviewer, leave blank. :
The personnel providing the review indicated in the selection box will enter digital signature here upon acceptance of completed review. :
Enter the name of the reviewer providing final clearance authority for this review. :
The personnel providing the final clearance review will enter digital signature here upon acceptance of completed review. Applying Signature here CLOSES the entire form to further editing. :
Select Not Applicable if no other additional reviewers are required. Simply Overwrite a Selection to create a unique value.:
Enter the name of the additional reviewer for the category selected. If no additional reviewer, leave blank. :
The personnel providing the review indicated in the selection box will enter digital signature here upon acceptance of completed review. :
Select Not Applicable if no other additional reviewers are required. Simply Overwrite a Selection to create a unique value.:
Enter the name of the additional reviewer for the category selected. If no additional reviewer, leave blank. :
The personnel providing the review indicated in the selection box will enter digital signature here upon acceptance of completed review. :
Select Not Applicable if no other additional reviewers are required. Simply Overwrite a Selection to create a unique value.:
Enter the name of the additional reviewer for the category selected. If no additional reviewer, leave blank. :
The personnel providing the review indicated in the selection box will enter digital signature here upon acceptance of completed review. :
Select Not Applicable if no other additional reviewers are required. Simply Overwrite a Selection to create a unique value.:
Enter the name of the additional reviewer for the category selected. If no additional reviewer, leave blank. :
The personnel providing the review indicated in the selection box will enter digital signature here upon acceptance of completed review. :
Select this button to remove this entire comment entry. :
Select this button to add another item for comment. :
Indicate the source of the comment below. :
Reference the page on which you are commenting. :
Be more specific, what paragraph on that page are you referencing. :
Be even more specific, what line number are you commenting upon?:
Select from which Reviewer category the comment originates. Simply Overwrite a Selection to create a unique value.:
Number your comments for easy reference later. :
Indicate if your comment below should be referred to legal for review. :
Indicate if this comment has been resolved. :
Select the Category for the Reviewer Comment from list below. Only ONE category per comment. :
You MUST select whether this comment requires a mandatory response or if the comment is advisory in nature. :
Enter your comment here. The entry box will expand and even paginate if necessary. :
Indicate response to Reviewer Comment above. The entry box will expand and even paginate if necessary. :
Reviewer to indicate whether the initial comment and reply are resolved, require additional input, etc. The entry box will expand and even paginate if necessary. :

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