S02.Pricing Schedule_Q0100.xlsx
XLSX spreadsheet 15 KB Posted
- Solicitation number
- 36C77024Q0100
About this file
This document contains a quote spreadsheet for a solicitation issued by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 15. The solicitation requests quotes for 15 line items of pharmaceutical products by January 5, 2024 at 5:00PM Central Standard Time. Vendors must complete the provided excel spreadsheet including company information, pricing for each line item, National Drug Code numbers, packaging and quantities. The spreadsheet also requests expiration dates for products if short-dated and notes if an alternate NDC is proposed. Awards will be made for delivery by January 15, 2024. Required documents include a signed SF1449 cover page, completed quote spreadsheet, and an unexpired state wholesale distributor license. Quotes should be emailed to the provided contracting officer representative.
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| File | Type | Posted |
|---|---|---|
| 36C77024Q0100.docx | DOCX document |
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Text version
Quote Spreadsheet
| CMOP - Leavenworth | ||||||
| RFQ: 36C77024Q0100 | Delivery on or before: 1/15/2024 | Required documents: | ||||
| Solicitation - Quote Spreadsheet | Posted Date: | 12/28/23 | 1. SF1449 - Soliciation cover page (signed) | |||
| Vendor shall complete all areas in orange | Closing Date: | 1/5/24 | 2. Quote - excel spreadsheet | |||
| Vendor Name: | Closing Time: | 5:00PM Central Standard Time (CST) | 3. State Wholesale Distributor License UNEXPIRED | |||
| ueiSAM: | ||||||
| POC Name: | * Vendors shall submit no more than (1) one quote per vendor | Email quotes to: kayla.powers@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 pharmacueticals 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 | Description | NDC# | Alternate | |||
| NDCs | Mfr | Country of | ||||
| Origin | Packaging | |||||
| Multiple | Unit | QTY | Unit | |||
| Price | Total | |||||
| Price | Vendor |
Comments
| 0001 | 18089 | ENTACAPONE 200MG TAB 100CT (E0294) | 65862-0654-01 | 100 | BT | 864 | $ - 0 | $0.00 |
| 0002 | 17966 | EPINASTINE HCL 0.05% OPH SOLN | 51991-0836-75 | 5 | BT | 72 | $ - 0 | $0.00 |
| 0003 | 5119 | FENOFIBRATE 200MG CAP, 100'S, F0227 | 43975-0306-10 | 100 | BT | 144 | $ - 0 | $0.00 |
| 0004 | 5120 | FENOFIBRATE 134MG CAP, 100'S, F0238 | 27241-0119-04 | 100 | BT | 216 | $ - 0 | $0.00 |
| 0005 | 19394 | FESOTERODINE FUMARATE 4MG SA TAB 30 COUNT (F0423) | 43598-0247-30 | 30 | BT | 648 | $ - 0 | $0.00 |
| 0006 | 18693 | GLIMEPIRIDE 2MG TAB 500CT (G0133) | 61442-0116-05 | 500 | BT | 468 | $ - 0 | $0.00 |
| 0007 | 18652 | GLIMEPIRIDE 4MG TAB 500CT (G0134) | 61442-0117-05 | 500 | BT | 756 | $ - 0 | $0.00 |
| 0008 | 15814 | (G0209)GALANTAMINE HYDROBROMIDE 4MG TAB 60 | 57237-0049-60 | 60 | BT | 528 | $ - 0 | $0.00 |
| 0009 | 3892 | HYDROCORTISONE 2.5% OINT 30GM (H0062) | 00168-0146-30 | 30 | TU | 720 | $ - 0 | $0.00 |
| 0010 | 2185 | HYDROXYZINE PAMOATE 25MG CAP 500CT (H0087) | 14539-0674-05 | 500 | BT | 420 | $ - 0 | $0.00 |
| 0011 | 13108 | HCTZ 12.5/OLMESARTAN 20MG TAB 90CT, H0426 | 43547-0391-09 | 90 | BT | 288 | $ - 0 | $0.00 |
| 0012 | 13109 | HCTZ 25/OLMESARTAN 40MG TAB 90CT, H0427 | 43547-0393-09 | 90 | BT | 480 | $ - 0 | $0.00 |
| 0013 | 14342 | HCTZ 25MG/VALSARTAN 320MG TAB 90CT, H0505 | 43547-0315-09 | 90 | BT | 480 | $ - 0 | $0.00 |
| 0014 | 19585 | ISOSORBIDE MONONITRATE 20MG ORAL TAB 100CT (I0084) | 00228-2620-11 | 100 | BT | 72 | $ - 0 | $0.00 |
| 0015 | 19872 | LITHIUM CARBONATE 300MG TAB 1000CT (L0048) | 62756-0430-18 | 1000 | BT | 24 | $ - 0 | $0.00 |
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