S02.Pricing Schedule_Q0252.xlsx
XLSX spreadsheet 15 KB Posted
- Solicitation number
- 36C77024Q0252
About this file
This document is a pricing schedule and solicitation cover sheet for Request for Quote (RFQ) 36C77024Q0252 issued by the Department of Veterans Affairs (VA) Veterans Health Administration Veterans Integrated Service Network 15 for pharmaceutical products to be delivered to the CMOP facility in Leavenworth.
The RFQ lists 15 line items for various pharmaceutical products including amoxicillin, albuterol, amlodipine/valsartan, ciprofloxacin, capecitabine, dicloxacillin, dipyridamole, etodolac, entacapone, and eletriptan. Vendors are required to submit a completed SF1449 solicitation cover page, quote spreadsheet, valid state wholesale distributor license, and Buy American Act certificate (if proposing non-domestic products). Quotes are due by 5:00 PM CST on 4/10/2024, and delivery is required by 4/29/2024. Vendors may submit only one quote per vendor and must note any differences from the required NDC/packaging in the comments section.
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| File | Type | Posted |
|---|---|---|
| 36C77024Q0252_1.docx | DOCX document |
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Quote Spreadsheet
| CMOP - Leavenworth | ||||||
| RFQ: 36C77024Q0252 | Delivery on or before: 4/29/2024 | Required documents: | ||||
| Solicitation - Quote Spreadsheet | Posted Date: | 4/3/24 | 1. SF1449 - Solicitation cover page (signed) | |||
| Vendor shall complete all areas in orange | Closing Date: | 4/10/24 | 2. Quote - excel spreadsheet | |||
| Vendor Name: | Closing Time: | 5:00PM Central Standard Time (CST) | 3. State Wholesale Distributor License (valid and unexpired) | |||
| ueiSAM: | 4. Buy American Act (BAA ) Certificate, if quoting non-domestic product | |||||
| POC Name: | * Vendors shall submit no more than (1) one quote per vendor | |||||
| 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 | Email quotes to kayla.powers@va.gov | |||||
| 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 | Local Stock+J13:J15# | Alternate | |||
| NDCs | Mfr | Country of | ||||
| Origin | Packaging | |||||
| Multiple | Unit | QTY | Unit | |||
| Price | Total | |||||
| Price | Vendor |
Comments
| 0001 | 17752 | AMOXICILLIN 875/CLAV K 125MG TAB 20 (A0712) | 42571-0162-42 | 20 | BT | 288 | $ - 0 | $0.00 |
| 0002 | 19856 | ALBUTEROL SO4 0.042% 3ML INHL 25CT (A1270) | 76204-0011-55 | 25 | BX | 3690 | $ - 0 | $0.00 |
| 0003 | 19339 | ALBUTEROL SO4 0.021% 3ML INHL 25CT (A1366) | 76204-0010-55 | 25 | BX | 1620 | $ - 0 | $0.00 |
| 0004 | 15571 | AMLODIPINE 5MG/VALSARTAN 160MG TAB 90CT, A1372 | 62332-0205-90 | 90 | BT | 192 | $ - 0 | $0.00 |
| 0005 | 16408 | AMLODIPINE 5MG/VALSARTAN 320MG TAB 90CT, A1376 | 62332-0207-90 | 90 | BT | 96 | $ - 0 | $0.00 |
| 0006 | 15004 | AMLODIPINE 10MG/VALSARTAN 160MG TAB 30CT, A1378 | 62332-0206-90 | 30 | BT | 72 | $ - 0 | $0.00 |
| 0007 | 13644 | CIPROFLOXACIN HCL 500MG TAB 500CT, C0260 | 65862-0077-05 | 500 | BT | 24 | $ - 0 | $0.00 |
| 0008 | 13712 | CAPECITABINE 150MG TAB 60CT (C0795) | 16729-0072-12 | 60 | BT | 192 | $ - 0 | $0.00 |
| 0009 | 2661 | DICLOXACILLIN NA 500MG CAP 100CT--D0065 | 00093-3125-01 | 100 | BT | 96 | $ - 0 | $0.00 |
| 0010 | 2668 | DIPYRIDAMOLE 50MG TAB 100CT (D0097) | 68382-0188-01 | 100 | EA | 168 | $ - 0 | $0.00 |
| 0011 | 19790 | ETODOLAC 200MG CAP 100 CT (E0059) | 62559-0250-01 | 100 | BT | 216 | $ - 0 | $0.00 |
| 0012 | 19456 | ETODOLAC 300MG CAP 100CT, E0075 | 62559-0251-01 | 100 | BT | 432 | $ - 0 | $0.00 |
| 0013 | 18089 | ENTACAPONE 200MG TAB 100CT (E0294) | 65862-0654-01 | 100 | BT | 864 | $ - 0 | $0.00 |
| 0014 | 13500 | ELETRIPTAN 20MG TAB 6 PKG E0362 | 59651-0104-69 | 6 | BT | 270 | $ - 0 | $0.00 |
| 0015 | 17966 | EPINASTINE HCL 0.05% OPH SOLN | 51991-0836-75 | 5 | BT | 96 | $ - 0 | $0.00 |
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