S02 - Pric. Schedule Q0112 - EPS CIPRO.xlsx

XLSX spreadsheet 17 KB Posted Apr 14, 2026

Attached to: Ciprofloxacin 400 MG/200ML-D5W - Base + 4 Option years - 765
Solicitation number: 36C77026Q0112
Issued by: Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 15

About this file

Written by GovTribe AI · Apr 14, 2026

This is a pricing schedule spreadsheet for a Request for Quote (RFQ) issued by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 15 (VA VISN 15) for pharmaceutical supplies to support the Hines Electronic Pharmacy System (EPS).

The solicitation (36C77026Q0112) requests quotes for Ciprofloxacin 400 MG/200ML-D5W intravenous solution, National Drug Code (NDC) 25021-0114-87, for delivery to the VA Hines facility. The base contract requires 3,062 units packaged in boxes containing 24 bags per carton, with a base delivery date of May 1, 2026. The RFQ includes four one-year option periods exercisable on May 3, 2027; May 1, 2028; May 1, 2029; and May 1, 2030, each with identical quantities and specifications. The solicitation closed on April 21, 2026 at 3:00 PM Central Time, with posted date of April 14, 2026. Required submittals include a signed SF1449 form, the completed pricing spreadsheet with place of manufacture, valid state wholesale distributor license, and Trade Agreement Act (TAA) certificate. Vendors must note in comments if proposing alternative NDCs with different counts or if providing short-dated pharmaceuticals; all products must have a minimum expiration date of one year from delivery date. The specification requires 16-18 month expiration dating, and EPS approval of all alternate products is mandatory.

View the file

Other files

File	Type	Posted
S02 - RFQ - 36C77026Q0112.pdf	PDF	Apr 14, 2026

On GovTribe

Work with this file

Download the original file
Contacts named in this file
Similar government files
Ask GovTribe AI about this file

Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

Quote Spreadsheet

	CMOP - Hines EPS
	RFQ: 36C77026Q0112			Delivery: TBD		Required documents:
	Solicitation - Quote Spreadsheet			Posted Date:	4.14.2026	1. SF1449 - Solicitation cover page (signed)
	Vendor shall complete all areas in orange			Closing Date:	4.21.2026	2. Quote - excel spreadsheet - including Place of Manufacture
	Vendor Name:			Closing Time:	3:00PM Central Time (CT)	3. State Wholesale Distributor License, valid and unexpired
	ueiSAM:					4. Trade Agreement Act (TAA) Certificate
	POC Name:
	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"		Email quotes to: Jennifer.Coleman4@va.gov
				* Per the Statement of Requirements, expiration dates of all pharmaceuticals 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
	Base Contract Delivery 5.1.2026 Estimated
	Line
Item	File
Number	CMOP
Facility	Description	Approved
NDCs	Proposed
NDC	Manufactuer	Place of Manufacture	Packaging
Multiple	Unit	QTY	Unit
Price	Total
Price	Delivery and/or

Vendor Comments

	0001	VA CMOP HINES EPS 765	CIPROFLOXACIN 400 MG/200ML-D5W	25021-0114-87	24	BX	3,062	$ - 0	$0.00
			Trade Agreement Act
(TAA) Certificate					$0.00
				NOTE: 24 BAGS PER CARTON/BOX ONLY / 16-18 MONTH EXPIRATION DATING
				EPS APPROVAL OF ALL ALTERNATES IS MANDATORY

	Option: 1, if exercised (5.3.2027 DATES MAY CHANGE AT TIME OF AWARD)
	Line
Item	File
Number	CMOP
Facility	Description	Example
NDCs	Proposed
NDC	Manufactuer	Place of Manufacture	Packaging
Multiple	Unit	QTY	Unit
Price	Total
Price	Delivery and/or

Vendor Comments

	1001		VA CMOP HINES EPS 765	CIPROFLOXACIN 400 MG/200ML-D5W	25021-0114-87	24	BX	3,062	$ - 0	$0.00
				Trade Agreement Act
(TAA) Certificate						$0.00
					NOTE: 24 BAGS PER CARTON/BOX ONLY / 16-18 MONTH EXPIRATION DATING
					EPS APPROVAL OF ALL ALTERNATES IS MANDATORY
	Option: 2, if exercised (5.1.2028 DATES MAY CHANGE AT TIME OF AWARD)
	Line
Item	File
Number	CMOP
Facility	Description	Approved
NDCs	Proposed
NDC	Manufactuer	Place of Manufacture	Packaging
Multiple	Unit	QTY	Unit
Price	Total
Price	Delivery and/or

Vendor Comments

	2001		VA CMOP HINES EPS 765	CIPROFLOXACIN 400 MG/200ML-D5W	25021-0114-87	24	BX	3,062	$ - 0	$0.00
				Trade Agreement Act
(TAA) Certificate						$0.00
					NOTE: 24 BAGS PER CARTON/BOX ONLY / 16-18 MONTH EXPIRATION DATING
					EPS APPROVAL OF ALL ALTERNATES IS MANDATORY
	Option: 3, if exercised (5.1.2029 DATES MAY CHANGE AT TIME OF AWARD)
	Line
Item	File
Number	CMOP
Facility	Description	Approved
NDCs	Proposed
NDC	Manufactuer	Place of Manufacture	Packaging
Multiple	Unit	QTY	Unit
Price	Total
Price	Delivery and/or

Vendor Comments

	2002		VA CMOP HINES EPS 765	CIPROFLOXACIN 400 MG/200ML-D5W	25021-0114-87	24	BX	3,062	$ - 0	$0.00
				Trade Agreement Act
(TAA) Certificate						$0.00
					NOTE: 24 BAGS PER CARTON/BOX ONLY / 16-18 MONTH EXPIRATION DATING
					EPS APPROVAL OF ALL ALTERNATES IS MANDATORY
	Option: 4, if exercised (5.1.2030 DATES MAY CHANGE AT TIME OF AWARD)
	Line
Item	File
Number	CMOP
Facility	Description	Approved
NDCs	Proposed
NDC	Manufactuer	Place of Manufacture	Packaging
Multiple	Unit	QTY	Unit
Price	Total
Price	Delivery and/or

Vendor Comments

	2004		VA CMOP HINES EPS 765	CIPROFLOXACIN 400 MG/200ML-D5W	25021-0114-87	24	BX	3,062	$ - 0	$0.00
				Trade Agreement Act
(TAA) Certificate						$0.00
					NOTE: 24 BAGS PER CARTON/BOX ONLY / 16-18 MONTH EXPIRATION DATING
					EPS APPROVAL OF ALL ALTERNATES IS MANDATORY
		NOTE: 24 BAGS PER CARTON ONLY / 16-18 MONTH EXPIRATION DATING

EPS APPROVAL OF ALL ALTERNATES IS MANDATORY

File details come from the government source that posted it. Updated Apr 14, 2026.