S02 - Pric. Schedule Q0112 - EPS CIPRO - EXT.xlsx
XLSX spreadsheet 17 KB Posted
- Attached to
- Ciprofloxacin 400 MG/200ML-D5W - Base + 4 Option years - 765 Federal contract opportunity
- Solicitation number
- Not on record
About this file
This is a pricing schedule spreadsheet for an RFQ issued by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 15 (VISN 15) for pharmaceutical supply to the VA CMOP Hines facility. The solicitation, RFQ 36C77026Q0112, seeks quotes for Ciprofloxacin 400 MG/200ML-D5W with an approved NDC of 25021-0114-87, required in quantities of 3,062 units packaged in boxes containing 24 bags per carton. The base contract delivery date is June 1, 2026, with four optional one-year periods (Option 1 delivery June 3, 2027; Option 2 delivery June 1, 2028; Option 3 delivery June 1, 2029; and Option 4 delivery June 1, 2030, with dates subject to change at time of award).
Vendors must submit quotes by the closing date of July 8, 2026, at 3:00 PM Central Time, including a completed SF1449 cover page, the excel quote spreadsheet with place of manufacture details, a valid state wholesale distributor license, and a Trade Agreement Act (TAA) certificate. All pharmaceuticals must have expiration dates no less than one year from the date of delivery, with the specification requiring 16-18 month expiration dating, and EPS approval of all alternates is mandatory. Required supporting documents and vendor information must be submitted to Jennifer.Coleman4@va.gov. Unit pricing and total price columns are currently blank in the template, indicating this is the blank pricing schedule distributed to vendors for their cost proposals.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| MS02 - RFQ - Q0112 0002 - RFQ MOD ONLY.pdf | ||
| MS02 - RFQ - Q0112 0002 - RFQ MOD FULL.pdf |
On GovTribe
Work with this file on GovTribe
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
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: | 7.8.2026 - EXTENDED | 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 6.1.2026 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 (6.3.2027 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 (6.1.2028 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 (6.1.2029 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 (6.1.2030 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 .