S02 - Pricing Sche - ACAMPROSATE - Q0124.xlsx
XLSX spreadsheet 15 KB Posted
- Solicitation number
- 36C77026Q0124
About this file
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 (VISN 15) at the Hines facility. The solicitation number is 36C77026Q0124, with a posting date of April 22, 2026, and a closing date of April 29, 2026, at 3:00 PM Central Time. Vendors are required to submit quotes via email to Jennifer.Coleman4@va.gov and must complete the SF1449 solicitation cover page (signed), provide a quote in the specified Excel spreadsheet format, submit a valid and unexpired State Wholesale Distributor License, and provide a Buy American Act Certificate. Only one quote per vendor is permitted.
The solicitation requires pricing for a single line item: Acamprosate Calcium 333 mg enteric-coated tablets in bottles of 180 count for the CMOP (Consolidated Mail Outpatient Pharmacy) facility. The proposed National Drug Code (NDC) is 68462-0435-18, with a total quantity of 1,440 units. The delivery requirement is 10 days after receipt of order. All pharmaceuticals must have expiration dates no less than one year from the date of delivery. Vendors proposing alternative NDCs with different counts must note the adjustment in vendor comments and adjust quantities accordingly. The spreadsheet template shows the line item description, packaging details (180 BT), unit pricing, and total pricing fields for vendor completion.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C77026Q0124.docx | DOCX document |
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Text version
Quote Spreadsheet
| CMOP - Hines | |||||||||||||
| RFQ: 36C77026Q0124 | Delivery 10 days After Receipt of Order (ARO) | Required documents: | |||||||||||
| Solicitation - Quote Spreadsheet | Posted Date: | 4.22.2026 | 1. SF1449 - Solicitation cover page (signed) | ||||||||||
| Vendor shall complete all areas in orange | Closing Date: | 4.29.2026 | 2. Quote - excel spreadsheet | ||||||||||
| Vendor Name: | Closing Time: | 3:00PM Central Time (CT) | 3. State Wholesale Distributor License, valid and unexpired | ||||||||||
| ueiSAM: | 4. Buy American Act Certificate | ||||||||||||
| 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, | Email quotes to: Jennifer.Coleman4@va.gov | |||||||||||
| 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 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 | |||||||||||||
| Line Item | CMOP Facility | Description | Propsed NDC# | Proposed Alternate NDCs | Mfr | Place of Manufacture | Packaging Multiple | Unit | QTY | Unit Price | Total Price | Vendor Comments | |
| 0001 | HINES | ACAMPROSATE CA 333MG EC TAB 180CT (A1222) | |||||||||||
| Note: USA Preference | 68462-0435-18 | 180 | BT | 1,440 | $ - 0 | $0.00 | |||||||
| Grand Total Price | $0.00 |
File details come from the government source that posted it. Updated .