S02 - Pricing Sche - HYDROCORTISONE - Q0087.xlsx

This is a pricing schedule template for a National Request for Quote (RFQ) issued by the Department of Veterans Affairs Veterans Health Administration, Veterans Integrated Service Network 15 for Hydrocortisone Acetate 25mg rectal suppositories in 12-count and 24-count packaging (Solicitation Number: 36C77026Q0087). The RFQ contains 12 line items distributed across eight VA facilities: Leavenworth, Chelmsford, Tucson, Lancaster, Murfreesboro, Hines, and Ladson. Total quantities across all line items amount to 26,424 units, with delivery required within 10 days after receipt of order and an expiration date requirement of no less than one year from date of delivery.

Vendors must submit responses by 3:25.2026 at 3:00 PM Central Time and are limited to one quote per vendor. Required documentation includes a completed SF1449 form, the pricing spreadsheet, a valid state wholesale distributor license, OEM authorized dealer or distributor documentation for over-the-counter products, and a Buy American Act certificate if proposing non-domestic products. Pharmaceutical products are being sourced using two primary NDCs (00574-7090-12 and 00713-0503-24), with vendors permitted to propose alternate NDCs as long as quantities are adjusted and noted in the vendor comments section. The pricing template currently shows all unit and total prices at $0.00, indicating vendors must complete this section with their proposed pricing.