S02_Pricing Schedule_Q0054.xlsx
XLSX spreadsheet 16 KB Posted
- Solicitation number
- 36C77025Q0054
About this file
This is a pricing schedule spreadsheet for RFQ 36C77025Q0054, seeking quotes for 13 pharmaceutical products for the VA Leavenworth CMOP (Consolidated Mail Outpatient Pharmacy). The response deadline is December 6, 2024, at 3:00 PM Central Time, with delivery required within 10 days after receipt of order.
The solicitation requires vendors to submit required documentation including a signed SF1449, quote spreadsheet, valid state wholesale distributor license, and Buy American Act certificate. The spreadsheet details 13 line items for various pharmaceuticals including contraceptives, esomeprazole, fosinopril, fesoterodine fumarate, glipizide, galantamine hydrobromide, gabapentin, and hydrocortisone acetate suppositories. Specific packaging requirements are noted for several items, including minimum height requirements of 3+ inches for certain products. All pharmaceuticals must have expiration dates no less than one year from delivery date, and vendors must provide full case quantities.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C77025Q0054_1.docx | DOCX document |
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Quote Spreadsheet
| CMOP - Leavenworth | ||||||||||||
| RFQ: 36C77025Q0054 | Delivery 10 days After Receipt of Order (ARO) | Required documents: | ||||||||||
| Solicitation - Quote Spreadsheet | Posted Date: | 11/27/24 | 1. SF1449 - Solicitation cover page (signed) | |||||||||
| Vendor shall complete all areas in orange | Closing Date: | 12/6/24 | 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 (BAA) 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: Kelley.Cunningham@va.gov | ||||||||||
| Phone: | QTY shall be adjusted for that count and this should be noted in "Vendor Comments" | Customer is requesting full case quantities for products below; please adjust quantity to change total for a full case and make note within 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 | NDC# | Alternate NDCs | Mfr | Country of Origin | Packaging Multiple | Unit | QTY | Unit Price | Total Price | Vendor Comments |
| 0001 | Leavenworth | EE 0.03MG/LEVONORG 0.15MG TAB,28, 3CT, (E0695) | 00378-6550-53 | 3 | BX | 288 | $ - 0 | $0.00 | ||||
| 0002 | Leavenworth | ESOMEPRAZOLE 20MG (BASE) EC CAP 90CT (E0811) (Must be 3+ inches tall) | 70069-0814-90 | 90 | BT | 2170 | $ - 0 | $0.00 | ||||
| 0003 | Leavenworth | FOSINOPRIL NA 40MG TAB 90CT (F0135) | 43547-0388-09 | 90 | BT | 552 | $ - 0 | $0.00 | ||||
| 0004 | Leavenworth | FESOTERODINE FUMARATE 4MG SA TAB 30CT (F0423) (Must be 3+ inches tall) | 31722-0033-30 | 30 | BT | 1152 | $ - 0 | $0.00 | ||||
| 0005 | Leavenworth | FESOTERODINE FUMARATE 8MG SA TAB 30CT (F0425) | 67877-0068-30 | 30 | BT | 1440 | $ - 0 | $0.00 | ||||
| 0006 | Leavenworth | GLIPIZIDE 2.5MG SA TAB, 30CT (G0194) (Must be 3+ inches tall) | 16714-0894-01 | 64980-0279-03 |
00591-0900-30
| Both unacceptable | 30 | BT | 3072 | $ - 0 | $0.00 | |||||||
| 0007 | Leavenworth | GALANTAMINE HYDROBROMIDE 8MG SA CAP 30CT, (G0257) | 65862-0744-30 | 30 | BT | 480 | $ - 0 | $0.00 | ||||
| 0008 | Leavenworth | GALANTAMINE HYDROBROMIDE 16MG SA CAP (G0259) | 65862-0745-30 | 30 | BT | 816 | $ - 0 | $0.00 | ||||
| 0009 | Leavenworth | GABAPENTIN (EQV-GRALISE) 300MG TAB,SA 90CT (G0531) | 31722-0091-90 | 90 | BT | 120 | $ - 0 | $0.00 | ||||
| 0010 | Leavenworth | GABAPENTIN (EQV-GRALISE) 600MG TAB,SA 90CT (G0532) | 31722-0092-90 | 90 | BT | 408 | $ - 0 | $0.00 | ||||
| 0011 | Leavenworth | HYDROCORTISONE ACETATE 25MG RTL SUPP SUPP12CT (H0066) (Must be 12Ct) | 69367-0243-12 | 12 | PG | 1776 | $ - 0 | $0.00 | ||||
| 0012 | Leavenworth | HYDROCORTISONE ACETATE 25MG RTL SUPP 24CT (H0066) (Must be 24Ct) | 10135-0751-24 | 24 | PG | 960 | $ - 0 | $0.00 | ||||
| 0013 | Leavenworth | HCTZ 12.5/IRBESARTAN 300MG TAB 90CT, (H0370) | 43547-0331-09 | 90 | BT | 288 | $ - 0 | $0.00 | ||||
| Grand Total Price | $0.00 |
File details come from the government source that posted it. Updated .