S02_Pricing Schedule_Q0079.xlsx
XLSX spreadsheet 22 KB Posted
- Solicitation number
- 36C77024Q0079
About this file
This is a quote spreadsheet for a solicitation issued by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 15. The solicitation requests pricing for 15 pharmaceutical products to be delivered to the Leavenworth CMOP facility on or before January 5, 2023. Vendors are instructed to complete the provided quote spreadsheet by inputting pricing for each line item in the total price column, and including any relevant notes in the vendor comments section. Additional requirements include submission of an SF1449 cover page, state wholesale distributor license, Buy American Act certificate, and quotes to be emailed to the listed point of contact by the closing date and time of December 15, 2023 at 5:00PM Central Time. The solicitation number is 36C77024Q0079 for the listed opportunity 6505--760-24-1-050-0167 -Leavenworth CMOP 15 PHARMACEUTICALS -(VA-24-00026551).
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Other files
| File | Type | Posted |
|---|---|---|
| 36C77024Q0079_1.docx | DOCX document |
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Text version
Quote Spreadsheet
| CMOP - Leavenworth | ||||||||||||||
| RFQ: 36C77024Q0079 | Delivery on or before: 1/05/2023 | Required documents: | ||||||||||||
| Solicitation - Quote Spreadsheet | Posted Date: | 12/4/23 | 1. SF1449 - Solicitation cover page (signed) | |||||||||||
| Vendor shall complete all areas in orange | Closing Date: | 12/15/23 | 2. Quote - excel spreadsheet | |||||||||||
| Vendor Name: | Closing Time: | 5:00PM Central Daylight Time (CDT) | 3. State Wholesale Distributor License | |||||||||||
| 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" | |||||||||||||
| * 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 | File Number | CMOP Facility | Description | NDC# | Alternate NDCs | Mfr | Country of Origin | Packaging Multiple | Unit | QTY | Unit Price | Total Price | Vendor Comments | |
| 0001 | 16868 | Leavenworth | ALFUZOSIN HCL 10MG SA TAB 500CT (A1212) | 76282-0302-05 | 500 | BT | 408 | $ - 0 | $0.00 | |||||
| 0002 | 14938 | Leavenworth | ABACAVIR SO4 600MG/LAMIVUDINE 300MG TAB 30CT (A1223) | |||||||||||
| Dispense in original container | 69097-0362-02 | 30 | BT | 312 | $ - 0 | $0.00 | ||||||||
| 0003 | 19856 | Leavenworth | ALBUTEROL SO4 0.042% 3ML INHL 25CT (A1270) | 76204-0011-55 | 25 | BX | 3600 | $ - 0 | $0.00 | |||||
| 0004 | 19339 | Leavenworth | ALBUTEROL SO4 0.021% 3ML INHL 25CT (A1366) | 76204-0010-55 | 25 | BX | 1656 | $ - 0 | $0.00 | |||||
| 0005 | 19317 | Leavenworth | BACITRACIN/HC 1%/NEO/POLYMYX OPH OINT (B0259) | 24208-0785-55 | 1 | TU | 144 | $ - 0 | $0.00 | |||||
| 0006 | 20281 | Leavenworth | BUDESONIDE 90MCG/INHL 60D ORAL INHL, B0568 | 61269-0509-06 | 1 | BX | 160 | $ - 0 | $0.00 | |||||
| 0007 | 3834 | Leavenworth | CIMETIDINE 300MG TAB 500CT (C0254) | 00093-8192-05 | 500 | BT | 36 | $ - 0 | $0.00 | |||||
| 0008 | 3156 | Leavenworth | CLINDAMYCIN PO4 1% TOP SWAB 60CT, C0820 | 45802-0263-37 | 60 | JR | 528 | $ - 0 | $0.00 | |||||
| 0009 | 2668 | Leavenworth | DIPYRIDAMOLE 50MG TAB 100CT (D0097) | 68382-0188-01 | 100 | EA | 144 | $ - 0 | $0.00 | |||||
| 0010 | 13501 | Leavenworth | ELETRIPTAN 40MG TAB 6 PKG E0363 | 59651-0105-69 | 6 | BT | 1560 | $ - 0 | $0.00 | |||||
| 0011 | 19552 | Leavenworth | EMTRICITABINE 200MG/TENOFOVIR 300MG TAB, 30 CT(E0385) | |||||||||||
| Dispense in original container | 42385-0953-30 | 30 | BT | 600 | $ - 0 | $0.00 | ||||||||
| 0012 | 13085 | Leavenworth | FLUOXETINE HCL 90MG EC CAP 4CT, F0264 | 55111-0284-48 | 4 | EA | 120 | $ - 0 | $0.00 | |||||
| 0013 | 4196 | Leavenworth | GLIPIZIDE 2.5MG SA TAB, 30CT | 59762-0540-01 | 30 | BT | 2976 | $ - 0 | $0.00 | |||||
| 0014 | 2952 | Leavenworth | GALANTAMINE HYDROBROMIDE 8MG SA CAP 30CT, G0257 | 65862-0744-30 | 30 | BT | 384 | $ - 0 | $0.00 | |||||
| 0015 | 16559 | Leavenworth | HYDROCORTISONE ACETATE 30MG RTL SUPP 12CT, H0391 | 42494-0342-12 | 12 | BX | 144 | $ - 0 | $0.00 | |||||
| Grand Total Price | $0.00 |
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