S02_Pricing Schedule_Q0125.xlsx
XLSX spreadsheet 15 KB Posted
- Attached to
- 6505--770-25-1-801-0073 - National CMOP D0286 DORZOLAMIDE -(VA-25-00021409) (VA-25-00021409)
- Solicitation number
- 36C77025Q0125
About this file
This is a pricing schedule spreadsheet for RFQ 36C77025Q0125 seeking quotes for Dorzolamide HCL 2% ophthalmic solution 10ML (NDC 61314-0019-10) for multiple VA Consolidated Mail Outpatient Pharmacy (CMOP) facilities. The solicitation requires delivery within 10 days after receipt of order.
The RFQ covers seven CMOP locations (Leavenworth, Chelmsford, Tucson, Lancaster/Dallas, Murfreesboro, Hines/Great Lakes, and Ladson/Charleston) with quantities ranging from 1,200 to 2,400 bottles per location, totaling 10,320 bottles. Quotes are due by January 30, 2025 at 3:00 PM CT. Required documents include a signed SF1449, completed pricing spreadsheet, state wholesale distributor license, OEM authorization documentation, and Buy American Act certificate if quoting non-domestic products. All pharmaceuticals must have at least one year until expiration from delivery date. The VA Health Administration Veterans Integrated Service Network 15 is the requesting agency.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C77025Q0125_1.docx | DOCX document |
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Text version
Quote Spreadsheet
| CMOP - National | |||||||||||||
| RFQ: 36C77025Q0125 | Delivery 10 days After Receipt of Order (ARO) | Required documents: | |||||||||||
| Solicitation - Quote Spreadsheet | Posted Date: | 1/27/25 | 1. SF1449 - Solicitation cover page (signed) | ||||||||||
| Vendor shall complete all areas in orange | Closing Date: | 1/30/25 | 2. Quote - excel spreadsheet | ||||||||||
| Vendor Name: | Closing Time: | 3:00PM Central Time (CT) | 3. State Wholesale Distributor License -and/or- | ||||||||||
| ueiSAM: | 4. OEM authorized dealer or distributor documentation for OTC products | ||||||||||||
| POC Name: | * Vendors shall submit no more than (1) one quote per vendor | 5. Buy American Act (BAA) Certificate, if quoting non-domestic product | |||||||||||
| 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 | Place of Manufacturing | Packaging Multiple | Unit | QTY | Unit Price | Total Price | Vendor Comments |
| 0001 | 13906 | VA CMOP Leavenworth | DORZOLAMIDE HCL 2% OPH SOLN 10ML (D0286) | 61314-0019-10 | 10 | BT | 1200 | $ - 0 | $0.00 | ||||
| 0002 | 13906 | VA CMOP Chelmsford | DORZOLAMIDE HCL 2% OPH SOLN 10ML (D0286) | 61314-0019-10 | 10 | BT | 1920 | $ - 0 | $0.00 | ||||
| 0003 | 13906 | VA CMOP Tucson | DORZOLAMIDE HCL 2% OPH SOLN 10ML (D0286) | 61314-0019-10 | 10 | BT | 1200 | $ - 0 | $0.00 | ||||
| 0004 | 13906 | VA CMOP Lancaster (Dallas) | DORZOLAMIDE HCL 2% OPH SOLN 10ML (D0286) | 61314-0019-10 | 10 | BT | 1200 | $ - 0 | $0.00 | ||||
| 0005 | 13906 | VA CMOP Murfreesboro SJ | DORZOLAMIDE HCL 2% OPH SOLN 10ML (D0286) | 61314-0019-10 | 10 | BT | 1200 | $ - 0 | $0.00 | ||||
| 0006 | 13906 | VA CMOP Hines (Great Lakes) | DORZOLAMIDE HCL 2% OPH SOLN 10ML (D0286) | 61314-0019-10 | 10 | BT | 1200 | $ - 0 | $0.00 | ||||
| 0007 | 13906 | VA CMOP Ladson (Charleston) | DORZOLAMIDE HCL 2% OPH SOLN 10ML (D0286) | 61314-0019-10 | 10 | BT | 2400 | $ - 0 | $0.00 | ||||
| $0.00 |
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