S02_Pricing Schedule_Q0142.xlsx
XLSX spreadsheet 22 KB Posted
- Solicitation number
- 36C77022Q0142
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| File | Type | Posted |
|---|---|---|
| 36C77022Q0142_1.docx | DOCX document |
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Quote Spreadsheet
| CMOP - Leavenworth | |||||||||||||
| RFQ: 36C77022Q0142 | Delivery on or before: 02/09/2022 | Required documents: | |||||||||||
| Solicitation - Quote Spreadsheet | Posted Date: | 1/20/22 | 1. SF1449 - Soliciation cover page (signed) | ||||||||||
| Vendor shall complete all areas in orange | Closing Date: | 1/26/22 | 2. Quote - excel spreadsheet | ||||||||||
| Vendor Name: | Closing Time: | 5:00PM Central Standard Time (CST) | 3. State Wholesale Distributor License | ||||||||||
| DUNS #: | |||||||||||||
| POC Name: | * Vendors shall submit no more than (1) one quote per vendor | Email quotes to: Kelley.Cunningham@va.gov | |||||||||||
| POC E-Mail: | * If vendor is proposing NDC with count other than CMOP listed NDC, | ||||||||||||
| 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 pharmacueticals 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 | 5392 | Leavenworth | ATENOLOL 50/CHLORTHALIDONE 25MG TAB 100CT, A0450 | 00591-5782-01 | 100 | BT | 600 | $ - 0 | $0.00 | ||||
| 0002 | 14153 | Leavenworth | AZATHIOPRINE 50MG TAB 100CT, A0478 | 68382-0003-01 | 100 | BT | 1632 | $ - 0 | $0.00 | ||||
| 0003 | 13377 | Leavenworth | AMLODIPINE 2.5/BENAZEPRIL 10MG CAP (A0604) | 65862-0582-01 | 100 | BT | 576 | $ - 0 | $0.00 | ||||
| 0004 | 13367 | Leavenworth | AMLODIPINE 10/BENAZEPRIL 40MG CAP 100CT (A1325) | 65862-0587-01 | 100 | BT | 2088 | $ - 0 | $0.00 | ||||
| 0005 | 12923 | Leavenworth | ALMOTRIPTAN MALATE 12.5MG UD TAB 12CT (A1642) | 27241-0042-21 | 12 | BT | 216 | $ - 0 | $0.00 | ||||
| 0006 | 14876 | Leavenworth | CITRIC ACID 334/NA CITRATE 500/5ML 480ML SOLN | 58657-0310-16 | 480 | BT | 228 | $ - 0 | $0.00 | ||||
| 0007 | 2310 | Leavenworth | DICLOFENAC NA 25MG EC TAB, 100CT | 16571-0203-10 | 100 | BT | 96 | $ - 0 | $0.00 | ||||
| 0008 | 5958 | Leavenworth | DICLOFENAC 50MG/MISOPROSTOL 200MCG TAB, 60CT | 00025-1411-60 | 60 | BT | 288 | $ - 0 | $0.00 | ||||
| 0009 | 5959 | Leavenworth | DICLOFENAC 50MG/MISOPROSTOL 200MCG TAB 90CT--D0437 | 59762-0028-02 | 90 | BT | 192 | $ - 0 | $0.00 | ||||
| 0010 | 2297 | Leavenworth | DILTIAZEM HCL 60MG 12HR SA CAP 100CT (D1035) | 00378-6060-01 | 100 | BT | 576 | $ - 0 | $0.00 | ||||
| 0011 | 15705 | Leavenworth | ETHINYL ESTRADIOL 0.035MG/NORGESTIMATE 0.25MG TAB,28, E0699 | 68462-0309-29 | 3 | CT | 552 | $ - 0 | $0.00 | ||||
| 0012 | 15814 | Leavenworth | (G0209)GALANTAMINE HYDROBROMIDE 4MG TAB 60 | 10147-0881-06 | 60 | BT | 432 | $ - 0 | $0.00 | ||||
| 0013 | 2160 | Leavenworth | HALOPERIDOL 5MG TAB 1000CT (H0013) | 00378-0327-10 | 1000 | BT | 36 | $ - 0 | $0.00 | ||||
| 0014 | 16559 | Leavenworth | HYDROCORTISONE ACETATE 30MG RTL SUPP 12CT, H0391 | 65649-0511-12 | 12 | BX | 144 | $ - 0 | $0.00 | ||||
| 0015 | 16168 | Leavenworth | HCTZ 25MG/VALSARTAN 160MG TAB 90CT, H0416 | 65862-0549-90 | 90 | BT | 288 | $ - 0 | $0.00 | ||||
| Grand Total Price | $0.00 |
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