S02_Pricing Schedule_Q0164.xlsx
XLSX spreadsheet 16 KB Posted
- Solicitation number
- 36C77025Q0164
About this file
This is a pricing schedule spreadsheet for RFQ 36C77025Q0164, requesting quotes for pharmaceutical supplies for the VA's Leavenworth CMOP (Consolidated Mail Outpatient Pharmacy). The solicitation closes on March 17, 2025, at 3:00 PM Central Time, with delivery required within 10 days after receipt of order.
The RFQ seeks quotes for 14 different pharmaceutical items, including various combinations of HCTZ with other medications (Valsartan, Olmesartan, Telmisartan, and Losartan), Lithium Carbonate, Minocycline HCL, Moexipril HCL, Memantine HCL, and Metformin. Specific packaging requirements are noted for several items, including bottle height requirements of 3+ inches for certain medications. Vendors must submit specific documentation including a signed SF1449, the completed quote spreadsheet, a valid State Wholesale Distributor License, and a Buy American Act Certificate. All pharmaceuticals must have expiration dates no less than one year from delivery date, and vendors are limited to submitting one quote each.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C77025Q0164_1.docx | DOCX document |
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Quote Spreadsheet
| CMOP - Leavenworth | |||||||||||||
| RFQ: 36C77025Q0164 | Delivery 10 days After Receipt of Order (ARO) | Required documents: | |||||||||||
| Solicitation - Quote Spreadsheet | Posted Date: | 3/6/25 | 1. SF1449 - Solicitation cover page (signed) | ||||||||||
| Vendor shall complete all areas in orange | Closing Date: | 3/17/25 | 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 | Place of Manufacture | Packaging Multiple | Unit | QTY | Unit Price | Total Price | Vendor Comments | |
| 0001 | Leavenworth | HCTZ 25MG/VALSARTAN 160MG TAB 90CT, (H0416) (Must be 90ct btl. Bottle must be 3+ inches tall) | 43547-0313-09 | 90 | BT | 312 | $ - 0 | $0.00 | |||||
| 0002 | Leavenworth | HCTZ 12.5/OLMESARTAN 20MG TAB 90CT, (H0426) | 43547-0391-09 | 90 | BT | 288 | $ - 0 | $0.00 | |||||
| 0003 | Leavenworth | HCTZ 25/OLMESARTAN 40MG TAB 90CT, (H0427) | 43547-0393-09 | 90 | BT | 480 | $ - 0 | $0.00 | |||||
| 0004 | Leavenworth | HCTZ 12.5MG/TELMISARTAN 80MG TAB (H0454)(Must be in original container. Must be 30ct btl. Must be 3+ inches tall) | 62332-0210-30 | 30 | BT | 480 | $ - 0 | $0.00 | |||||
| 0005 | Leavenworth | HCTZ 12.5MG/LOSARTAN 100MG TAB 90CT, (H0481) (Must be 90ct btl. Must be | |||||||||||
| 3+ inches tall) | 43547-0425-09 | 90 | BT | 1872 | $ - 0 | $0.00 | |||||||
| 0006 | Leavenworth | HCTZ 12.5MG/LOSARTAN 50MG TAB 90CT, (H0491) (Must be 90ct btl. Must be 3+ inches tall) | 43547-0423-09 | 68180-0215-09 | |||||||||
| Not acceptable | 90 | BT | 3552 | $ - 0 | $0.00 | ||||||||
| 0007 | Leavenworth | HCTZ 25MG/LOSARTAN 100MG TAB 90CT (H0494)(Must be 90ct btl. Must be 3+ inches tall) | 43547-0424-09 | 90 | BT | 4320 | $ - 0 | $0.00 | |||||
| 0008 | Leavenworth | LITHIUM CARBONATE 300MG TAB 100 (L0048) | 00054-4527-25 | 100 | BT | 200 | $ - 0 | $0.00 | |||||
| 0009 | Leavenworth | LITHIUM CARBONATE 600MG CAP 100CT (L0099) | 68462-0222-01 | 100 | BT | 384 | $ - 0 | $0.00 | |||||
| 0010 | Leavenworth | MINOCYCLINE HCL 100MG CAP 500CT, (M0102) | 65862-0211-05 | 500 | BT | 96 | $ - 0 | $0.00 | |||||
| 0011 | Leavenworth | MINOCYCLINE HCL 50MG CAP 100CT (M0103) | 65862-0209-01 | 100 | BT | 288 | $ - 0 | $0.00 | |||||
| 0012 | Leavenworth | MOEXIPRIL HCL 15MG TAB 100CT (M0266) | 68462-0208-01 | 10006-0730-48 | |||||||||
| Not acceptable | 100 | BT | 48 | $ - 0 | $0.00 | ||||||||
| 0013 | Leavenworth | MEMANTINE HCL 28MG SA CAP 90CT (M0999)(Must be 90ct btl. Must be 3+ inches tall) | 68382-0549-16 | 90 | BT | 336 | $ - 0 | $0.00 | |||||
| 0014 | Leavenworth | METFORMIN (EQV-FORTAMET) 1000MG SA TAB 60CT (M1295) | 68180-0337-07 | 60 | BT | 2208 | $ - 0 | $0.00 | |||||
| Grand Total Price | $0.00 |
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