S02_Pricing Schedule_Q0430.xlsx
XLSX spreadsheet 22 KB Posted
- Solicitation number
- 36C77021Q0430
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| File | Type | Posted |
|---|---|---|
| 36C77021Q0430_1.docx | DOCX document |
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Quote Spreadsheet
| CMOP - Leavenworth | |||||||||||||
| RFQ: 36C77021Q0430 | Delivery on or before: 6/3/2021 | Required documents: | |||||||||||
| Solicitation - Quote Spreadsheet | Posted Date: | 5/18/21 | 1. SF1449 - Soliciation cover page (signed) | ||||||||||
| Vendor shall complete all areas in orange | Closing Date: | 5/21/21 | 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 | 2957 | Leavenworth | BISOPROLOL FUMARATE 2.5/HCTZ 6.25MG TAB--B0281 | 00378-0501-01 | 100 | BT | 180 | $ - 0 | $0.00 | ||||
| 0002 | 2297 | Leavenworth | DILTIAZEM HCL 60MG 12HR SA CAP 100CT (D1035) | 00378-6060-01 | 100 | BT | 432 | $ - 0 | $0.00 | ||||
| 0003 | 17925 | Leavenworth | GIANVI TAB,28 3CT, G0372 | 00093-5423-62 | 3 | CT | 336 | $ - 0 | $0.00 | ||||
| 0004 | 16559 | Leavenworth | HYDROCORTISONE ACETATE 30MG RTL SUPP 12CT, H0391 | 65649-0511-12 | 12 | BX | 240 | $ - 0 | $0.00 | ||||
| 0005 | 102272 | Leavenworth | HYDROCORTISONE 1%/PRAMOXINE 1% TOP OINT 30GM (H0469) | 54766-0763-04 | 30 | BT | 144 | $ - 0 | $0.00 | ||||
| 0006 | 5751 | Leavenworth | HCTZ 12.5MG/LOSARTAN 100MG TAB 90CT, H0481 | 00093-7369-98 | 90 | BT | 1488 | $ - 0 | $0.00 | ||||
| 0007 | 14342 | Leavenworth | HCTZ 25MG/VALSARTAN 320MG TAB 90CT, H0505 | 62332-0083-90 | 90 | BT | 480 | $ - 0 | $0.00 | ||||
| 0008 | 102285 | Leavenworth | MULTIVITAMINS W/MIN,PRENATAL CHEW TAB 100CT, M0541 | 13925-0117-01 | 100 | BT | 528 | $ - 0 | $0.00 | ||||
| 0009 | 2551 | Leavenworth | NITROGLYCERIN 2% OINT 60GM, N0066 | 00281-0326-60 | 60 | TU | 360 | $ - 0 | $0.00 | ||||
| 0010 | 3939 | Leavenworth | NAPROXEN 500MG EC TAB 100CT N0250 | 00093-1006-01 | 100 | BT | 120 | $ - 0 | $0.00 | ||||
| 0011 | 15642 | Leavenworth | POTASSIUM CHLORIDE 8MEQ SA TAB 500CT, P0086 | 00574-0274-05 | 500 | BT | 216 | $ - 0 | $0.00 | ||||
| 0012 | 9147 | Leavenworth | SULFACETAMIDE NA 10%/SULFUR 5% TOP FOAM 60GM, S0530 | 42192-0143-60 | 60 | BT | 144 | $ - 0 | $0.00 | ||||
| 0013 | 5501 | Leavenworth | SULFACETAMIDE NA 10%/SULFUR 5% TOP WASH 180ML--S0531 | 42192-0136-06 | 180 | BT | 828 | $ - 0 | $0.00 | ||||
| 0014 | 2935 | Leavenworth | TORSEMIDE 10MG TAB 100CT (T0235) | 31722-0530-01 | 100 | BT | 2304 | $ - 0 | $0.00 | ||||
| 0015 | 15604 | Leavenworth | VERAPAMIL HCL 240MG SA TAB 500CT (V0010) | 75834-0159-05 | 500 | BT | 264 | $ - 0 | $0.00 | ||||
| Grand Total Price | $0.00 |
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