Schedule B - Bid Pricing Sheet- RFP 26-1046 MDHHS WIC Infant Formula Rebate Program.xlsx
XLSX spreadsheet 17 KB Posted
- Solicitation number
- RFP 491 260000001094 5
- Issued by
- Michigan
About this file
This is a bid pricing sheet template for the Michigan Department of Health and Human Services (MDHHS) WIC Infant Formula Rebate Program, designed to collect competitive bids for primary contract infant formula as part of a single-supplier solicitation. The template requires bidders to submit pricing and product information across three physical forms of infant formula: powdered, liquid concentrate, and ready-to-feed formulations. Bidders must provide pricing data for multiple infant age categories (0-3 months, 4-5 months, and 6-11 months) across both fully formula-fed and partially breastfed infant populations. The solicitation is structured to comply with federal requirements outlined in 7 C.F.R. 246.10(e)(9) and 246.16a(c). Bidders are required to complete designated cells in the pricing sheet with rebate bids per unit, lowest wholesale full truckload prices, and supporting calculations, providing data to at least three decimal places when possible.
Bidders must certify compliance with multiple federal requirements, including registration under the Food, Drug and Cosmetic Act, adherence to federal regulations, and the ability to supply 100 percent of the WIC Program's needs across all geographic areas within Michigan. The pricing sheet includes estimated average numbers of infants by physical form and age category based on six months of recent program data, though the state provides no assurances regarding actual quantities, types, or physical forms that will be issued under any resulting agreement. All bidder certifications and pricing submissions must be signed and submitted according to procurement instructions provided in the state agency's bid solicitation. Bidders must acknowledge that their products are suitable for routine issuance to healthy, full-term infants and comply with all applicable federal food and drug regulations.
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Text version
Infant Formula Bid Sheet
| WIC Infant Formula Rebate Bid Sheet Template for a Single Bid Solicitation |
| Purpose: Template for WIC State agencies to use in order to collect bids for primary contract infant formula as part of its single-supplier competitive bid solicitation to meet the federal requirements outlined in 7 C.F.R. 246.10(e)(9)(Table 1) and §246.16a(c)(2, 4-7). |
| Instructions for the WIC State agency: Please complete all fillable cells in this template highlighted in pink (i.e., cells K8:L16; B25:E25). |
| Instructions for the Bidder: Please complete all fillable cells in this template highlighted in gray (i.e., cells B8:G16; B26:E26; K25:Q26) and read through the certification statements below. Please provide data to at least 3 decimal places when possible. Once complete, please sign and reference procurement instructions provided in the State agency's bid solicitation. |
| Physical Form | Product Name | UPC Code | Unit Size (in ounces) | Reconstituted Ounce Per Unit | Lowest Wholesale Full Truckload Price Per Unit | Rebate Bid Per Unit | Infant Age Categories | Number of Reconstituted Ounces Issued per Month Based on Max* | Estimated Average Number of Infants by Physical Form Based on 6 Months Average** | Net Price Per Unit | Percent Rebate | Total Monthly Reconstituted Ounces to Bid | Standardized Number of Units of Infant Formula | Total Cost | ||
| Fully Formula Fed Infants | Partially Breastfed Infants | Fully Formula Fed Infants | Partially Breastfed Infants | |||||||||||||
| Powdered | 0-3 months | 870 | 435 | 6,602 | 3,128 | $0.000 | ERROR:#DIV/0! | 21,075,474 | ERROR:#DIV/0! | ERROR:#DIV/0! | ||||||
| 4-5 months | 960 | 522 | 3,824 | 1,075 | ||||||||||||
| 6-11 months | 696 | 384 | 12,802 | 2,158 | ||||||||||||
| Liquid Concentrate | 0-3 months | 823 | 388 | 11 | 6 | $0.000 | ERROR:#DIV/0! | 28,751 | ERROR:#DIV/0! | ERROR:#DIV/0! | ||||||
| 4-5 months | 896 | 460 | 5 | 2 | ||||||||||||
| 6-11 months | 630 | 315 | 16 | 6 | ||||||||||||
| Ready-to-Feed | 0-3 months | 832 | 384 | 22 | 10 | $0.000 | ERROR:#DIV/0! | 67,616 | ERROR:#DIV/0! | ERROR:#DIV/0! | ||||||
| 4-5 months | 913 | 474 | 12 | 2 | ||||||||||||
| 6-11 months | 643 | 338 | 48 | 8 | ||||||||||||
| *Based on WIC Program Regulations (§246.10(e)(9)(Table 1) and §246.16a(c)(5)(i)) | Total Monthly Price | ERROR:#DIV/0! | ||||||||||||||
| **Estimated average based on six months of the most recent data available. Excludes infants that are exclusively breastfed or issued exempt infant formula and includes infants that are issued milk- or soy- based infant formula. |
Please Note: No assurances are provided on the quantity, type, or physical forms that will be issued under the agreement that will become a result of this bid solicitation. Additionally, the estimated average number of infants provided on this bid sheet is an approximation and excludes infants that are exclusively breastfed or issued exempt infant formula.
| Certification: |
| The bidder hereby certifies that: |
1. The bidder is registered under the Food, Drug and Cosmetic Act with the U.S. Department of Health & Human Services and its products are in compliance with Federal regulations issued pursuant to P.L. 100-237.
2. Bids for all physical forms of formula meet the requirements of 246.10 (e) (l)(iii) and 246.10(e)(2)(iii) and are suitable for the routine issuance to the majority of generally healthy, full term infants.
3. Each infant formula product to be supplied under the terms of this contract complies with the Federal Food, Drug, and Cosmetic Act.
4. The bidder can and will supply the quantities of infant formula offered to meet one hundred percent (100%) of the WIC Program’s needs in all geographic areas as outlined in the bid solicitation.
| State Agency Name: | Michigan WIC | Manufacturer's Signature: |
| Manufacturer Name: |
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