HARRIS COUNTY Sodium Hyaluronate

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					         HARRIS COUNTY
                BID COVER SHEET                                                         JOB NO.: 08/0455
                                                                                Date Due: OCTOBER 20, 2008
                                                                                     DUE NO LATER THAN 2:00 P.M.
                                                                                    LOCAL TIME IN HOUSTON, TEXAS
                                                                                Bids received later than the date and time
                                                                                above will not be considered.


   BID FOR: Term Contract for Outpatient Pharmaceutical Products for the Harris County Hospital
   District (Beginning March 1, 2009 and ending February 28, 2010)
                                                       OFFERORS NOTE!!
  Carefully read all instructions, requirements and                       Please return bid in an appropriately sized envelope or
  specifications. Fill out all forms properly and completely.             box. PACKAGE MUST SHOW THE JOB NUMBER,
  Submit your bid with all appropriate supplements and/or                 DESCRIPTION AND BE MARKED "SEALED BID".
  samples.                                                                Designated bids may be submitted electronically through
                                                                          the BuySpeed Online system only.

                                                RETURN BID TO:
                                      HARRIS COUNTY PURCHASING AGENT
                                        1001 PRESTON AVENUE, SUITE 670
                                              HOUSTON, TEXAS 77002
For additional information, contact: Candelario Guerrero at 713-755-4280 or candelario.guerrero@pur.hctx.net
You must sign below in INK; failure to sign WILL disqualify the offer. All prices must be typewritten or written in
ink.
                                           Total Amount of Bid: $
Company Name:

Company Address: ___________________________________________________________________________

City, State, Zip Code:

Taxpayer Identification Number (T.I.N.):

Telephone No. :                              Fax No.:                             E-mail:
Do you carry Health Insurance on your employees? ___Yes ___No

If yes, what is the percentage of employees insured? _____%
Print Name:

Signature:
[Your signature attests to your offer to provide the goods and/or services in this bid according to the published provisions of this Job.
When an award letter is issued, it becomes a part of this contract. Contract is not valid until Purchase Order is issued.]
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                                                        TABLE OF CONTENTS
Items checked below represent components which comprise this bid/proposal package. If the item IS NOT checked, it is NOT
APPLICABLE to this bid/proposal. Offerors are asked to review the package to be sure that all applicable parts are included. If any portion
of the package is missing, notify the Purchasing Department immediately.

It is the Offeror's responsibility to be thoroughly familiar with all Requirements and Specifications. Be sure you understand the following
before you return your bid packet.
__X__ 1.            Cover Sheet
                    Your company name, address, the total amount of the bid/proposal, and your signature (IN INK) should appear on this
                    page.

__X__ 2.          Table of Contents
                  This page is the Table of Contents.

__X__ 3.          General Requirements
                  You should be familiar with all of the General Requirements.

__X__ 4.          Special Requirements/Instructions
                  This section provides information you must know in order to make an offer properly.

_____     5.      Specifications
                  This section contains the detailed description of the product/service sought by the County.

__X__ 6.          Pricing/Delivery Information
                  This form is used to solicit exact pricing of goods/services and delivery costs.

__X__ 7.          Attachments
                  __X__ a.           Residence Certification/Tax Form
                                     Be sure to complete this form and return with packet.

                  _____    b.        Bid Guaranty & Performance Bond Information & Requirements
                                     This form applies only to certain bids/proposals. All public work contracts over $25,000 require a
                                     Payment Bond and over $100,000 must also have a Performance Bond, in a form approved by the
                                     County. Please read carefully and fill out completely.

                  _____    c.        Bid Check Return Authorization Form
                                     This form applies only to certain bids/proposals. Please read carefully and fill out completely.

                  _____    d.        Vehicle Delivery Instructions
                                     Included only when purchasing vehicles.

                  _____    e.        Minimum Insurance Requirements
                                     Included when applicable (does not supersede "Hold Harmless" section of General Requirements).

                  _____    f.        Worker’s Compensation Insurance Coverage Rule 110.110
                                     This requirement is applicable for a building or construction contract.

                  _____    g.        Financial Statement
                                     When this information is required, you must use this form.

                  _____    h.        Reference Sheet
                                     When this information is required, you must use this sheet.

                  _____    i.        HIPAA Requirements


                  __X__ j.           Other (Vendor Certification)
                                     From time to time other attachments may be included.
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                                      GENERAL REQUIREMENTS FOR BIDS

READ THIS ENTIRE DOCUMENT CAREFULLY.    FOLLOW ALL INSTRUCTIONS.    YOU ARE
RESPONSIBLE FOR FULFILLING ALL REQUIREMENTS AND SPECIFICATIONS. BE SURE YOU
UNDERSTAND THEM.

General Requirements apply to all advertised bids; however, these may be superseded, whole or in part, by the SPECIAL
REQUIREMENTS/INSTRUCTIONS OR OTHER DATA CONTAINED HEREIN. Review the Table of Contents. Be
sure your bid package is complete.

ACCESS TO RECORDS
In special circumstances, vendor may be required to allow duly authorized representatives of Harris County, the Harris
County Hospital District or the state and federal government access to contracts, books, documents, and records
necessary to verify the nature and extent of the cost of services provided by vendor.

ADDENDA
When specifications are revised, the Harris County Purchasing Department will issue an addendum addressing the nature
of the change. Offerors must sign and include it in the returned bid package.

ASSIGNMENT
The successful offeror may not assign, sell or otherwise transfer this contract without written permission of Harris
County Commissioners Court.

AWARD
Harris County reserves the right to award this contract on the basis of LOWEST AND BEST OFFER in accordance with
the laws of the State of Texas, to waive any formality or irregularity, to make awards to more than one offeror, to reject
any or all bids. In the event the lowest dollar offeror meeting specifications is not awarded a contract, the offeror may
appear before the Commissioners Court, Hospital District Board of Managers, Community Supervision & Corrections
Department Board, the Juvenile Board or other applicable governing body and present evidence concerning his
responsibility after officially notifying the Office of the Purchasing Agent of his intent to appear.

BID FORM COMPLETION
Fill out and return to the Harris County Purchasing Department ONE (1) complete bid form in an appropriately sized
envelope or box. PACKAGE MUST SHOW THE JOB NUMBER, DESCRIPTION AND BE MARKED “SEALED
BID.” An authorized representative of the offeror should sign the Bid Cover Sheet. The contract will be binding only
when signed by Harris County, funds are certified by the County Auditor and or the Hospital District, as applicable, and a
Purchase Order issued.

BID RETURNS
Offerors must return all completed bids to the Harris County Purchasing Department reception desk at 1001 Preston
Avenue, Suite 670, Houston, Texas before 2:00 P.M. LOCAL TIME IN HOUSTON, TEXAS on the date specified.
Late bids will not be accepted. Electronic bids requiring documentation, samples, etc. which cannot be uploaded must be
received in the Purchasing by the due date and time. Signatures requiring confirmation will be confirmed by the
Purchasing Office.

BONDS
If this bid requires submission of bid guarantee and performance bond, there will be a separate page explaining those
requirements. Bids submitted without the required bid bond or cashier's checks are not acceptable.




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                                                                                                              Page 3 of 57
CERTIFICATION REGARDING DEBARMENT, SUSPENSION INELIGIBILITY, AND VOLUNTARY
EXCLUSION
The Contractor certifies by execution of this Contract that it is not ineligible for participation in federal or state assistance
programs under Executive Order 12549, "Debarment and Suspension." The Contractor further agrees to include this
certification in all contracts between itself and any subcontractors in connection with the services performed under this
Contract. Contractor also certifies that contractor will notify Harris County in writing immediately if contractor is not in
compliance with Executive Order 12549 during the term of this contract. Contractor agrees to refund Harris County for
any payments made to the contractor while ineligible.

COLOR SELECTION
Determination of colors of materials is a right reserved by the using department unless otherwise specified in the bid.
Unspecified colors shall be quoted as standard colors, NOT colors which require up charges or special handling.
Unspecified fabrics or vinyls should be construed as medium grade. If offeror fails to get color/material approvals prior
to delivery of merchandise, the using department may refuse to accept the items and demand correct shipment without
penalty, subject to other legal remedies.

CONTRACT OBLIGATION
Harris County Commissioners Court must award the contract and the County Judge or other person authorized by the
Harris County Commissioners Court must sign the contract before it becomes binding on Harris County or the offerors.
Department heads are NOT authorized to sign agreements for Harris County. Binding agreements shall remain in effect
until all products and/or services covered by this purchase have been satisfactorily delivered and accepted.

CONTRACT RENEWALS
Renewals may be made ONLY by written agreement between Harris County and the offeror. Any price escalations are
limited to those stated by the offeror in the original bid.

DIGITAL FORMAT
If offeror obtained the bid specifications in digital format in order to prepare a response, the bid must be submitted in
hard copy according to the instructions contained in this bid package. If, in its bid response, offeror makes any changes
whatsoever to the County's published bid specifications, the County's bid specifications as published shall control.
Furthermore, if an alteration of any kind to the County's published bid specifications is only discovered after the contract
is executed and is or is not being performed, the contract is subject to immediate cancellation.

DISQUALIFICATION OF OFFEROR
Upon signing this bid document, an offeror offering to sell supplies, materials, services, or equipment to Harris County
certifies that the offeror has not violated the antitrust laws of this state codified in Texas Business and Commerce Code
§15.01, et seq., as amended, or the federal antitrust laws, and has not communicated directly or indirectly the bid made to
any competitor or any other person engaged in such line of business. Any or all bids may be rejected if the County
believes that collusion exists among the offerors. Bids in which the prices are obviously unbalanced may be rejected. If
multiple bids are submitted by an offeror and after the bids are opened, one of the bids is withdrawn, the result will be
that all of the bids submitted by that offeror will be withdrawn; however, nothing herein prohibits a vendor from
submitting multiple bids for different products or services.

E-MAIL ADDRESSES CONSENT
Vendor affirmatively consents to the disclosure of its e-mail addresses that are provided to Harris County, the Harris
County Flood Control District, the Harris County Hospital District including its HMO, the Harris County Appraisal
District, or any agency of Harris County. This consent is intended to comply with the requirements of the Texas Public
Information Act, Tex. Gov’t Code Ann. §522.137, as amended, and shall survive termination of this agreement. This
consent shall apply to e-mail addresses provided by Vendor, its employees, officers, and agents acting on Vendor’s behalf
and shall apply to any e-mail address provided in any form for any reason whether related to this bid/proposal or
otherwise.
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EVALUATION
Evaluation shall be used as a determinant as to which bid items or services are the most efficient and/or most economical
for the County. It shall be based on all factors which have a bearing on price and performance of the items in the user
environment. All bids are subject to tabulation by the Harris County Purchasing Department and recommendation to the
appropriate governing body. Compliance with all bid requirements, delivery and needs of the using department are
considerations in evaluating bids. Pricing is NOT the only criteria for making a recommendation. The Harris
County Purchasing Department reserves the right to contact any offeror, at any time, to clarify, verify or request
information with regard to any bid.

FISCAL FUNDING
A multi-year lease or lease/purchase arrangement (if requested by the Special Requirements/Instructions), or any contract
continuing as a result of an extension option, must include fiscal funding out. If, for any reason, funds are not
appropriated to continue the lease or contract, said lease or contract shall become null and void on the last day of the
current appropriation of funds. After expiration of the lease, leased equipment shall be removed by the offeror from the
using department without penalty of any kind or form to Harris County. All charges and physical activity related to
delivery, installation, removal and redelivery shall be the responsibility of the offeror.

GOVERNING FORMS
In the event of any conflict between the terms and provisions of these requirements and the specifications, the
specifications shall govern. In the event of any conflict of interpretation of any part of this overall document, Harris
County's interpretation shall govern.

GOVERNING LAW
This bid solicitation is governed by the competitive bidding requirements of the County Purchasing Act, Texas Local
Government Code, §262.021 et seq., as amended. Offerors shall comply with all applicable federal, state and local laws and
regulations. Offeror is further advised that these requirements shall be fully governed by the laws of the State of Texas and
that Harris County may request and rely on advice, decisions and opinions of the Attorney General of Texas and the County
Attorney concerning any portion of these requirements.

GRANT FUNDING
Any contract entered into by the County that is to be paid from grant funds shall be limited to payment from the grant
funding and the vendor/provider understands that the County has not set aside any County funds for the payment of
obligations under a grant contract. If grant funding should become unavailable at any time for the continuation of
services paid for by the grant, and further funding cannot be obtained for the contract, then the sole recourse of the
provider shall be to terminate any further services under the contract and the contract shall be null and void.

HIPAA COMPLIANCE
Offeror agrees to comply with the Standards for Privacy of Individually Identifiable Health Information of the Health
Insurance Portability and Accountability Act of 1996, PL 104-191, 45 CFR Parts 160-164, as amended, and the Texas
Medical Records Privacy Act, Texas Health and Safety Code Chapter 181, as amended, collectively referred to as
"HIPAA", to the extent that the Offeror uses, discloses or has access to protected health information as defined by
HIPAA. Offeror may be required to enter a Business Associate Agreement pursuant to HIPAA.

HOLD HARMLESS AGREEMENT
Contractor, the successful offeror, shall indemnify and hold Harris County harmless from all claims for personal injury,
death and/or property damage resulting directly or indirectly from contractor's performance. Contractor shall procure and
maintain, with respect to the subject matter of this bid, appropriate insurance coverage including, as a minimum, public
liability and property damage with adequate limits to cover contractor's liability as may arise directly or indirectly from
work performed under terms of this bid. Certification of such coverage must be provided to the County upon request.


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INSPECTIONS & TESTING
Harris County reserves the right to inspect any item(s) or service location for compliance with specifications and
requirements and needs of the using department. If an offeror cannot furnish a sample of a bid item, where applicable,
for review, or fails to satisfactorily show an ability to perform, the County can reject the bid as inadequate.

INVOICES AND PAYMENTS
Offerors shall submit an original invoice on each purchase order or purchase release after each delivery, indicating the
purchase order number. Invoices must be itemized. Any invoice, which cannot be verified by the contract price and/or is
otherwise incorrect, will be returned to the offeror for correction. Under term contracts, when multiple deliveries and/or
services are required, the offeror may invoice following each delivery and the County will pay on invoice. Contracts
providing for a monthly charge will be billed and paid on a monthly basis only. Prior to any and all payments made for
goods and/or services provided under this contract, the offeror should provide his Taxpayer Identification Number or
social security number as applicable. This information must be on file with the Harris County Auditor’s office. Failure
to provide this information may result in a delay in payment and/or back-up withholding as required by the Internal
Revenue Service.

MAINTENANCE
Maintenance required for equipment bid should be available in Harris County by a manufacturer-authorized maintenance
facility. Costs for this service shall be shown on the Pricing/Delivery Information form. If Harris County opts to include
maintenance, it shall be so stated in the purchase order and said cost will be included. Service will commence only upon
expiration of applicable warranties and should be priced accordingly.

MATERIAL SAFETY DATA SHEETS
Under the "Hazardous Communication Act", commonly known as the "Texas Right To Know Act", an offeror must
provide to the County with each delivery, material safety data sheets which are applicable to hazardous substances
defined in the Act. Failure of the offeror to furnish this documentation will be cause to reject any bid applying thereto.

NAME BRANDS
Specifications may reference name brands and model numbers. It is not the intent of Harris County to restrict these bids
in such cases, but to establish a desired quality level of merchandise or to meet a pre-established standard due to like
existing items. Offerors may offer items of equal stature and the burden of proof of such stature rests with offerors.
Harris County shall act as sole judge in determining equality and acceptability of products offered.

NEW MILLENIUM COMPLIANCE
All products and/or services furnished as part of this contract must be compliant for the present year and forward. This
applies to all computers including hardware and software as well as all other commodities with date sensitive embedded
chips.

POTENTIAL CONFLICTS OF INTEREST
An outside consultant or contractor is prohibited from submitting a bid for services on a Harris County project of which
the consultant or contractor was a designer or other previous contributor, or was an affiliate, subsidiary, joint venturer or
was in any other manner associated by ownership to any party that was a designer or other previous contributor. If such a
consultant or contractor submits a prohibited bid, that bid shall be disqualified on the basis of conflict of interest, no
matter when the conflict is discovered by Harris County. Potential bidders are advised that they may have disclosure
requirements pursuant to Texas Local Government Code, Chapter 176. This law requires persons desiring to do business
with the County to disclose any gifts valued in excess of $250 given to any County Official or the County Official’s
family member, or employment of any County Official or the County Official’s family member during the preceding
twelve (12) month period. The disclosure questionnaire must be filed with the Harris County Clerk. Refer to Texas
Local Government Code, Chapter 176 for the details of this law.


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PRICING
Prices for all goods and/or services shall be firm for the duration of this contract and shall be stated on the
Pricing/Delivery Information form. Prices shall be all inclusive: No price changes, additions, or subsequent
qualifications will be honored during the course of the contract. All prices must be written in ink or typewritten.
Pricing on all transportation, freight, drayage and other charges are to be prepaid by the contractor and included in the bid
prices. If there are any additional charges of any kind, other than those mentioned above, specified or unspecified,
offeror MUST indicate the items required and attendant costs or forfeit the right to payment for such items. Where unit
pricing and extended pricing differ, unit pricing prevails.

PURCHASE ORDER AND DELIVERY
The successful offeror shall not deliver products or provide services without a Harris County Purchase Order, signed by
an authorized agent of the Harris County Purchasing Department. The fastest, most reasonable delivery time shall be
indicated by the offeror in the proper place on the Pricing/Delivery Information form. Any special information
concerning delivery should also be included, on a separate sheet, if necessary. All items shall be shipped F.O.B. INSIDE
DELIVERY unless otherwise stated in the specifications. This shall be understood to include bringing merchandise to
the appropriate room or place designated by the using department. Every tender or delivery of goods must fully comply
with all provisions of these requirements and the specifications including time, delivery and quality. Nonconformance
shall constitute a breach which must be rectified prior to expiration of the time for performance. Failure to rectify within
the performance period will be considered cause to reject future deliveries and cancellation of the contract by Harris
County without prejudice to other remedies provided by law. Where delivery times are critical, Harris County
reserves the right to award accordingly.

RECYCLED MATERIALS
Harris County encourages the use of products made of recycled materials and shall give preference in purchasing to
products made of recycled materials if the products meet applicable specifications as to quantity and quality. Harris
County will be the sole judge in determining product preference application.

SEVERABILITY
If any section, subsection, paragraph, sentence, clause, phrase or word of these requirements or the specifications shall be
held invalid, such holding shall not affect the remaining portions of these requirements and the specifications and it is
hereby declared that such remaining portions would have been included in these requirements and the specifications as
though the invalid portion had been omitted.

SILENCE OF SPECIFICATIONS
The apparent silence of specifications as to any detail, or the apparent omission from it of a detailed description
concerning any point, shall be regarded as meaning that only the best commercial practice is to prevail and that only
material and workmanship of the finest quality are to be used. All interpretations of specifications shall be made on the
basis of this statement. The items furnished under this contract shall be new, unused of the latest product in production to
commercial trade and shall be of the highest quality as to materials used and workmanship. Manufacturer furnishing
these items shall be experienced in design and construction of such items and shall be an established supplier of the item
bid.

SUPPLEMENTAL MATERIALS
Offerors are responsible for including all pertinent product data in the returned bid package. Literature, brochures, data
sheets, specification information, completed forms requested as part of the bid package and any other facts which may
affect the evaluation and subsequent contract award should be included. Materials such as legal documents and
contractual agreements, which the offeror wishes to include as a condition of the bid, must also be in the returned bid
package. Failure to include all necessary and proper supplemental materials may be cause to reject the entire bid.




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TAXES
Harris County is exempt from all federal excise, state and local taxes unless otherwise stated in this document. Harris
County claims exemption from all sales and/or use taxes under Texas Tax Code §151.309, as amended. Texas Limited
Sales Tax Exemption Certificates will be furnished upon written request to the Harris County Purchasing Agent.

TERM CONTRACTS
If the contract is intended to cover a specific time period, the term will be given in the specifications under SCOPE.

TERMINATION
Harris County reserves the right to terminate the contract for default if offeror breaches any of the terms therein,
including warranties of offeror or if the offeror becomes insolvent or commits acts of bankruptcy. Such right of
termination is in addition to and not in lieu of any other remedies which Harris County may have in law or equity.
Default may be construed as, but not limited to, failure to deliver the proper goods and/or services within the proper
amount of time, and/or to properly perform any and all services required to Harris County's satisfaction and/or to meet all
other obligations and requirements. Harris County may terminate the contract without cause upon thirty (30) days written
notice.

Termination for Health and Safety Violations
Harris County has the option to terminate this contract immediately without prior notice if offeror fails to perform any of
its obligations in this contract if the failure (a) created a potential threat to health or safety or (b) violated a law,
ordinance, or regulation designed to protect health or safety.

TITLE TRANSFER
Title and Risk of Loss of goods shall not pass to Harris County until Harris County actually receives and takes possession
of the goods at the point or points of delivery. Receiving times may vary with the using department. Generally,
deliveries may be made between 8:30 a.m. and 4:00 p.m., Monday through Friday. Offerors are advised to consult the
using department for instructions. The place of delivery shall be shown under the "Special Requirements/Instructions"
section of this bid package and/or on the Purchase Order as a "Deliver To:" address.

WAIVER OF SUBROGATION
Offeror and offeror's insurance carrier waive any and all rights whatsoever with regard to subrogation against Harris
County as an indirect party to any suit arising out of personal or property damages resulting from offeror's performance
under this agreement.

WARRANTIES
Offerors shall furnish all data pertinent to warranties or guarantees which may apply to items in the bid. Offerors may
not limit or exclude any implied warranties. Offeror warrants that product sold to the County shall conform to the
standards established by the U.S. Department of Labor under the Occupational Safety and Health Act of 1970. In the
event product does not conform to OSHA Standards, where applicable, Harris County may return the product for
correction or replacement at the offeror's expense. If offeror fails to make the appropriate correction within a reasonable
time, Harris County may correct at the offeror's expense.
                                               VENDORS OWING TAXES
Pursuant to TX Local Government Code 262.0276, the Hospital District Board of Managers has adopted a policy which
requires that vendors’ taxes be current as of the date bids/proposals are due. Bidders with delinquent county taxes on the
due date will not be eligible for award. Whether or not a vendor’s taxes are delinquent will be determined by an
independent review of the Tax Office records. Vendors who believe a delinquency is reflected in error must contact the
Tax Office to correct any errors or discrepancies prior to submitting their bid in order to ensure that their bid will be
considered. Tax records are available online at the Tax Office website—www.hctax.net. Prior to submitting a bid,
vendors are encouraged to visit the Tax Office website, set up a portfolio of their accounts and make their own initial
determination of the status of their tax accounts. This policy is effective for all bids due on or after July 1, 2004.
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                                SPECIAL REQUIREMENTS/INSTRUCTIONS

              TERM CONTRACT FOR OUTPATIENT PHARMACEUTICAL PRODUCTS
                      FOR THE HARRIS COUNTY HOSPITAL DISTRICT

Where these Specific Requirement differ from the preceding General Requirements, these Specific Requirements
shall control. The term “Harris County” is understood to include the Harris County Hospital District.

Scope
The District has elected to secure Outpatient Pharmaceutical Products through a charge-back, Prime Vendor
Program. The District is requesting that the price, terms and conditions of established contracts between your
company and the District be made available to the District through its designated Prime Vendor. As such,
preference will be shown to vendors whose company participates in such a charge-back, Prime Vendor
Program. This contract will commence from March 1, 2009 and terminate February 28, 2010. If you need
additional information, contact Candelario Guerrero,R.Ph. at (713) 755-4280.

There will be a PRE-BID CONFERENCE on October 7, 2008 at Ben Taub General Hospital, Pharmacy
Administration Conference Room, 1504 Taub Loop, Houston, Texas 77030.
        VENDORS ARE STRONGLY ADVISED TO ATTEND THE PRE-BID CONFERENCE.

Renewal Option
Harris County may consider a renewal option for a two (2) one year periods, based upon the same terms, conditions
and pricing as the original year. Renewal is subject to approval by the Harris County Hospital District each period.
Once renewal option is exhausted, the contract must be rebid. If a bidder does not wish to consider a renewal,
write "N.A." in the space for the year indicated.

Harris County retains the option to rebid at any time if in its best interest and is not automatically bound to renewal
or rebid.

Award
1. Awards are made on the basis of the best bid that fully meets and/or exceeds specifications. Prices quoted
   must be NET and FOB DESTINATION. Purchase Orders will be issued by Harris County Purchasing
   Department, Medical Division, and invoices should be submitted in duplicate as follow: Harris County
   Hospital District, Accounts Payable, P.O. Box 66769, Houston, Texas 77266.

2. The Harris County Hospital District, as part of the evaluation process, may consider patient education, patient
   assistance programs and other value-added programs as may be provided by the Vendor. Consideration of
   such programs and the evaluation thereof, will be at the option of the District and as deemed advantageous to
   the District and/or its patients.

3. The award will be to financially sound vendors; bidders are encouraged to provide such evidence of financial
   stability as is conveniently available as a part of their bids. Harris County reserves the right to require such
   financial statements, audited or otherwise, as it feels necessary to qualify vendors for awards. No advance
   payments will be made; bids made on the basis of a payment "with order" will be rejected without further
   consideration.




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                            SPECIAL REQUIREMENTS/INSTRUCTIONS (Continued)

CONTRACT
1. In the event the Contractor fails to deliver the articles requested within 14 days, the Hospital District reserves
   the right to authorize immediate purchases on the open market. On all such purchases, the Contractor agrees
   promptly to reimburse the Hospital District for the extra costs incurred by such purchases.

2. The quantities listed are approximate annual usage figures. The bidder may not increase price during the
   contract period or renewal period unless specified by vendor and shown as an alternate bid. If so specified, the
   bidder understands and agrees that thirty days written notice must be submitted in advance of any price increase
   and the District then will have the option to cancel the contract. This will also be considered in awarding the
   contract.

PROVISIONS FOR PHARMACEUTICAL BIDDING
1. The District will continue to purchase any of the drugs contained within the contract and during the contract
   period as long as the Medical Staff and Pharmacy Committee approve it.

2. The estimated annual quantity figure is provided for the bidders information and does not necessarily represent
   the total quantity of a particular drug dosage form the District will purchase during the contract period.

3. DO NOT alter the bid sheet in any manner. Bid ONLY in accordance with the information provided. If you
   propose a bid alternative: 1) attach a separate sheet outlining your bid; and 2) place an (A) to the right of the
   Unit Price line for the item(s) involved in your bid.

(DO NOT RETURN ANY BLANK PRICING/DELIVERY INFORMATION SHEETS. IF YOU "NO
BID" AN ITEM, SO STATE THAT ON THE FORM.)

4. Preference will be shown to vendors who: a) provide solid dosage forms imprinted with a distinctive code or
   monogram referable to identification of the product; b) provide special packaging (ie., unit dose packaging,
   plastic bottles, etc.) or more convenient packaging for the item. Any reference to "packet" in the package
   description section of the "Request for Bid", refers to unit dose packaging.

5. Preference will also be shown to vendors with a more liberal return drug policy. The vendor's return drug
   policy should accompany this bid.

6. Preference will be shown to direct account vendors with the shorter guaranteed lead time. A lead time of 3
   days or less is preferable. Failure to routinely provide items within the stated delivery time may be considered
   non-performance of this contract.

7. Greater consideration will be given to vendors who will provide a monthly summary of District purchases of
   their items. The summary should list purchases by item and show quantity purchased, dollar amount for the
   month and the year to date. Vendors should attach to the bid sample of the purchasing summary that will be
   provided.




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                           SPECIAL REQUIREMENTS/INSTRUCTIONS (Continued)

8. Bidders must be able to furnish adequate proof of the following items. Any bidder not actually manufacturing
   an item bid, must furnish with the bid, the name of the manufacturer producing the item and this manufacturer
   in turn must be able to furnish proof of the following items:

       a.     Maintenance of a reliable research and development program as to quality and manufacturing
              procedures and controls.

       b.     Assay of raw materials and of finished products to make each batch equal as to potency, purity and
              quantity of active ingredients.

       c.     Shelf life control in order to eliminate contamination and loss of potency.

       d.     A control number system (not code numbers) which will be referable to a complete
              manufacturing control record, including all assays of finished products.

       e.     Bio-availability data consisting of one or more of the following: a) the concentration of drug in the
              blood at various times; b) the cumulative amount of drug excreted unchanged in the urine at various
              times: or c) a reliable pharmaceutical parameter indicating drug body levels, also as a function of
              time. Product should compare favorably with a marketed product accepted as standard.

9.     All products purchased must meet the latest standards or regulations of the F.D.A., U.S.P., N.F., Public
       Health Service Act of July 1, 1944, the National Institutes of Health and/or the Harris County Hospital
       District and have received an "A" Therapeutic Equivalence Code, as listed in the Approved Drug Product
       with Therapeutic Equivalence Evaluation publication, latest edition. Additionally, all pharmaceuticals
       must be pharmaceutically elegant and consistent in regard to color, taste, odor and general appearance; with
       a minimum of 12 month expiration date. [Orange Book]

10.    All products purchased must be currently listed in the Texas Drug Code Index (T.D.C.I.) of the Texas
       Vendor Drug Program, with the Texas Department of Health.

11.   An important element in the purchase of drugs is service. Any firm qualifying as described above, must
      also have a Medical Service Representative available for service, who will make periodic appearances. His
      name, address and telephone number must be on file with the Pharmacy Department and Purchasing
      Department.
Submission of Bid

1.     The properly submitted bid will contain:
       a.      A PROPERLY EXECUTED & COMPLETED COVER SHEET
       b.      A COMPLETED RESIDENCY CERTIFICATION
       c.      COMPLETED ATTACHMENTS
       d.      APPROPRIATE DETAIL OF THE BID FOR REQUESTED PRODUCTS
       e.      OTHER INFORMATION AS REQUIRED BY THE BID SOLICITATION
       f.      (1) ONE ORIGINAL AND (1) ONE COPY OF BID
2.     Unless qualified by the provision "No Substitute", the use of a manufacturer, brand or catalog number is
       descriptive - Not restrictive - it is to indicate type and quality desired.




                                                                                                       Page 11 of 57
                       SPECIAL REQUIREMENTS/INSTRUCTIONS (Continued)


3.     In the event of a discrepancy between the unit price and the extension, the unit price shall govern.

ITEMS LISTED BELOW AND ALL APPENDIX AND ATTACHMENTS HERETO APPLY TO AND
BECOME A PART OF TERMS AND CONDITIONS OF BID SPECIAL REQUIREMENTS/
SPECIFICATIONS. ANY EXCEPTIONS THERETO MUST BE IN WRITING.

Bidding Requirements
a.    Bid prices must be firm for acceptance for 120 days from bid opening date.

b.     Sign at the bottom of each page on which a bid price appears and return only those pages. Check your bid
       carefully. ERRORS MAY NOT BE CHANGED AFTER THE DUE DATE. ERRORS ARE THE
       RESPONSIBILITY OF THE BIDDER AND THE BIDDER MAY BE REQUIRED TO HONOR THE
       ERRONEOUS BID.

c.     Samples, when requested must be furnished free of expense to the District.

d.     In the case of tie bids, price and quality being equal, the award will be made by draw. Identical price and
       quality may not necessarily constitute a tie bid. Final award will be made on the basis of the most favorable
       overall "best bid" to the District, taking into consideration price, quality, storage, distribution, product
       continuity, patient compliance and other factors deemed advantageous to the District and/or its patients.

e.     Failure to state delivery time obligates the bidder to complete delivery in 14 calendar days.

f.     During the course of the contract, no substitutions or cancellations will be permitted without written
       approval.

g.     Delivery shall be made during normal working hours only, 8:00 am to 4:00 pm, unless prior approval for
       late delivery has been obtained.

h.     The contractor agrees to indemnify the District from claims involving infringement of patents or
       copyrights.




                                                                                                         Page 12 of 57
                                                   APPENDIX I

The Harris County Hospital District (the "District") and its outpatient service components are disproportionate share
facilities as defined by the Veterans Health Care Act of 1992 (Public Law No. 102-585), the District expects
compliance and will only consider bids from those vendors who comply with the provisions of the referenced
legislation. The District recognizes that prices in section 602 of the Drug Pricing Program are subject to change
quarterly, compliance by bidders to provide the most current Discounted Prices in COLUMN C of the bid request is
expected; the District is requesting sub-ceiling prices on covered Outpatient drugs below the ceiling price
established under the Act listed above and noted by bidder in COLUMN B , price quotes will be firm and
valid for the contract period March 1, 2009 through February 28, 2010. Harris County reserves the right to
withdraw from the contract if the contract price to the County is found to be higher than the P.H.S. price
during the contract period. The District will make its award on a line-by-line basis. The District reserves the right
to review outpatient prices subject to final approval of the Harris County Hospital District Board of Managers on a
quarterly basis and re-bid products(s) as the District deems necessary.


ALTERNATE BID(S)

The District may consider alternate bid(s) submitted by Bidder, only for District formulary products, in
determining an award. Bidders submitting alternate bid(s) for District formulary products shall include a
detailed description of the alternate bid(s) under section titled ATTACHMENT I (ALTERNATE BID SHEET),
alternate bid(s) will ONLY be considered if the response is formatted as per Vendor Instructions in the enclosed
REQUEST FOR BID.




                                                                                                         Page 13 of 57
                                                        APPENDIX II

The Harris County Hospital District is competitively bidding the Outpatient products in the various classes listed below, in addition
to cost other factors will be considered (DOSING INTERVALS, INDICATIONS, SIDE EFFECT PROFILE, COST OF
SWITCHING BRANDS, etc.) in making an award with the goal to achieve cost effectiveness in drug therapy.

ANTIMICROBIALS AGENTS
Antifungals
Posaconazole (Noxafil)
Voriconazole (Vfend)
Antivirals
Famciclovir vs. Valacyclovir (Valtrex)

Pegylated Interferon 2a vs. 2b (Pegasys vs. Peg-Intron)

Valganciclovir (Valcyte)


Cephalosporins
2nd Generation (all oral formulations) Cefprozil (generic) vs Cefuroxime (generic)

3rd Generation (all oral formulations) Cefpodoxime (generic) vs Cefdinir (generic) vs Cefixime (Suprax)

Fluoroquinolones
Levofloxacin (Levaquin) vs. Moxifloxacin (Avelox)

Macrolides
Clarithromycin XL (Biaxin XL) vs. Azithromycin (Zmax )

Miscellaneous
Linezolid (Zyvox)

CARDIOVASCULAR AGENTS
ACE-Inhibitor/Thiazide Diuretic Combination
Benazepril/HCTZ vs. Captopril/HCTZ vs. Enalapril/HCTZ vs. Fosinopril/HCTZ vs. Lisinopril/HCTZ vs.
Moexipril/HCTZ vs. Quinapril/HCTZ
ACE-Inhibitor
Benazepril vs.Enalapril vs Fosinopril vs. Lisinopril vs. Moexipril vs. Ramipril vs. Trandolapril vs Quinapril vs
Captopril
Angiotensin II Receptor Antagonist
Candesartan (Atacand) vs. Eprosartan (Teveten) vs. Irbesartan (Avapro) vs. Losartan (Cozaar) vs. Olmesartan
(Benicar) vs. Telmisartan (Micardis) vs. Valsartan (Diovan)

Angiotensin II Receptor Antagonist/Thiazide Diuretic Combination
Candesartan/HCTZ (Atacand HCT) vs. Eprosartan/HCTZ (Teveten HCT) vs. Irbesartan/HCTZ (Avalide) vs.
Losartan/HCTZ (Hyzaar) vs. Olmesartan/HCTZ (Benicar HCT) vs. Telmisartan/HCTZ (Micardis HCT) vs.
Valsartan/HCTZ (Diovan HCT)



                                                                                                                      Page 14 of 57
CARDIOVASCULAR AGENTS - Continued

Calcium Channel Blockers
Amlodipine vs. Felodipine vs. Nisoldipine (Sular)

HMG-CoA Reductase Inhibitors
Atorvastatin (Lipitor) vs.Fluvastatin (Lescol) vs Lovastatin vs. Pravastatin vs. Rosuvastatin (Crestor) vs.
Simvastatin
Combination Products
Amlodipine/Atorvastatin (Caduet)
Ezetimibe/Simvastatin (Vytorin)

Miscellaneous
Isosorbide Dintrate/hydralazine (Bidil)

LMWH
Enoxaparin (Lovenox) vs Dalteparin (Fragmin) vs Tinzaparin (Innohep)

CENTRAL NERVOUS SYSTEM AGENTS

CNS Stimulant
Methylphenidate [(Concerta) vs (Metadate CD) vs (Metadate ER)] vs. Amphetamine/Dextroamphetamine
(Adderall XR)

Cholinesterase .Inhibitor
Donepezil (Aricept) vs Rivastigmine (Exelon) vs Galantamine (Generic, Razadyne, Razadyne ER)

Antidepressants
Sertraline vs Fluoxetine vs Paroxetine vs Citalopram vs Escitalopram (Lexapro)

Duloxetine (Cymbalta) vs Venlafaxine (Effexor ER) vs Bupropion vs Mirtazapine

Diabetic Neuropathy
Duloxetine (Cymbalta) vs Pregabalin (Lyrica) vs Gabapentin

Antipsychotics
Risperidone (Risperdal, Risperdal MT) vs Olanzapine (Zyprexa, Zyprexa Zydis) vs Quetiapine (Seroquel,
Seroquel SR) vs Ziprasidone (Geodon) vs Aripiprazole (Abilify) vs Paliperidone (Invega)

Analgesic
Morphine Sulfate [MSContin vs (Avinza) vs (Kadian) vs (Oramorph SR)] vs Oxycodone (Oxycontin)

Antiparkinsonian
Pramipexole (Mirapex) vs Ropinirole (Generic, Requip) vs Rotigotine (Neupro)

Selegiline vs Rasagiline (Azilect)

Antirheumatoid
Etanercept (Enbrel) vs Adalimumab (Humira) vs Abatacept (Orencia)




                                                                                                       Page 15 of 57
CENTRAL NERVOUS SYSTEM AGENTS - Continued

Multiple Sclerosis Drugs
Interferon Beta-1a [(Avonex) vs (Rebif)] vs Interferon Beta-1b (Betaseron) vs
Glatiramer (Copaxone) vs Natalizumab (Tysabri)

Triptans
Rizatriptan (Maxalt, Maxalt MLT) vs Sumatriptan (Imitrex) vs Naratriptan (Amerge) vs Almotriptan (Axert) vs
Zolmitriptan (Zomig, Zomig ZMT) vs Frovatriptan (Frova) vs Eletriptan (Relpax)

Hypnotics
Zolpidem (generic, Ambien CR) vs Zaleplon (Generic, Sonata) vs Eszopiclone (Lunesta) vs Ramelteon
(Rozerem)

Alzheimer’s/Dementia
Memantine (Namenda)

Alcohol Abuse
Acamprosate (Campral) vs Naltrexone

Viscosupplements
Hyaluronate Sodium: Supartz vs Euflexxa vs Hyalgan ve Orthovisc vs Synvisc

Nondepolarizing Neuromuscular Blockers
Cisatracurium (Nimbex) vs Rocuronium (Zemuron) vs Vecuronium (Generic) vs Atracurium


GENERAL FORMULARY AGENTS
Loratadine-Pseudoephedrine (Alavert D, Claritin D) vs. Cetirizine (Zyrtec, Zyrtec D) vs. Fexofenadine (Generic,
Allegra, Allegra-D) vs. Desloratadine (Clarinex , Clarinex-D)

Flunisolide (Generic, Nasarel) vs. Fluticasone (Generic, Flonase) vs. Beclomethasone (Beconase AQ) vs.
Budesonide (Rhinocort) vs. Triamcinolone (Nasacort) vs. Mometasone (Nasonex)

Darbepoetin (Aranesp) vs. Epoietin (Epogen) vs. Epoietin (Procrit)

Ciprofloxacin OPTH (Generic) vs. Ofloxacin (Generic, Ocuflox) vs. Levofloxacin (Quixin)

Moxifloxacin OPTH (Vigamox) VS. Gatifloxacin (Zymar)

Budesonide (Pulmicort Flexhaler) vs. Fluticasone (Flovent FHA) vs. Triamcinolone (Azmacort) vs.
Beclomethasone (QVAR) vs. Flunisolide (Aerobid) vs. Mometasone (Asmanex)

Albuterol (generic, HFA, Ventolin, Ventolin HFA, Proventil & Proventil HFA) vs. Pirbuterol (Maxair) vs.
Levalbuterol (Xopenex, Xopenex HFA)

Salmeterol (Serevent) vs. Formoterol (Foradil)

Montelukast (Singulair) vs. Zafirlukast (Accolate) vs Zileuton (Zyflo CR)




                                                                                                   Page 16 of 57
GENERAL FORMULARY AGENTS - Continued

Advair Diskus vs Advair HFA vs. Fluticasone / Salmeterol vs Budesonide/Formoterol (Symbicort)

Combivent vs. Ipratropium / Albuterol

Ipratropium (Atrovent HFA) vs Tiotropium (Spiriva)

Nepafenac (Nevanac) vs. Bromfenac (Xibrom) vs Ketorolac (Acular) vs Flurbiprofen (Ocufen, generic)

Latanoprost (Xalatan) vs. Travoprost (Travatan, Travatan Z) vs. Bimatoprost (Lumigan)

Azelastine (Optivar) vs. Olopatadine (Patanol, Pataday) vs. Epinastine (Elestat)

Cromolyn Na (Generic, Crolom) vs. Nedocromil Na (Alocril) vs. Pemirolast K (Alamast) vs. Lodoxamide
(Alomide)

Testosterone patch (Androderm) vs. Testosterone gel (Androgel, Testim) vs Testosterone Buccal (Striant) vs
Testosterone Implant (Testopel) vs Testosterone injection (Delatestryl, Depo-Testosterone)

Estrogen: Vivelle vs. Climara vs. Estraderm vs. Alora

Glimepiride (Amaryl, generic) vs Glipizide XL (Generic) vs Glipizide XL (Glucotrol XL) vs Glipizide ER
(Generic)

Miglitol (Glyset) vs. Acarbose (Precose)

Nateglinide (Starlix) vs. Repaglinide (Prandin)

Sitagliptin (Januvia)

Novolin N, R, 70/30 and Innolets & Novolog (Novo Nordisk) vs. Humulin N, R, 70/30, and Innolets, 50/50 &
Humalog (Lilly)

Insulin Detemir (Levemir) vs Insulin Glargine (Lantus)

Alendronate (Fosamax) vs. Alendronate with Vitamin D (Fosamax Plus D) vs. Risedronate (Actonel) vs.
Risedronate with Calcium (Actonel / Calcium)

Paricalcitol (Zemplar) vs. Doxercalciferol (Hectorol) vs. Calcitriol (Generic, Rocaltrol)

Famotidine (Generic, Pepcid Susp) vs. Ranitidine (Generic, Zantac) vs. Nizatidine (Generic, Axid) vs.
Cimetidine (Generic, Tagamet)

Lansoprazole (Prevacid) vs. Esomeprazole (Nexium) vs. Pantoprazole (Generic, Protonix) vs. Rabeprazole
(Aciphex) vs. Omeprazole (Generic, Prilosec)

Pantoprazole IV (Protonix) vs. Esomeprazole IV (Nexium)

Ondansetron (generic and ODT) vs. Dolasetron (Anzemet) vs. Granisetron (Generic, Kytril) vs. Palosentron
(Aloxi) vs Aprepitant (Emend)




                                                                                                    Page 17 of 57
GENERAL FORMULARY AGENTS - Continued

Tacrolimus (Protopic) vs. Pimecrolimus (Elidel)

Prazosin (generic) vs Doxazosin (generic) vs Alfluzosin (Uroxatral) vs. Tamsulosin (Flomax)

Oxybutynin XL (Ditropan XL) vs. Oxybutynin patch (Oxytrol) vs. Tolterodine (Detrol, Detrol LA) vs.
Trospium (Sanctura) vs. Darifenacin (Enablex) vs. Solifenacin (Vesicare)

Post-menopausal agents: Prempro vs. Premphase vs. Prefest vs. Femhrt vs. Activella vs Combipatch, vs Estratest
vs Estratest HS, vs Climara Pro

Oral contraceptives (20 mcg Ethinyl Estradiol): Alesse vs. Levlite vs. Aviane vs. Lessina vs. Loestrin vs. Junel
vs. Microgestin vs. Loestrin FE vs. Microgestin FE vs. Junel FE vs. Mircette vs. Kariva vs. Estrostep FE

Oral contraceptives (25 mcg Ethinyl Estradiol): Ortho-Tricyclen Lo vs. Cyclessa vs. Velivet

Oral contraceptives (30 mcg Ethinyl Estradiol): Loestrin FE vs. Microgestin FE vs. Junel FE vs. Loestin vs.
Microgestin vs. Junel vs. Lo/Ovral vs. Low-Ogestrel vs. Cryselle vs. Nordete vs. Levlen vs. Levora vs. Portia vs.
Tri-Levlen 28 vs. Enpresse 28 vs. Triphasil 28 vs. Trivora 28 vs. Desogen vs. OrthoCept vs. Apri vs. Solia

Oral contraceptives (35 mcg Ethinyl Estradiol): Ortho-Cyclen vs. Mononessa vs. Previfem vs. Sprintec vs. Zovia
1/35 vs. Janest 28 vs. Necon 10/11 vs. Ortho-Novum 10/11 vs. Ortho-Tri Cyclen 28 vs. Trinessa vs. Tri-Previfem
vs. Tri Sprintec vs. Ortho-Novum 7/7/7 vs. Nortrel 7/7/7 vs. Necon 7/7/7 vs. Ortho-Novum vs. Necon vs. Norinyl
vs. Nelova vs. Nortrel vs. Genora 1/35 vs. TriNorinyl vs. Zovia vs. Brevicon vs. Modicon vs. Ovcon 35 vs.
Jolivette vs. Nor-Q-D vs. Camila vs. Errin vs. Nora-Be vs. Ovrette

Oral contraceptives (50 mcg Ethinyl Estradiol): Ortho-Novum vs. Necon vs. Norinyl vs. Nelova vs. Demulen vs.
Zovia vs. Ovcon 50

Etonogestrel (Implanon) vs Levonorgestrel (Mirena)

Iron Dextran (Infed) vs Iron Gluconate (Ferrlecit) vs Iron Sucrose (Venofer)

Sevelamer (Renagel) vs Lanthanum Carbonate (Fosrenol)

Dimethyl Sulfoxide (Rimso-50) vs Pentosan Polysulfate Sodium (Elmiron)

ONCOLOGY AGENTS

Anastrozole (Arimidex) vs. Letrozole (Femara)

Goserelin (Zoladex) vs. Leuprolide (Lupron)

Flutamide 125 mg vs Bicalutamide (Casodex) 50 mg vs Nilutamide (Nilandron) 150 mg




                                                                                                      Page 18 of 57
                                   ATTACHMENT I
                                 ALTERNATE BID SHEET



COMPANY: _______________________________________ DATE: ___________________




                                                                             Page 19 of 57
                                        ATTACHMENT II
                                    VENDOR INFORMATION
                                         2009 - 2010

Please assist us by providing the following information. This will enable us to have a current bid listing on
your company.
                                                                                        Thank You.

       COMPANY NAME________________________________________________________

       PRINT NAME____________________________________________________________
       (Mr. Mrs. Ms.)
       TITLE___________________________________________________________________

       COMPANY ADDRESS_____________________________________________________

       ________________________________________________________________________

       AUTHORIZED SIGNATURE________________________________________________

       TELEPHONE_____________________________________________________________

       FAX NO._________________________________________________________________

SEND AWARD INFORMATION TO:
     COMPANY NAME________________________________________________________

       ATTENTION_____________________________________________________________

       COMPANY ADDRESS_____________________________________________________

       _________________________________________________________________________

       TELEPHONE_____________________________________________________________

       FAX NO._________________________________________________________________




                                                                                                 Page 20 of 57
                                             ATTACHMENT III

COMPANY _____________________________________ DATE_________________________


The Harris County Hospital District and its outpatient services components are disproportionate
share facilities as defined by the Veterans Health Care Act of 1992 (Public Law No. 102-595).

Please list appropriate information below:


       COMPANY NAME________________________________________________________

       PRINT NAME____________________________________________________________
       (Mr. Mrs. Ms.)
       TITLE___________________________________________________________________

       COMPANY ADDRESS_____________________________________________________

       ________________________________________________________________________

       AUTHORIZED SIGNATURE________________________________________________

       TELEPHONE_____________________________________________________________



DOES YOUR COMPANY PARTICIPATE IN A CHARGE-BACK PROGRAM (PRIME VENDOR),
THROUGH A DESIGNATED WHOLESALER?

               YES ____________                NO_____________


CONTACT PERSON_____________________________________________________________
                                 (type/print)

TITLE_________________________________________________________________________

COMPANY ADDRESS___________________________________________________________


TELEPHONE___________________________________________________________________




                                                                                           Page 21 of 57
                                   PRICING/DELIVERY INFORMATION

Inquiries pertaining to bid invitation must give bid designation and opening date and should be directed to:
                                Manager, Pharmacy Purchasing
                                Harris County Purchasing Department, Pharmaceutical Division
                                1001 Preston, Suite 670
                                Houston, Texas 77002
                                Tel: (713) 755-4280

Renewal
Vendor agrees to continue this contract for the time frame stated below under the same terms and conditions and
pricing as the original contract. If bidder does not wish to renew, write "N.A." in the space provided.

Renewal Year 1 (2010-2011):

Renewal Year 1 (2011-2012):

Cash Discount
Please insert in the blank space below your company's cash discount policy for payment of invoices. (Example -
2% 15-days, 1% 30-days, Net 30-days)                   %. The County would prefer to pay on the 15th and 30th
of the month.




                                                                                                        Page 22 of 57
                                      PRICING/DELIVERY INFORMATION

               REQUEST FOR BID                2009-2010          H.C.H.D      JOB NO. 08/0455


BIDDER MUST ENTER THE NATIONAL DRUG CODE IN COLUMN A, THE SUB-CEILING OUTPATIENT PRICE BELOW
THE P.H.S. CEILING PRICE IN COLUMN B, AND THE MOST CURRENT P.H.S. PRICE IN COLUMN C. DO NOT RETURN

ANDY BLANK SHEETS. IF YOU "NO BID" AN ITEM, SO STATE THAT IN COLUMN B.


VENDOR______________________________


PRODUCT LIST                                    ANNUAL          COLUMN A      COLUMN B           COLUMN C
                                                                                                  (Current PHS
*FORMULARY STATUS                              ESTIMATE       (NDC NUMBER)     (Sub-ceiling bid)     price)

                                                USAGE
Voriconazole (Vfend)
50mg tab btl 30*                                  14
200mg tab btl 30*                                 19
40mg/ml soln btl 75ml                              0


Posaconazole (Noxafil)
200mg/5mL Susp btl 105mL                           7


Valacyclovir (Valtrex)
500mg tab btl 30*                                 913
1000mg tab btl 30*                                332


Valganciclovir (Valcyte)
450mg tab btl 60*                                 46


Peginterferone Alfa 2a (Pegasys)
180mcg/ml 1ml vial 1*                              0
180mcg/ml 0.5 ml syr kit 4*                       100


Peginterferone Alfa 2b (Peg-Intron)
50mcg/0.5ml vial kit 1*                            0
80mcg/0.5ml vial kit 1*                            0
120mcg/0.5ml vial kit 1*                           0
150mcg/0.5ml vial kit 1*                           0


Cefixime (Suprax)
100mg/5ml soln btl 50ml                            0
100mg/5ml soln btl100ml                            0
200mg/5ml soln btl 50ml                            0
200mg/5ml soln btl 75ml                            0




                                                                                                                 Page 23 of 57
                                    PRICING/DELIVERY INFORMATION

                  REQUEST FOR BID             2009-2010          H.C.H.D      JOB NO. 08/0455


BIDDER MUST ENTER THE NATIONAL DRUG CODE IN COLUMN A, THE SUB-CEILING OUTPATIENT PRICE BELOW
THE P.H.S. CEILING PRICE IN COLUMN B, AND THE MOST CURRENT P.H.S. PRICE IN COLUMN C. DO NOT RETURN

ANDY BLANK SHEETS. IF YOU "NO BID" AN ITEM, SO STATE THAT IN COLUMN B.


VENDOR______________________________


PRODUCT LIST                                    ANNUAL          COLUMN A      COLUMN B           COLUMN C
                                                                                                  (Current PHS
*FORMULARY STATUS                              ESTIMATE       (NDC NUMBER)     (Sub-ceiling bid)     price)

                                                USAGE
Levofloxacin (Levaquin)
250mg tab btl 50                                   0
500mg tab btl 50                                   0
750mg tab btl 20                                   0
750mg tab uu 3x5                                   0
25mg/ml soln btl 480 ml                            0


Moxifloxacin (Avelox)
400mg tab btl 30*                                 258
400mg ABC 5-pk*                                    0


Clarithromycin XL (Biaxin XL)
500mg XL tab 4 x 14 uu                             0


Azithromycin (Zithromax - ZMAX)
2 gm soln btl 60*                                  0


Linezolid (Zyvox)
600mg tab btl 20*                                 34
100mg/5ml soln btl 150ml*                          0


Candesartan (Atacand)
4mg tab btl 30                                    13
8mg tab btl 30*                                   977
16mg tab btl 30*                                 3,070
32mg tab btl 30*                                 4,673


Eprosartan (Teveten)
400mg tab btl 100                                  0
600mg tab btl 100                                  0


Irbesartan (Avapro)
75m tab btl 90                                     0
150mg tab btl 90                                   0
300mg tab btl 90                                   0


                                                                                                                 Page 24 of 57
                                    PRICING/DELIVERY INFORMATION

                 REQUEST FOR BID              2009-2010          H.C.H.D      JOB NO. 08/0455


BIDDER MUST ENTER THE NATIONAL DRUG CODE IN COLUMN A, THE SUB-CEILING OUTPATIENT PRICE BELOW
THE P.H.S. CEILING PRICE IN COLUMN B, AND THE MOST CURRENT P.H.S. PRICE IN COLUMN C. DO NOT RETURN

ANDY BLANK SHEETS. IF YOU "NO BID" AN ITEM, SO STATE THAT IN COLUMN B.


VENDOR______________________________


PRODUCT LIST                                    ANNUAL          COLUMN A      COLUMN B           COLUMN C
                                                                                                  (Current PHS
*FORMULARY STATUS                              ESTIMATE       (NDC NUMBER)     (Sub-ceiling bid)     price)

                                                USAGE
Losartan (Cozaar)
25mg tab btl 90*                                 6,262
25mg tab btl 1000*                                334
50mg tab btl 90                                   611
100mg tab btl 90                                  266


Olmesartan (Benicar)
5mg tab btl 30                                     0
20mg tab btl 90                                    0
40mg tab btl 90                                    0


Telmisartan (Micardis)
20mg tab pck 30                                    0
40mg tab pck 30                                    0
80mg tab pck 30                                    0


Valsartan (Diovan)
40mg tab btl 30                                    3
80mg tab btl 90                                   16
160mg tab btl 90                                  10
320mg tab btl 90                                   0


Candesartan / Hctz (Atacand Hct)
16-12.5mg tab btl 90                               0
32-12.5mg tab btl 90                               0


Eprosartan / Hctz (Teveten Hct)
600-12.5mg tab btl 100                             0
600-25mg tab btl 100                               0


Irbesartan / Hctz (Avalide)
150-12.5mg tab btl 90                              0
300-12.5mg tab btl 90                              0




                                                                                                                 Page 25 of 57
                                    PRICING/DELIVERY INFORMATION

                REQUEST FOR BID               2009-2010          H.C.H.D      JOB NO. 08/0455


BIDDER MUST ENTER THE NATIONAL DRUG CODE IN COLUMN A, THE SUB-CEILING OUTPATIENT PRICE BELOW
THE P.H.S. CEILING PRICE IN COLUMN B, AND THE MOST CURRENT P.H.S. PRICE IN COLUMN C. DO NOT RETURN

ANDY BLANK SHEETS. IF YOU "NO BID" AN ITEM, SO STATE THAT IN COLUMN B.


VENDOR______________________________


PRODUCT LIST                                    ANNUAL          COLUMN A      COLUMN B           COLUMN C
                                                                                                  (Current PHS
*FORMULARY STATUS                              ESTIMATE       (NDC NUMBER)     (Sub-ceiling bid)     price)

                                                USAGE
Losartan / Hctz (Hyzaar)
50-12.5mg tab btl 90                               0
100-25mg tab btl 90                                0


Olmesartan / Hctz (Benicar Hct)
20-12.5mg tab btl 90                               0
40-12.5mg tab btl 90                               0
40-25mg tab btl 90                                 0


Telmisartan / Hctz (Micardis Hct)
40-12.5mg tab pck 30                               0
80-12.5mg tab pck 30                               0
80-25mg tab pck 30                                 0


Valsartan / Hctz (Diovan Hct)
80-12.5mg tab btl 90                               0
160-12.5mg tab btl 90                              0
160-25mg tab btl 90                                0


Nisoldipine (Sular)
8.5mg tab btl 100                                2,407
10mg tab btl 100                                 5,826
17mg tab btl 100                                 3,300
20mg tab btl 100                                   0
22.5mg tab btl 100                                 0
30 mg tab btl 100                                  0
34mg tab btl 100                                 4,791


Atorvastatin (Lipitor)
10mg tab btl 90*                                  332
20mg tab btl 90*                                  435
40mg tab btl 90*                                  455
80mg tab btl 90*                                  811




                                                                                                                 Page 26 of 57
                                           PRICING/DELIVERY INFORMATION

                REQUEST FOR BID                 2009-2010        H.C.H.D      JOB NO. 08/0455


BIDDER MUST ENTER THE NATIONAL DRUG CODE IN COLUMN A, THE SUB-CEILING OUTPATIENT PRICE BELOW
THE P.H.S. CEILING PRICE IN COLUMN B, AND THE MOST CURRENT P.H.S. PRICE IN COLUMN C. DO NOT RETURN

ANDY BLANK SHEETS. IF YOU "NO BID" AN ITEM, SO STATE THAT IN COLUMN B.


VENDOR______________________________


PRODUCT LIST                                     ANNUAL         COLUMN A      COLUMN B           COLUMN C
                                                                                                  (Current PHS
*FORMULARY STATUS                                ESTIMATE     (NDC NUMBER)     (Sub-ceiling bid)     price)

                                                  USAGE
Fluvastatin (Lescol)
20mg cap btl 100                                    0
40mg cap btl 100                                    0


Rosuvastatin (Crestor)
5mg tab btl 90*                                     0
10mg tab btl 90*                                    2
20mg tab btl 90*                                    8
40mg tab btl 30*                                    0


Ezetimibe / Simvastatin (Vytorin)
10-10mg tab btl 90*                               1,256
10-20mg tab btl 90*                               4,172
10-40mg tab btl 90*                               5,180
10-80mg tab btl 90*                               1,780


Amlodipine/Atorvastatin (Caduet)
2.5-10 mg tab btl 30*                               0
2.5-20 mg tab btl 30*                               0
2.5-40 mg tab btl 30*                               0
5-10 mg tab btl 30*                                37
5-20 mg tab btl 30*                                18
5-40 mg tab btl 30*                                 0
5-80 mg tab btl 30*                                12
10-10 mg tab btl 30*                               10
10-20 mg tab btl 30*                               14
10-40 mg tab btl 30*                                1
10-80 mg tab btl 30*                                0


Isosorbide Dinitrate/Hydralazine (BiDil)
20-37.5 mg tab btl 180                              0




                                                                                                                 Page 27 of 57
                                    PRICING/DELIVERY INFORMATION

                  REQUEST FOR BID             2009-2010          H.C.H.D      JOB NO. 08/0455


BIDDER MUST ENTER THE NATIONAL DRUG CODE IN COLUMN A, THE SUB-CEILING OUTPATIENT PRICE BELOW
THE P.H.S. CEILING PRICE IN COLUMN B, AND THE MOST CURRENT P.H.S. PRICE IN COLUMN C. DO NOT RETURN

ANDY BLANK SHEETS. IF YOU "NO BID" AN ITEM, SO STATE THAT IN COLUMN B.


VENDOR______________________________


PRODUCT LIST                                    ANNUAL          COLUMN A      COLUMN B           COLUMN C
                                                                                                  (Current PHS
*FORMULARY STATUS                              ESTIMATE       (NDC NUMBER)     (Sub-ceiling bid)     price)

                                                USAGE
Aripiprazole (Abilify)
5mg tab btl 30*                                   219
10mg tab btl 30*                                  325
15mg tab btl 30*                                  138
20mg tab btl 30*                                  124
30mg tab btl 30*                                  51
1mg/ml soln btl 150ml                              0


Olanzapine (Zyprexa)
2.5mg tab btl 30*                                 144
5mg tab btl 30*                                   466
7.5mg tab btl 30*                                 281
10mg tab btl 30*                                 1,140

Olanzapine (Zyprexa Zydis)
5mg tab uu btl 30*                                 4
10mg tab uu btl 30*                                1
15mg tab uu btl 30*                                0
20mg tab uu btl 30*                                0

Quetiapine (Seroquel)
25mg tab btl 100*                                 915
50mg tab btl 100*                                 227
100mg tab btl 100*                                749
200mg tab btl 100*                                624
300mg tab btl 60*                                 460
400mg tab btl 100*                                90


Quetiapine (Seroquel SR)
200mg tab btl 60*                                  3
300mg tab btl 60*                                  0
400mg tab btl 60*                                  0




                                                                                                                 Page 28 of 57
                                    PRICING/DELIVERY INFORMATION

                  REQUEST FOR BID             2009-2010          H.C.H.D      JOB NO. 08/0455


BIDDER MUST ENTER THE NATIONAL DRUG CODE IN COLUMN A, THE SUB-CEILING OUTPATIENT PRICE BELOW
THE P.H.S. CEILING PRICE IN COLUMN B, AND THE MOST CURRENT P.H.S. PRICE IN COLUMN C. DO NOT RETURN

ANDY BLANK SHEETS. IF YOU "NO BID" AN ITEM, SO STATE THAT IN COLUMN B.


VENDOR______________________________


PRODUCT LIST                                    ANNUAL          COLUMN A      COLUMN B           COLUMN C
                                                                                                  (Current PHS
*FORMULARY STATUS                              ESTIMATE       (NDC NUMBER)     (Sub-ceiling bid)     price)

                                                USAGE
Risperidone (Risperdal MT)
0.5mg tab uu btl 28*                               5
1mg tab uu btl 28*                                 4
2mg tab uu btl 28*                                 2


Ziprasidone (Geodon)
20mg cap btl 60*                                  77
40mg cap btl 60*                                  82
60mg cap btl 60*                                  59
80mg cap btl 60*                                  89


Paliperidone (Invega)
3mg tab btl 30*                                   49
6mg tab btl 30*                                   36
9mg tab btl 30*                                   28


Paroxetine (Paxil)
10mg/5ml soln btl 250ml*                           6


Escitalopram (Lexapro)
10mg tab btl 100                                   6
20mg tab btl 100                                  21
5mg/5ml soln btl 240ml                             0


Duloxetine (Cymbalta)
20mg cap btl 60                                    0
30mg cap btl 30*                                  42
60mg cap btl 30*                                 1,396


Venlafaxine (Effexor XR)
37.5mg cap btl 30*                               2,981
75mg cap btl 30*                                 5,263
150mg cap btl 30*                                3,201




                                                                                                                 Page 29 of 57
                                        PRICING/DELIVERY INFORMATION

                REQUEST FOR BID               2009-2010          H.C.H.D      JOB NO. 08/0455


BIDDER MUST ENTER THE NATIONAL DRUG CODE IN COLUMN A, THE SUB-CEILING OUTPATIENT PRICE BELOW
THE P.H.S. CEILING PRICE IN COLUMN B, AND THE MOST CURRENT P.H.S. PRICE IN COLUMN C. DO NOT RETURN

ANDY BLANK SHEETS. IF YOU "NO BID" AN ITEM, SO STATE THAT IN COLUMN B.


VENDOR______________________________


PRODUCT LIST                                    ANNUAL          COLUMN A      COLUMN B           COLUMN C
                                                                                                  (Current PHS
*FORMULARY STATUS                              ESTIMATE       (NDC NUMBER)     (Sub-ceiling bid)     price)

                                                USAGE
D-amphetamine / Ampheth (Adderall XR)
5mg cap btl 100*                                   7
10mg cap btl 100*                                 22
15mg cap btl 100*                                  5
20mg cap btl 100*                                 27
25mg cap btl 100*                                  3
30mg cap btl 100*                                 17


Methylphenidate (Concerta)
18mg tab btl 100*                                 62
27mg tab btl 100*                                 47
36mg tab btl 100*                                 74
54mg tab btl 100*                                 28


Methylphenidate (Metadate CD)
10mg cap btl 100*                                  3
20mg cap btl 100*                                  7
30mg cap btl 100*                                  1


Methylphenidate (Metadate ER)
10mg tab btl 100                                   0
20mg tab btl 100                                   0

Glatiramer (Copaxone)
20mg/ml 1ml inj kit 30*                           234


Interferon Beta 1a (Rebif)
22mcg/0.5ml inj syr 12/bx                          0
44mcg/0.5ml inj syr 12/bx                          0


Interferon beta 1b (Betaseron)
0.3mg inj kit 15/bx*                              164




                                                                                                                 Page 30 of 57
                                    PRICING/DELIVERY INFORMATION

                REQUEST FOR BID               2009-2010          H.C.H.D      JOB NO. 08/0455


BIDDER MUST ENTER THE NATIONAL DRUG CODE IN COLUMN A, THE SUB-CEILING OUTPATIENT PRICE BELOW
THE P.H.S. CEILING PRICE IN COLUMN B, AND THE MOST CURRENT P.H.S. PRICE IN COLUMN C. DO NOT RETURN

ANDY BLANK SHEETS. IF YOU "NO BID" AN ITEM, SO STATE THAT IN COLUMN B.


VENDOR______________________________


PRODUCT LIST                                    ANNUAL          COLUMN A      COLUMN B           COLUMN C
                                                                                                  (Current PHS
*FORMULARY STATUS                              ESTIMATE       (NDC NUMBER)     (Sub-ceiling bid)     price)

                                                USAGE
Interferone Beta 1a (Avonex)
30mcg inj kit 4/bx*                               146


Natalizumab (Tysabri)
20mg/ml inj 15ml                                   0


Adalimumab (Humira)
40mg/0.8ml inj syr kit 2/bx*                      569
40mg/0.8ml inj pen kit 2/bx*                      494


Etanercept (Enbrel)
25mg vial inj kit 4/bx*                           953
50mg /ml syn 0.98ml 4/bx*                         479


Abatacept (Orencia)
250 mg 15ml pwvl                                   0


Pramipexole (Mirapex)
0.125mg tab btl 90*                               182
0.25mg tab btl 90*                                206
0.5mg tab btl 90*                                 99
1mg tab btl 90*                                   149
1.5mg tab btl 90*                                 84


Rotigotine (Neupro)
2mg/24hr ptch box 30                               0
4mg/24hr ptch box 7                                0
6mg/24hr ptch box 7                                0


Rasagiline (Azilect)
0.5 mg tabs btl 30*                                0
1mg tabs btl 30*                                   0




                                                                                                                 Page 31 of 57
                                    PRICING/DELIVERY INFORMATION

                  REQUEST FOR BID             2009-2010          H.C.H.D      JOB NO. 08/0455


BIDDER MUST ENTER THE NATIONAL DRUG CODE IN COLUMN A, THE SUB-CEILING OUTPATIENT PRICE BELOW
THE P.H.S. CEILING PRICE IN COLUMN B, AND THE MOST CURRENT P.H.S. PRICE IN COLUMN C. DO NOT RETURN

ANDY BLANK SHEETS. IF YOU "NO BID" AN ITEM, SO STATE THAT IN COLUMN B.


VENDOR______________________________


PRODUCT LIST                                    ANNUAL          COLUMN A      COLUMN B           COLUMN C
                                                                                                  (Current PHS
*FORMULARY STATUS                              ESTIMATE       (NDC NUMBER)     (Sub-ceiling bid)     price)

                                                USAGE
Morphine Sulfate (Avinza)
30mg cap btl 100                                   0
60mg cap btl 100                                   0
90mg cap btl 100                                   0
120mg cap btl 100                                  0


Morphine sulfate (Kadian)
20mg cap btl 100*                                 186
30mg cap btl 100*                                 236
50mg cap btl 100*                                 106
60mg cap btl 100*                                 135
80mg cap btl 100                                   0
100mg cap btl 100*                                46
200mg cap btl 100                                  0


Donepezil (Aricept)
5mg tab btl 30*                                   979
10mg tab btl 30*                                  311


Galantamine (Razadyne ER)
8mg cap btl 30                                     0
16mg cap btl 30                                    0
24mg cap btl 30                                    0
4mg/ml soln btl 100ml*                             0


Rivastigmine (Exelon)
1.5mg cap btl 60                                   0
3mg cap btl 60                                     0
4.5mg cap btl 60                                   0
6mg cap btl 60                                     0
2mg/ml soln btl 120ml                              0

Memantine (Namenda)
5mg tab btl 60*                                   170
10mg tab btl 60*                                  325




                                                                                                                 Page 32 of 57
                                    PRICING/DELIVERY INFORMATION

                  REQUEST FOR BID             2009-2010          H.C.H.D      JOB NO. 08/0455


BIDDER MUST ENTER THE NATIONAL DRUG CODE IN COLUMN A, THE SUB-CEILING OUTPATIENT PRICE BELOW
THE P.H.S. CEILING PRICE IN COLUMN B, AND THE MOST CURRENT P.H.S. PRICE IN COLUMN C. DO NOT RETURN

ANDY BLANK SHEETS. IF YOU "NO BID" AN ITEM, SO STATE THAT IN COLUMN B.


VENDOR______________________________


PRODUCT LIST                                    ANNUAL          COLUMN A      COLUMN B           COLUMN C
                                                                                                  (Current PHS
*FORMULARY STATUS                              ESTIMATE       (NDC NUMBER)     (Sub-ceiling bid)     price)

                                                USAGE
Almotriptan (Axert)
6.25mg tab uu 6*                                  37
12.5mg tab uu 2 x 6*                              43


Eletriptan (Relpax)
20mg tab btl 6                                     0
40mg tab btl 6                                     0


Frovatriptan (Frova)
2.5mg tab uu 9                                     0


Naratriptan (Amerge)
1mg tab btl 9                                      0
2.5mg tab btl 9                                    0


Rizatriptan (Maxalt)
5mg tab uu 4x3ea                                   0
10mg tab uu 4x3ea                                  0


Rizatriptan (Maxalt MLT)
5mg tab btl 4x3                                    0
10mg tab btl 4x3                                   0


Sumatriptan (Imitrex)
25mg tab btl 9                                     0
50mg tab btl 9                                     0
100mg tab btl 9                                    0
6mg/0.5ml inj kit 1*                              25
6mg/0.5ml inj sdv 5x0.5ml *                       43
20mg nsl 6*                                       369
5mg nsl 6*                                         0

Zolmitriptan (Zomig)
2.5mg tab btl 6*                                 2,273
5mg tab btl 3*                                   1,899




                                                                                                                 Page 33 of 57
                                    PRICING/DELIVERY INFORMATION

                 REQUEST FOR BID              2009-2010          H.C.H.D      JOB NO. 08/0455


BIDDER MUST ENTER THE NATIONAL DRUG CODE IN COLUMN A, THE SUB-CEILING OUTPATIENT PRICE BELOW
THE P.H.S. CEILING PRICE IN COLUMN B, AND THE MOST CURRENT P.H.S. PRICE IN COLUMN C. DO NOT RETURN

ANDY BLANK SHEETS. IF YOU "NO BID" AN ITEM, SO STATE THAT IN COLUMN B.


VENDOR______________________________


PRODUCT LIST                                    ANNUAL          COLUMN A      COLUMN B           COLUMN C
                                                                                                  (Current PHS
*FORMULARY STATUS                              ESTIMATE       (NDC NUMBER)     (Sub-ceiling bid)     price)

                                                USAGE
Zolmitriptan (Zomig ZMT)
2.5mg tab btl 6*                                  531
5mg tab btl 3*                                    633


Zolpidem (Ambien CR)
6.25 ER tab btl 100                                0
12.5 ER tab btl 100                                0


Eszopiclone (Lunesta)
1mg tab btl 100                                    1
2mg tab btl 100                                    4
3mg tab btl 100                                    0


Ramelteon (Rozerem)
8mg tab btl 30                                     4
8mg tab btl 100                                    5


Pregabalin (Lyrica)
25 mg cap btl 90                                   0
50 mg cap btl 90                                  27
75 mg cap btl 90                                  10
100 mg cap btl 90                                  2
150 mg cap btl 90                                  0
200 mg cap btl 90                                  0
225 mg cap btl 90                                  0
300 mg cap btl 90                                  0


Hyaluronate Sodium
10mg/ml 1x2ml (Hyalgan)                            0
8mg/ml 3x2ml (Synvisc)                            28
10mg/ml 5x2.5ml (Supartz)                         11
15mg/ml 1x2ml (Orthovisc)                          0
10mg/ml 3x2ml (Euflexxa)                           0




                                                                                                                 Page 34 of 57
                                               PRICING/DELIVERY INFORMATION

                REQUEST FOR BID                      2009-2010     H.C.H.D      JOB NO. 08/0455


BIDDER MUST ENTER THE NATIONAL DRUG CODE IN COLUMN A, THE SUB-CEILING OUTPATIENT PRICE BELOW
THE P.H.S. CEILING PRICE IN COLUMN B, AND THE MOST CURRENT P.H.S. PRICE IN COLUMN C. DO NOT RETURN

ANDY BLANK SHEETS. IF YOU "NO BID" AN ITEM, SO STATE THAT IN COLUMN B.

VENDOR______________________________


PRODUCT LIST                                          ANNUAL      COLUMN A      COLUMN B           COLUMN C
                                                                                                    (Current PHS
*FORMULARY STATUS                                    ESTIMATE    (NDC NUMBER)    (Sub-ceiling bid)     price)

                                                      USAGE
Acamprosate (Campral)
333 mg tab btl 180*                                     57


Cisatracurium (Nimbex)
2mg/ml inj 10x10*                                        0
10mg/ml inj 20 ml*                                       0


Rocuronium (Zemuron)
10 mg/ml inj 10x5 ml*                                    0
10 mg/ml inj 10x10ml*                                    0


Fexofenadine/pseudoephed (Allegra-D)
60-120mg tab btl 100                                     0


Cetirizine (Zyrtec)
1mg/ml syrp btl 120ml*                                  82


Cetirizine/pseudoephed (Zyrtec-D)
5-120mg tab btl 100                                      0


Desloratadine (Clarinex)
5mg tab btl 100                                          0
0.5 mg/ml syrp btl 120ml                                 0


Desloratadine/pseudoephed (Clarinex-D)
5-240 mg tab btl 100                                     0


Loratadine-pseudoephedrine (Claritin D, Alavert D)
5-120mg tab btl 10*                                     550
5-120mg tab btl 12*                                    1,258
5-120mg tab btl 20*                                     441
5-120mg tab btl 24*                                    11,078
5-120mg tab btl 30*                                    1,759


Beclomethasone (Beconase Aq)
42mcg nsl btl 25gm                                       0


                                                                                                                   Page 35 of 57
                                    PRICING/DELIVERY INFORMATION

               REQUEST FOR BID                2009-2010          H.C.H.D      JOB NO. 08/0455


BIDDER MUST ENTER THE NATIONAL DRUG CODE IN COLUMN A, THE SUB-CEILING OUTPATIENT PRICE BELOW
THE P.H.S. CEILING PRICE IN COLUMN B, AND THE MOST CURRENT P.H.S. PRICE IN COLUMN C. DO NOT RETURN

ANDY BLANK SHEETS. IF YOU "NO BID" AN ITEM, SO STATE THAT IN COLUMN B.

VENDOR______________________________


PRODUCT LIST                                    ANNUAL          COLUMN A      COLUMN B           COLUMN C
                                                                                                  (Current PHS
*FORMULARY STATUS                              ESTIMATE       (NDC NUMBER)     (Sub-ceiling bid)     price)

                                                USAGE
Mometasone (Nasonex)
50mcg nsl btl 17gm                                 5


Budesonide (Rhinocort Aqua)
32mcg nsl btl 8.6gm                                0


Triamcinolone (Nasacort Aq)
55mcg nsl btl 16.5gm                               0


Darbepoetin (Aranesp)
60mcg/0.3ml inj syr 4/bx*                         207
40mcg/0.4ml inj syr 4/bx*                         80

300mcg/0.6ml inj syr 1/bx*                        50
25mcg/0.4ml inj syr 4/bx*                         53
200mcg/0.4ml inj syr 1/bx*                        465
150mcg/0.3ml inj syr 4/bx*                        11
100mcg/0.5ml inj syr 4/bx*                        322
25mcg/ml vial 4/bx                                 0
40mcg/ml vial 4/bx                                 0
60mcg/ml vial 4/bx                                 0
100mcg/ml vial 4/bx                                0
200mcg/ml vial 1/bx                                0
300mcg/ml vial 1/bx                                0


Epoetin Alfa (Epogen)
4,000 u/ml 1ml inj vial 10/bx                      0
40,000 u/ml 1ml inj vial 10/bx                     0
3,000 u/ml 1ml inj vial 10/bx                      0
2,000 u/ml 1ml inj vial 10/bx                      0

20,000 u/ml 1ml inj vial 10/bx                     0
10,000 u/ml 2ml inj vial 10/bx                     0
10,000 u/ml 1ml inj vial 10/bx                     0


Epoetin Alfa (Procrit)
4,000 u/ml 1ml inj vial 25/bx                      0
40,000 u/ml 1ml inj vial 4/bx                      0
3,000 u/ml 1ml inj vial 25/bx                      0
                                                                                                                 Page 36 of 57
                                     PRICING/DELIVERY INFORMATION

                  REQUEST FOR BID             2009-2010          H.C.H.D      JOB NO. 08/0455


BIDDER MUST ENTER THE NATIONAL DRUG CODE IN COLUMN A, THE SUB-CEILING OUTPATIENT PRICE BELOW
THE P.H.S. CEILING PRICE IN COLUMN B, AND THE MOST CURRENT P.H.S. PRICE IN COLUMN C. DO NOT RETURN

ANDY BLANK SHEETS. IF YOU "NO BID" AN ITEM, SO STATE THAT IN COLUMN B.

VENDOR______________________________


PRODUCT LIST                                    ANNUAL          COLUMN A      COLUMN B           COLUMN C
                                                                                                  (Current PHS
*FORMULARY STATUS                              ESTIMATE       (NDC NUMBER)     (Sub-ceiling bid)     price)

                                                USAGE
Epoetin Alfa (Procrit) - Continued
2,000 u/ml 1ml inj vial 25/bx                      0
20,000 u/ml 1ml inj vial 6/bx                      0
10,000 u/ml 2ml inj vial 6/bx                      0
10,000 u/ml 1ml inj vial 25/bx                     0


Levofloxacin (Quixin)
0.5% opth soln btl 5ml                             0


Moxifloxacin (Vigamox)
0.5% opth soln btl 3ml*                           874


Gatifloxacin (Zymar)
0.3% opth soln btl 5ml                             0


Fluticasone (Flovent HFA)
44mcg inhal btl 10.6gm*                           402
220mcg inhal btl 12gm*                           1,020
110mcg inhal btl 12gm*                           1,451


Budesonide (Pulmicort Flexhaler)
90mcg inhal btl                                    0
180mcg inhal btl                                   0


Triamcinolone (Azmacort)
75mcg inhal btl 20gm                               0


Beclomethasone (Qvar)
80mcg inhal btl 7.3gm*                            212
40mcg inhal btl 7.3gm*                            136


Flunisolide (Aerobid)
250mcg inhal btl 7gm                              13


Mometasone (Asmanex)
220mcg 60 inhal btl 0.24gm*                        0
220mcg 120 inhal btl 0.24gm*                       0
                                                                                                                 Page 37 of 57
                                            PRICING/DELIVERY INFORMATION

                REQUEST FOR BID                       2009-2010     H.C.H.D      JOB NO. 08/0455


BIDDER MUST ENTER THE NATIONAL DRUG CODE IN COLUMN A, THE SUB-CEILING OUTPATIENT PRICE BELOW
THE P.H.S. CEILING PRICE IN COLUMN B, AND THE MOST CURRENT P.H.S. PRICE IN COLUMN C. DO NOT RETURN

ANDY BLANK SHEETS. IF YOU "NO BID" AN ITEM, SO STATE THAT IN COLUMN B.

VENDOR______________________________


PRODUCT LIST                                           ANNUAL      COLUMN A      COLUMN B           COLUMN C
                                                                                                     (Current PHS
*FORMULARY STATUS                                     ESTIMATE    (NDC NUMBER)    (Sub-ceiling bid)     price)

                                                       USAGE
Albuterol (Ventolin HFA, Proventil HFA, ProAir HFA)
90mcg inhal btl 18gm                                     18
90mcg inhal btl 6.7gm*                                  6,400
90mcg inhal btl 17gm                                    12,292
90mcg inhal btl 8.5gm                                     0


Pirbuterol (Maxair)
0.2mg inhal btl 14ml*                                   1,787


Levalbuterol (Xopenex HFA, Xopenex)
45mcg inhal btl 15gm                                      5
1.25mg/3ml 24x3ml                                        28
1.25 mg/0.5ml 30x0.5ml                                    0
0.31 mg/3ml 24x3ml                                        0
0.63 mg/3ml 24x3ml                                        0


Salmeterol (Serevent Diskus)
50mcg inhal btl 60*                                      239
50mcg inhal btl 28*                                       0


Formoterol (Foradil)
12mcg inhal dev 60*                                       4
12mcg inhal dev 12                                        0


Montelukast (Singulair)
5mg chew tab btl 90*                                     198

4mg chew tab btl 90*                                     41

10mg tab btl 90*                                        1,791

4mg chew tab btl 30                                       0
5mg chew tab btl 30                                       0
Zileuton (Zyflo CR)
600 mg tab btl 120                                        0
Zafirlukast (Accolate)
20mg tab btl 60                                           0
10mg tab btl 60                                           0



                                                                                                                    Page 38 of 57
                                         PRICING/DELIVERY INFORMATION

                REQUEST FOR BID               2009-2010          H.C.H.D      JOB NO. 08/0455


BIDDER MUST ENTER THE NATIONAL DRUG CODE IN COLUMN A, THE SUB-CEILING OUTPATIENT PRICE BELOW
THE P.H.S. CEILING PRICE IN COLUMN B, AND THE MOST CURRENT P.H.S. PRICE IN COLUMN C. DO NOT RETURN

ANDY BLANK SHEETS. IF YOU "NO BID" AN ITEM, SO STATE THAT IN COLUMN B.

VENDOR______________________________


PRODUCT LIST                                    ANNUAL          COLUMN A      COLUMN B           COLUMN C
                                                                                                  (Current PHS
*FORMULARY STATUS                              ESTIMATE       (NDC NUMBER)     (Sub-ceiling bid)     price)

                                                USAGE
Fluticasone/Salmeterol (Advair Diskus)
500-50mcg inhal btl 60*                          1,242

250-50mcg inhal btl 60*                         10,258

100-50mcg inhal btl 60*                          2,320


Fluticasone/Salmeterol (Advair HFA)
230-21mcg inhal 12gm                               0
115-21mcg inhal 12gm                               0
45-21mcg inhal 12gm                                0


Fluticasone/Salmeterol (Advair Diskus)
500-50mcg inhal btl 28*                            0

250-50mcg inhal btl 28*                           81

100-50mcg inhal btl 28*                           15
Budesonide/Formoterol (Symbicort)
160-4.5 mcg 10.2 gm*                               0
80-4.5 mcg 10.2 gm*                                0
Albuterol / Ipratropium (Combivent)
103-18mcg inhal btl 14.7gm*                      8,716

Ipratropium (Atrovent HFA)
0.1% opth soln btl 3ml*                           861

Tiotropium (Spiriva)
18 mcg 30 ea*                                    1,981
Nepafenac (Nevanac)
0.1% opth soln btl 3ml*                           40
Ketorolac (Acular)
0.5% opth soln btl 3ml                             0
0.5% opth soln btl 5ml                             0
0.5% opth soln btl 10ml                            0

0.5% opth soln btl 12 x 0.4ml                      0

0.4% opth soln btl 5ml                             0




                                                                                                                 Page 39 of 57
                                    PRICING/DELIVERY INFORMATION

                REQUEST FOR BID               2009-2010          H.C.H.D      JOB NO. 08/0455


BIDDER MUST ENTER THE NATIONAL DRUG CODE IN COLUMN A, THE SUB-CEILING OUTPATIENT PRICE BELOW
THE P.H.S. CEILING PRICE IN COLUMN B, AND THE MOST CURRENT P.H.S. PRICE IN COLUMN C. DO NOT RETURN

ANDY BLANK SHEETS. IF YOU "NO BID" AN ITEM, SO STATE THAT IN COLUMN B.

VENDOR______________________________


PRODUCT LIST                                    ANNUAL          COLUMN A      COLUMN B           COLUMN C
                                                                                                  (Current PHS
*FORMULARY STATUS                              ESTIMATE       (NDC NUMBER)     (Sub-ceiling bid)     price)

                                                USAGE
Nepafenac (Nevanac)
0.1% opth soln btl 3ml*                           58


Bromfenac (Xibrom)
0.09% opth soln btl 2.5 ml                         0
0.09% opth soln btl 5 ml                           0


Latanoprost (Xalatan)
0.005% opth soln btl 2.5ml*                      6,808


Bimatoprost (Lumigan)
0.03% opth soln btl 2.5ml                          0
0.03% opth soln btl 5ml
                                                   0
0.03% opth soln btl 7.5ml


Latanoprost (Xalatan)
0.005% opth soln btl 2.5ml*                      6,048


Travoprost (Travatan)
0.004% opth soln btl 2.5ml*                       214

0.004% opth soln btl 5ml                           3


Travoprost (Travatan Z)
0.004% opth soln btl 2.5ml                         0

0.004% opth soln btl 5ml                           3


Olopatadine (Patanol)
0.1% opth soln btl 5ml                             0


Olopatadine (Pataday)
0.2 % opth soln btl 2.5 ml                         0


Epinastine (Elestat)
0.05% opth soln btl 5ml                            0




                                                                                                                 Page 40 of 57
                                    PRICING/DELIVERY INFORMATION

                  REQUEST FOR BID             2009-2010          H.C.H.D      JOB NO. 08/0455


BIDDER MUST ENTER THE NATIONAL DRUG CODE IN COLUMN A, THE SUB-CEILING OUTPATIENT PRICE BELOW
THE P.H.S. CEILING PRICE IN COLUMN B, AND THE MOST CURRENT P.H.S. PRICE IN COLUMN C. DO NOT RETURN

ANDY BLANK SHEETS. IF YOU "NO BID" AN ITEM, SO STATE THAT IN COLUMN B.

VENDOR______________________________


PRODUCT LIST                                    ANNUAL          COLUMN A      COLUMN B           COLUMN C
                                                                                                  (Current PHS
*FORMULARY STATUS                              ESTIMATE       (NDC NUMBER)     (Sub-ceiling bid)     price)

                                                USAGE
Azelastine (Optivar)
0.05% opth soln btl 6ml*                         3,628

Cromolyn Na (Crolom)
4% opth soln btl 10ml                              0


Pemirolast Pot (Alamast)
0.1% opth soln btl 10ml                            0


Nedocromil Sod (Alocril)
2% opth soln btl 5ml                               0


Lodoxamide (Alomide)
0.1% opth soln btl 10ml                            0


Testosterone Gel (Testim)
1% 30 x 5gm                                        0


Testosterone Buccal (Striant)
30 mg 6 x 10 ea                                    0


Testosterone Implant (Testopel)
75 mg 1 x 10 ea                                    0


Testosterone (Delatestryl)
200 mg/ml inj 5ml                                  0


Testosterone (Depo-Testosterone)
200 mg/ml inj 1ml*                                 0
200 mg/ml inj 10ml*                                0


Testosterone (Androderm)
5mg/24hr ptch 30/bx                               18
2.5mg/24hr ptch 60/bx*                            153




                                                                                                                 Page 41 of 57
                                    PRICING/DELIVERY INFORMATION

                REQUEST FOR BID               2009-2010          H.C.H.D      JOB NO. 08/0455


BIDDER MUST ENTER THE NATIONAL DRUG CODE IN COLUMN A, THE SUB-CEILING OUTPATIENT PRICE BELOW
THE P.H.S. CEILING PRICE IN COLUMN B, AND THE MOST CURRENT P.H.S. PRICE IN COLUMN C. DO NOT RETURN

ANDY BLANK SHEETS. IF YOU "NO BID" AN ITEM, SO STATE THAT IN COLUMN B.

VENDOR______________________________


PRODUCT LIST                                    ANNUAL          COLUMN A      COLUMN B           COLUMN C
                                                                                                  (Current PHS
*FORMULARY STATUS                              ESTIMATE       (NDC NUMBER)     (Sub-ceiling bid)     price)

                                                USAGE
Testosterone (Androgel)
1% gel 5gm 30/bx                                   0
1% gel 2.5gm 30/bx                                 0

Estradiol (Climara)
0.1mg/24hr ptch 4/bx                               0
0.075mg/24hr ptch 4/bx                             0
0.06mg/24hr ptch 4/bx                              0
0.05mg/24hr ptch 4/bx                              0
0.0375mg/24hr ptch 4/bx                            0
0.025mg/24hr ptch 4/bx                             0


Estradiol (Estraderm)
0.1mg/24hr patch 6x8*                              8
0.05mg/24hr patch 6x8*                            21


Estradiol (Vvivelle-Dot)
0.1mg/24hr ptch 3x8                                0
0.075mg/24hr ptch 3x8                              0
0.05mg/24hr ptch 3x8                               0
0.0375mg/24hr ptch 3x8                             0
0.025mg/24hr ptch 3x8                              0


Estradiol (Alora)
0.05mg/24hr ptch 8/bx                              0
0.075mg/24hr ptch 8/bx                             0
0.025mg/24hr ptch 8/bx                             0
0.1mg/24hr ptch 8/bx                               0

Miglitol (Glyset)
50mg tab btl 100*                                1,294
25mg tab btl 100*                                1,461
100mg tab btl 100*                                566


Nateglinide (Starlix)
60mg tab btl 100*                                 862
120mg tab btl 100*                               1,179


                                                                                                                 Page 42 of 57
                                    PRICING/DELIVERY INFORMATION

                  REQUEST FOR BID             2009-2010          H.C.H.D      JOB NO. 08/0455


BIDDER MUST ENTER THE NATIONAL DRUG CODE IN COLUMN A, THE SUB-CEILING OUTPATIENT PRICE BELOW
THE P.H.S. CEILING PRICE IN COLUMN B, AND THE MOST CURRENT P.H.S. PRICE IN COLUMN C. DO NOT RETURN

ANDY BLANK SHEETS. IF YOU "NO BID" AN ITEM, SO STATE THAT IN COLUMN B.

VENDOR______________________________


PRODUCT LIST                                    ANNUAL          COLUMN A      COLUMN B           COLUMN C
                                                                                                  (Current PHS
*FORMULARY STATUS                              ESTIMATE       (NDC NUMBER)     (Sub-ceiling bid)     price)

                                                USAGE
Repaglinide (Prandin)
2mg tab btl 100                                    0
1mg tab btl 100                                    0
0.5mg tab btl 100                                  0

Novolin Insulin
R 100 u/ml inj vial 10ml*                        7,460
N 100 u/ml inj vial 10ml*                       45,658

70/30 100 u/ml inj vial 10ml*                    19,331


Novolin Insulin Innolet
R 100 u/ml inj syr 3mlx5*                         28

N 100 u/ml inj syr 3mlx5*                         147

70/30 u/ml inj syr 3mlx5*                         25


Humulin Insulin
R 100 u/ml inj vial 10ml                          20
N 100 u/ml inj vial 10ml                           9
70/30 100 u/ml inj vial 10ml                      13
50/50 100 u/ml inj vial 10ml*                     88


Humulin Insulin Pens
N 100 u/ml inj syr 3mlx5                           0
70/30 u/ml inj syr 3mlx5                           0


Insulin Aspart (Novolog)
100 u/ml inj vial 10ml                            104


Insulin Lispro (Humalog)
100 u/ml inj vial 10ml*                          2,522
100 u/ml inj syr 3mlx5                             3


Insulin Detemir (Levemir)
100 u/ml inj vial 10ml                             0


Insulin Glargine (Lantus)
100 u/ml inj vial 10ml*                          11,133

                                                                                                                 Page 43 of 57
                                     PRICING/DELIVERY INFORMATION

                  REQUEST FOR BID             2009-2010          H.C.H.D      JOB NO. 08/0455


BIDDER MUST ENTER THE NATIONAL DRUG CODE IN COLUMN A, THE SUB-CEILING OUTPATIENT PRICE BELOW
THE P.H.S. CEILING PRICE IN COLUMN B, AND THE MOST CURRENT P.H.S. PRICE IN COLUMN C. DO NOT RETURN

ANDY BLANK SHEETS. IF YOU "NO BID" AN ITEM, SO STATE THAT IN COLUMN B.

VENDOR______________________________


PRODUCT LIST                                    ANNUAL          COLUMN A      COLUMN B           COLUMN C
                                                                                                  (Current PHS
*FORMULARY STATUS                              ESTIMATE       (NDC NUMBER)     (Sub-ceiling bid)     price)

                                                USAGE
Sitagliptin (Januvia)
25 mg tab btl 90                                   0
50 mg tab btl 90                                   0
100 mg tab btl 90                                  0

Alendronate (Fosamax)
70mg/75ml soln btl 4x75ml*                         1


Alendronate (Fosamax Plus D)
70mg/2800U tablet uu 4*                           684


Risedronate (Actonel)
5mg tab btl 30*                                   96

35mg tab btl 4*                                   399
30mg tab btl 30                                    2


Risedronate (Actonel/Calcium)
35mg 4 tabs/1250mg 24 tabs btl 28*                 8


Famotidine (Pepcid)
40mg/5ml susp btl 50ml*                           193


Nizatidine (Axid)
75mg tab btl 50                                    0
15mg/ml soln btl 480ml                             0


Lansoprazole (Prevacid)
30mg solutab 10x10                                 0
30mg cap btl 100*                               35,346

15mg solutab 10x10                                 0
15mg cap btl 30*                                 7,513
15mg cap btl 100                                   0




                                                                                                                 Page 44 of 57
                                    PRICING/DELIVERY INFORMATION

                  REQUEST FOR BID             2009-2010          H.C.H.D      JOB NO. 08/0455


BIDDER MUST ENTER THE NATIONAL DRUG CODE IN COLUMN A, THE SUB-CEILING OUTPATIENT PRICE BELOW
THE P.H.S. CEILING PRICE IN COLUMN B, AND THE MOST CURRENT P.H.S. PRICE IN COLUMN C. DO NOT RETURN

ANDY BLANK SHEETS. IF YOU "NO BID" AN ITEM, SO STATE THAT IN COLUMN B.

VENDOR______________________________


PRODUCT LIST                                    ANNUAL          COLUMN A      COLUMN B           COLUMN C
                                                                                                  (Current PHS
*FORMULARY STATUS                              ESTIMATE       (NDC NUMBER)     (Sub-ceiling bid)     price)

                                                USAGE
Esomeprazole (Nexium)
20mg cap btl 30                                   578

20mg cap btl 90                                   12

40mg cap btl 90                                   803

40mg cap btl 100                                   2

40mg cap btl 30                                 12,383

Rabeprazole (Aciphex)
20mg tab btl 30                                    7

Pantoprazole (Protonix IV)
40mg inj vial 10                                  422


Esomeprazole (Nexium)
40mg inj vial 10/bx*                             1,337
20mg inj vial 10/bx*                              14


Dolasetron (Anzemet)
50mg tab btl 5                                     0

100mg tab btl 5                                    0

                                                   0
20mg/ml inj vial 5ml x 1
12.5mg/0.62ml inj vial x 10                        0


Palonosetron (Aloxi)
0.05mg/ml inj vial 5ml*                           81


Aprepitant (Emend)
40mg cap btl 5                                     0
80mg cap btl 6*                                   25
125mg cap btl 6*                                  10


Pimecrolimus (Elidel)
1% cream 30gm*                                    25
1% cream 60gm                                      1
1% cream 100gm                                     0




                                                                                                                 Page 45 of 57
                                                 PRICING/DELIVERY INFORMATION

                REQUEST FOR BID                       2009-2010     H.C.H.D      JOB NO. 08/0455


BIDDER MUST ENTER THE NATIONAL DRUG CODE IN COLUMN A, THE SUB-CEILING OUTPATIENT PRICE BELOW
THE P.H.S. CEILING PRICE IN COLUMN B, AND THE MOST CURRENT P.H.S. PRICE IN COLUMN C. DO NOT RETURN

ANDY BLANK SHEETS. IF YOU "NO BID" AN ITEM, SO STATE THAT IN COLUMN B.

VENDOR______________________________


PRODUCT LIST                                           ANNUAL      COLUMN A      COLUMN B           COLUMN C
                                                                                                     (Current PHS
*FORMULARY STATUS                                      ESTIMATE   (NDC NUMBER)    (Sub-ceiling bid)     price)

                                                        USAGE
Tacrolimus (Protopic)
0.03% oint 30gm*                                          0

0.1% oint 30gm*                                          109

0.1% oint 60gm                                            0


Alfuzosin (Uroxatral)
10mg tab btl 100                                          0


Tamsulosin (Flomax)
0.4mg cap btl 100*                                      1,815

Conj Estrogen/Medroxyprogesterone (Prempro)
5-0.625mg tab 28x3*                                      18
2.5-0.625mg tab 28x3*                                    173
1.5-0.45mg tab 28x3*                                     22
1.5-0.3mg tab 28x3*                                      123


Conj Estrogen/Medroxyprogesterone (Premphase)
5-0.625mg tab 28                                         39


Estradiol/Norgestimate (Prefest)
0.09-1mg tab 30x6                                         0


Estinyl Estradiol/Norethindrone (Femhrt)
Femhrt 1-0.005mg tab 28x5                                 0


Estradiol/Norethindrone (Activella)
0.5-1mg tab 28x5                                          0
0.1-0.5mg tab 28x5                                        0


Estradiol/Norethindrone (Combipatch)
0.25-0.05 mg/24hr ptch 8                                  0
0.14-0.05mg/24hr ptch 8                                   0


Esterified Estrogen/Methyltestosterone (Estratest)
1.25-2.5 100 btl                                          0



                                                                                                                    Page 46 of 57
                                                PRICING/DELIVERY INFORMATION

                 REQUEST FOR BID                     2009-2010     H.C.H.D      JOB NO. 08/0455


BIDDER MUST ENTER THE NATIONAL DRUG CODE IN COLUMN A, THE SUB-CEILING OUTPATIENT PRICE BELOW
THE P.H.S. CEILING PRICE IN COLUMN B, AND THE MOST CURRENT P.H.S. PRICE IN COLUMN C. DO NOT RETURN

ANDY BLANK SHEETS. IF YOU "NO BID" AN ITEM, SO STATE THAT IN COLUMN B.

VENDOR______________________________


PRODUCT LIST                                          ANNUAL      COLUMN A      COLUMN B           COLUMN C
                                                                                                    (Current PHS
*FORMULARY STATUS                                     ESTIMATE   (NDC NUMBER)    (Sub-ceiling bid)     price)

                                                       USAGE
Esterified Estro/Methyltestosterone (Estratest HS)
0.625-1.25 100 btl                                       0


Estradiol/Levonorgestrel (Climara Pro)
0.015-0.045/24hr ptch 4                                  0


Lutera 0.1-0.02mg tab 28x3*                              0


Levlite-28 0.1-0.02mg tab 28x3                         1,561


Aviane 0.1-0.02mg tab 28x6                              90

Lessina 0.1-0.02mg tabs 28x3                             0


Estrostep Fe 1-0.02mg tabs 28x5                          0


Mircette 0.15-0.02mg tabs 28x6                           0


Kariva 0.15-0.02mg tabs 28x6                             0


Loestrin      1-0.02MG tabs 21x5                         0


Loestrin Fe     1-0.02mg tabs 28x5                       0


Microgestin      1-0.02mg tabs 21x6                      0


Microgestin Fe      1-0.02mg tabs 28x6                   0


Junel      1-0.02mg tabs 21x3                            0


Junel Fe     1-0.02mg tabs 28x6                          0


Cyclessa tabs 28x6                                       1


Velivet tabs 28x3                                        0




                                                                                                                   Page 47 of 57
                                           PRICING/DELIVERY INFORMATION

                  REQUEST FOR BID               2009-2010        H.C.H.D      JOB NO. 08/0455


BIDDER MUST ENTER THE NATIONAL DRUG CODE IN COLUMN A, THE SUB-CEILING OUTPATIENT PRICE BELOW
THE P.H.S. CEILING PRICE IN COLUMN B, AND THE MOST CURRENT P.H.S. PRICE IN COLUMN C. DO NOT RETURN

ANDY BLANK SHEETS. IF YOU "NO BID" AN ITEM, SO STATE THAT IN COLUMN B.

VENDOR______________________________


PRODUCT LIST                                     ANNUAL         COLUMN A      COLUMN B           COLUMN C
                                                                                                  (Current PHS
*FORMULARY STATUS                                ESTIMATE     (NDC NUMBER)     (Sub-ceiling bid)     price)

                                                  USAGE
Ortho Tri-Cyclen tabs 28x6                          3


Lo/Ovral 28 0.3-0.03mg tabs 28x6*                  481


Microgestin      1.5-0.03mg tabs 21x6               0


Loestrin Fe     1.5-0.03mg tabs 28x5                0


Microgestin Fe      1.5-0.03mg tabs 28x6            0


Loestrin      1.5-0.03mg tabs 21x5                  0


Junel      1.5-0.03mg tabs 21x6                     0

Nordette      0.15-0.03mg tabs 28x6                 0


Junel Fe     1.5-0.03mg tabs 28x6                   0


Low-Ogestrel 0.3-0.03mg tabs 28x6                  47


Cryselle-28 0.3-0.03mg tabs 28x6                    0


Levora-28 0.15-0.03mg tabs 28x6                     0


Portia-28 0.15-0.03mg tabs 28x6                     0


Desogen 0.15-0.03mg tabs 28x6                       0


Ortho-Cept 0.15-0.03mg tabs 28x6                    0


Apri 0.15-0.03mg tabs 28x6                          0


Solia 0.15-0.03mg tabs 28x6                         0


Enpresse-28 6-5-10mg tabs 28x6                      0




                                                                                                                 Page 48 of 57
                                       PRICING/DELIVERY INFORMATION

                REQUEST FOR BID               2009-2010          H.C.H.D      JOB NO. 08/0455


BIDDER MUST ENTER THE NATIONAL DRUG CODE IN COLUMN A, THE SUB-CEILING OUTPATIENT PRICE BELOW
THE P.H.S. CEILING PRICE IN COLUMN B, AND THE MOST CURRENT P.H.S. PRICE IN COLUMN C. DO NOT RETURN

ANDY BLANK SHEETS. IF YOU "NO BID" AN ITEM, SO STATE THAT IN COLUMN B.

VENDOR______________________________


PRODUCT LIST                                    ANNUAL          COLUMN A      COLUMN B           COLUMN C
                                                                                                  (Current PHS
*FORMULARY STATUS                              ESTIMATE       (NDC NUMBER)     (Sub-ceiling bid)     price)

                                                USAGE
Trivora-28 tabs 28x6                               0


Ortho-Novum 1-0.035mg tabs 28x6*                   0


Ortho-Cyclen 0.25-0.035mg tabs 28x6                0


Necon 10/11 tabs 28x6*                             0


Mononessa 0.25-0.035mg tabs 28x6                   0


Previfem 0.25-0.035mg tabs 28x6                    0


Sprintec 0.25-0.035mg tabs 28x6                    0


Zovia     1/35e 1-0.035mg tabs 28x6                0

Necon      0.5-0.035mg tabs 28x6                   0


Necon     1-0.035mg tabs 28x6                      0


Nortrel     0.5-0.035mg tabs 28x3                  0


Nortrel     1-0.035mg tabs 21x6                    0


Nortrel     1-0.035mg tabs 28x3                    0


Norinyl     1+35 1-0.035mg tabs 28x6              376


Brevicon 0.5-0.035mg tabs 28x3                     0


Modicon 0.5-0.035mg tabs 28x6                      0


Ovcon-35 0.4-0.035mg tabs 28x5                     0


Ortho-Novum 7/7/7 tabs 28x6                        0




                                                                                                                 Page 49 of 57
                                    PRICING/DELIVERY INFORMATION

               REQUEST FOR BID                2009-2010          H.C.H.D      JOB NO. 08/0455


BIDDER MUST ENTER THE NATIONAL DRUG CODE IN COLUMN A, THE SUB-CEILING OUTPATIENT PRICE BELOW
THE P.H.S. CEILING PRICE IN COLUMN B, AND THE MOST CURRENT P.H.S. PRICE IN COLUMN C. DO NOT RETURN

ANDY BLANK SHEETS. IF YOU "NO BID" AN ITEM, SO STATE THAT IN COLUMN B.

VENDOR______________________________


PRODUCT LIST                                    ANNUAL          COLUMN A      COLUMN B           COLUMN C
                                                                                                  (Current PHS
*FORMULARY STATUS                              ESTIMATE       (NDC NUMBER)     (Sub-ceiling bid)     price)

                                                USAGE
Nortrel 7/7/7 tabs 28x6                            0


Ortho-Tricyclen Lo tabs 28x6*                     968


Trinessa tabs 28x6                                 0


Tri-Previfem tabs 28x6                             0


Tri-Sprintec tabs 28x6                             0


Tri-Norinyl tabs 28x6                              0


Ortho-Novum 1-0.05mg tab 28x6                     64


Zovia   1/50e 1-0.05mg tabs 28x6                   0


Necon    1-0.05mg tabs 28x6*                       0

Necon    1+50 1-0.05mg tabs 28x3*                  0


Ovcon-50 1-0.05mg tabs 28x6                        0


Ortho Micronor 0.35mg 28x6*                       315


Jolivette 0.35mg 28x6                              0


Nor-Q-D 0.35mg 28x6                                0


Camila 0.35mg 28x6                                 0


Errin 0.35mg 28x6                                  0


Nora-Be 0.35mg 28x6                                0


Ovrette 0.075mg 28x6                               0




                                                                                                                 Page 50 of 57
                                    PRICING/DELIVERY INFORMATION

                  REQUEST FOR BID             2009-2010          H.C.H.D      JOB NO. 08/0455


BIDDER MUST ENTER THE NATIONAL DRUG CODE IN COLUMN A, THE SUB-CEILING OUTPATIENT PRICE BELOW
THE P.H.S. CEILING PRICE IN COLUMN B, AND THE MOST CURRENT P.H.S. PRICE IN COLUMN C. DO NOT RETURN

ANDY BLANK SHEETS. IF YOU "NO BID" AN ITEM, SO STATE THAT IN COLUMN B.

VENDOR______________________________


PRODUCT LIST                                    ANNUAL          COLUMN A      COLUMN B           COLUMN C
                                                                                                  (Current PHS
*FORMULARY STATUS                              ESTIMATE       (NDC NUMBER)     (Sub-ceiling bid)     price)

                                                USAGE
Doxercalciferol (Hectorol)
0.5mcg cap btl 50*                                 8
2.5mcg cap btl 50*                                 6
2mcg/ml 2ml inj vial 50/bx*                        0


Paricalcitol (Zemplar)
1mcg cap btl 30                                    0
2mcg cap btl 30                                    0
4mcg cap btl 30                                    0
2mcg/ml inj vial 25/bx                             0
5mcg/1ml inj vial 25/bx                            0
5mcg/2ml inj vial 25/bx                            0


Oxybutynin (Ditropan XL)
5mg tab btl 100                                    1

10mg tab btl 100                                   0
15mg tab btl 100                                   0

Oxybutynin (Oxytrol)
3.9mg/24hr ptch 8/bx*                             11


Tolterodine (Detrol)
1 mg btl 60*                                      67

2 mg btl 60*                                      191


Tolterodine (Detrol LA)
2mg cap btl 90*                                   195

4mg cap btl 90*                                   522


Trospium (Sanctura)
20mg tab btl 60                                    0


Darifenacin (Enablex)
7.5mg tab btl 30                                   0
7.5mg tab btl 90                                   0
15mg tab btl 30                                    0
15mg tab btl 90                                    0

                                                                                                                 Page 51 of 57
                                    PRICING/DELIVERY INFORMATION

                  REQUEST FOR BID             2009-2010          H.C.H.D      JOB NO. 08/0455


BIDDER MUST ENTER THE NATIONAL DRUG CODE IN COLUMN A, THE SUB-CEILING OUTPATIENT PRICE BELOW
THE P.H.S. CEILING PRICE IN COLUMN B, AND THE MOST CURRENT P.H.S. PRICE IN COLUMN C. DO NOT RETURN

ANDY BLANK SHEETS. IF YOU "NO BID" AN ITEM, SO STATE THAT IN COLUMN B.

VENDOR______________________________


PRODUCT LIST                                    ANNUAL          COLUMN A      COLUMN B           COLUMN C
                                                                                                  (Current PHS
*FORMULARY STATUS                              ESTIMATE       (NDC NUMBER)     (Sub-ceiling bid)     price)

                                                USAGE
Solifenacin (Vesicare)
5mg tab btl 30                                     0
5mg tab btl 90                                     0
10mg tab btl 30                                    0
10mg tab btl 90                                    0


Anastrazole (Arimidex)
1mg tab btl 30*                                  1,151


Letrozole (Femara)
2.5mg tab btl 30*                                 340


Goserelin (Zoladex)
3.6mg implant kit*                                72
10.8mg implant kit*                               354

Leuprolide (Lupron Depot)
7.5mg inj vial ped kit*                           33
7.5mg inj vial kit*                               10
30mg inj vial kit*                                41
3.75mg inj vial kit*                              81

22.5mg inj vial kit*                              211

15mg inj vial ped kit*                             0
11.25mg inj vial ped kit*                          0
11.25mg inj vial kit*                             103


Bicalutamide (Casodex)
50 mg tab btl 30 ea                                0
50 mg tab btl 100 ea                               0

Nilutamide (Nilandron)
150 mg tab 3x10                                    0

Etonogestrel (Implanon)
68 mg Implant*                                    17




                                                                                                                 Page 52 of 57
                                     PRICING/DELIVERY INFORMATION

                  REQUEST FOR BID             2009-2010          H.C.H.D      JOB NO. 08/0455


BIDDER MUST ENTER THE NATIONAL DRUG CODE IN COLUMN A, THE SUB-CEILING OUTPATIENT PRICE BELOW
THE P.H.S. CEILING PRICE IN COLUMN B, AND THE MOST CURRENT P.H.S. PRICE IN COLUMN C. DO NOT RETURN

ANDY BLANK SHEETS. IF YOU "NO BID" AN ITEM, SO STATE THAT IN COLUMN B.

VENDOR______________________________


PRODUCT LIST                                    ANNUAL          COLUMN A      COLUMN B           COLUMN C
                                                                                                  (Current PHS
*FORMULARY STATUS                              ESTIMATE       (NDC NUMBER)     (Sub-ceiling bid)     price)

                                                USAGE
Levonorgestrel (Mirena)
20 mcg/24 hr 1 ea*                                45


Injectable Iron
Iron Dextran (Infed)*                             14
Iron Gluconate (Ferrlecit)*                       113
Iron Sucrose (Venofer)                             0


Sevelamer (Renagel)
400 mg tabs btl 360*                              38
800 mg tabs btl 180*                             1,671


Lanthanum Carbonate (Fosrenol)
500 mg chew btl 90                                 0
750 mg chew 6x15                                   0
1000 mg 9x10                                       0


Dimethyl Sulfoxide (Rimso-50)
50% 50 ml soln*                                   54


Pentosan Sodium (Elmiron)
100 mg caps btl 100                                7


Nilutamide (Nilandron)
150 mg bpk 3 x 10                                  0


Enoxaparin Sod (Lovenox Preventis)
30mg/ 0.3ml inj syr 10*                           116
40mg/ 0.4ml inj syr 10*                           555
60mg/ 0.6ml inj syr 10*                           490
80mg/ 0.8mlinj syr 10*                            834
100mg/ 1ml inj syr 10*                            370




                                                                                                                 Page 53 of 57
                                    PRICING/DELIVERY INFORMATION

               REQUEST FOR BID                2009-2010          H.C.H.D      JOB NO. 08/0455


BIDDER MUST ENTER THE NATIONAL DRUG CODE IN COLUMN A, THE SUB-CEILING OUTPATIENT PRICE BELOW
THE P.H.S. CEILING PRICE IN COLUMN B, AND THE MOST CURRENT P.H.S. PRICE IN COLUMN C. DO NOT RETURN

ANDY BLANK SHEETS. IF YOU "NO BID" AN ITEM, SO STATE THAT IN COLUMN B.

VENDOR______________________________


PRODUCT LIST                                    ANNUAL          COLUMN A      COLUMN B           COLUMN C
                                                                                                  (Current PHS
*FORMULARY STATUS                              ESTIMATE       (NDC NUMBER)     (Sub-ceiling bid)     price)

                                                USAGE


Dalteparin Sod (Fragmin)
2.5 MU / 0.2ml inj syr 10                          0
5 MU / 0.2ml inj syr 10                            0
7.5 MU / 0.3ml inj syr 10                          0
10 MU / 1ml inj syr 10                             0

12.5 MU / 0.5ml inj syr 10                         0

15 MU / 0.6ml inj syr 10                           0

18 MU / 0.72ml inj syr 10                          0


Tinzaparin Sod (Innohep)
20 MU / ml inj vial 2ml                            0




                                                                                                                 Page 54 of 57
                                                                                                               Attachment a
                                                                                                             Job No. 08/0455
                                 RESIDENCE CERTIFICATION/TAX FORM
Pursuant to Texas Government Code §2252.001 et seq., as amended, Harris County requests Residence
Certification. §2252.001 et seq. of the Government Code provides some restrictions on the awarding of
governmental contracts; pertinent provisions of §2252.001 are stated below:
          (3)      "Nonresident bidder" refers to a person who is not a resident.

          (4)      "Resident bidder" refers to a person whose principal place of business is in this state, including a
                   contractor whose ultimate parent company or majority owner has its principal place of business in
                   this state.

          I certify that                             is a Resident Bidder of Texas as defined in
                     [Company Name]
          Government Code §2252.001.

          I certify that                             is a Nonresident Bidder as defined in
                           [Company Name]
          Government Code §2252.001 and our principal place of business is                            .
                                                                              [City and State]


Taxpayer Identification Number (T. I. N.):

Company Name submitting Bid/Proposal:

Mailing Address:

If you are an individual, list the names and addresses of any partnership of which you are a general partner:




PROPERTY: List all taxable property owned by you or above partnerships in Harris County.

Harris County Tax Acct. No.*                  Property address or location**




 * This is the property account identification number assigned by the Harris County Appraisal District.
** For real property, specify the property address or legal description. For business personal property, specify the
   address where the property is located. For example, office equipment will normally be at your office, but inventory
   may be stored at a warehouse or other location
Revised
                                                                                                                Attachment j
                                                                                                                 Page 1 of 2

                                    CERTIFICATION OF ELIGIBILITY TO PARTICIPATE
                                        IN FEDERAL HEALTH CARE PROGRAMS
                                                                                                                  Page 55 of 57
                                                     (Vendors)

       The Harris County Hospital District (HCHD) entered into an agreement with the Office of Inspector
General, the Certification of Compliance Agreement (CCA), to ensure that HCHD complies with all Federal
Health Care Program regulations. The CCA requires that HCHD vendors must be eligible to participate in
Federal Health Care Programs.

        Harris County Hospital District (“HCHD”) screens all vendors upon engagement, and, at least, annually
thereafter against the General Services Administration’s List of Parties Excluded from Federal Programs and the
HHS/OIG List of Excluded Individuals/Entities (“LEIE/EPLS”) to ensure that they are not an “Ineligible
Person” as defined below. All vendors are required to disclose whether they or any of their owners, officers,
directors, employees, or principals (collectively, “Principals”) are, or become, an Ineligible Person.

An “Ineligible Person” is an individual or entity who:

       (i)        Is currently excluded, debarred, suspended, or otherwise ineligible to participate in the Federal
                  health care programs or in Federal procurement or nonprocurement programs. This includes
                  Persons who are on the LEIE/EPLS or the Medicaid Sanction List; or
       (ii)       Has been convicted of a criminal offense related to the provision of healthcare items or
                  services (within the rules and regulations of 42 U.S.C. § 1320a-7(a)), but has not yet been
                  excluded, debarred, suspended, or otherwise declared ineligible.

        I hereby certify that neither the vendor listed below itself nor any of its Principals is an Ineligible Person
and that the vendor will report immediately to the HCHD’s Vice President of Corporate Compliance if either the
vendor or any of its Principals becomes an Ineligible Person at any time in the future while the vendor is
associated with HCHD. I understand that if the vendor is now or subsequently becomes an Ineligible Person,
HCHD will remove the vendor from responsibility for, or involvement with, HCHD’s business operations. I
further understand that if the vendor fails to immediately terminate any of its Principals who become an
Ineligible Person, HCHD will remove the vendor from responsibility for, or involvement with, HCHD’s
business operations.

        If the vendor listed below provides patient care items or services or performs billing, coding, or claims
submission functions on behalf of HCHD, I also certify that the vendor’s Principals attend at least one hour of
annual compliance training that addresses compliance codes of conduct and the operation of a compliance
program, and, to the extent the vendor’s Principals provide patient care items or services, or perform billing,
coding, or claims submission functions on behalf of HCHD, attend additional hours of training that addresses:
(a) the Federal health care program requirements regarding the accurate coding and submission of claims; (b)
policies, procedures, and other requirements applicable to the documentation of medical records; (c) the
personal obligation of each individual involved in the claims submission process to ensure that such claims are
accurate; (d) applicable reimbursement statutes, regulations, and program requirements and directives; (e) the
legal




                                                                                                         Page 56 of 57
                                                                                                       Attachment j
                                                                                                        Page 2 of 2

sanctions for violations of Federal health care program requirements; (f) examples of proper and improper
claims submission practices; and (g) proper procedures for processing Medicare secondary payer claims. If
training is required as per this paragraph, the vendor maintains written or electronic records that identify the type
of annual training provided, the date(s) of the training, and the attendees. Persons providing the training must
be knowledgeable about the subject matter. The vendor reviews the training content on an annual basis and, as
appropriate, updates the training to reflect changes in Federal health care program requirements.

        I certify that the vendor understands that its Principals are expected to disclose or report to HCHD’s
Vice President of Corporate Compliance or other appropriate individual designated by HCHD any suspected
violation of any state or Federal health care program requirements or of HCHD’s own Policies and Procedures.
HCHD’s Disclosure Program emphasizes a no retribution, no retaliation policy and includes a reporting
mechanisms for anonymous communications for which appropriate confidentiality is maintained. The address
for the Post Office Box is:

               Compliance Department
               HCHD
               P.O. Box 300033
               Houston, Texas 77230-0033

HCHD has also arranged for a hotline service with an outside agency. The applicable number is:

               Hotline Phone Number: 1-800-500-0333



Vendor Name

Address

_________________________              ____________________           __________________
City                                   State                          Zip Code


Signature

Print Name

_______________________________________               ________________________________________
Title                                                 Phone Number

_______________________________________               ________________________________________
Email Address                                         Date




                                                                                                        Page 57 of 57

				
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Description: HARRIS COUNTY Sodium Hyaluronate