MARKET RESEARCH QUESTIONNAIRE Company Name: _________________________ I am conducting market research for the procurement of Epoetin Vials for the Department of Veterans Affairs (VA), Department of Defense (DoD), Indian Health Service (IHS), Bureau of Prisons (BOP), and Federal Health Care Center (FHCC). This procurement will result in a national mandatory requirements contract for the above agencies. Other companies with the same/similar product will be blocked out for ordering; therefore it is our goal to award lower than FSS/Open Market prices on the resultant national contract based on purchases of a committed volume. These products will be awarded in the aggregate for all strengths and sizes for the base year and all option years included in the solicitation. Please provide a response to the following: 1. Is your Company able to meet the following minimum requirements: National Drug Code (NDC): Offerors shall provide a separate and distinct eleven-digit NDC number unique to the offeror (e.g., 00012-3456-78) for each product proposed. The first five numbers of the eleven-digit NDC number for each product proposed shall identify the offeror. Does your company have a unique NDC (Labeler Code)?_____________ If the offeror is not the manufacturer of the offered items, the offeror shall submit a letter of commitment from the manufacturer to the offeror which will assure the offeror a source of supply sufficient to satisfy the Government's requirements for the contract period. Name of Manufacturer:_________________ Would you be able to provide a letter of commitment from the manufacturer of the offered drug?_____________ Pharmaceutical Prime Vendor: All Ordering Activities under the Department of Veterans Affairs and Department of Defense acquire their pharmaceutical requirements through their Pharmaceutical Prime Vendor Program (PPV). The contractor shall ensure that chargeback agreements with the PPVs have been executed with sufficient time to permit the PPVs to begin timely distribution of Government orders, if an award is made. Does your company currently have a business-to-business agreement with the PPVs?_________ d. Under NAICS code 325412, is your company size (check one): Large Business ______ Small Business ______ e. If a small business, does your company manufacture (measure, weigh, mix, and compound) at least 50% of the product offered?_________ f. Is the offered end product U.S end-made or designated end made product?_________ g. Can your company meet the following product, bottle size and usage: ITEM DESCRIPTION PKG SIZE(Vials) TOTAL EST ANNUAL USAGE (Vials) 1 EPOETIN 2000UNIT/ML INJ,SOLN 1 43,026 2 EPOETIN 3000UNIT/ML INJ,SOLN 1 44,306 3 EPOETIN 4000UNIT/ML INJ,SOLN 1 33,018 4 EPOETIN 10000UNIT/ML INJ,SOLN 1 63,901 5 EPOETIN 20000UNIT/2ML INJ,MDV 1 3,181 6 EPOETIN 20000UNIT/ML INJ,SOLN 1 14,418 7 EPOETIN 40000UNIT/ML INJ,SOLN 1 14,540 2 . Is your Company interested in submitting a response to a solicitation?________ 3. As this is a national standardized contract, our preference is for a base plus four option years to provide our customers continuity and consistency of product by allowing long term committed purchases of your product. If interested, please indicate Base year and how many Option periods, not to exceed 4._________________ 4. If an award were to be made based on the above requirements, would your company be able to begin supplying the product in the estimated quantities within 60 days of the contract award date? ______________________________________________________________________ 5. If your company is not interested in participating, please respond with the reason why. This aids our market research for future procurements. ______________________________________________________________________ If you could provide your response as soon as possible, it would be greatly appreciated. Please contact me at Amber.Zavala@va.gov if you have any questions.