Chester Clinic

 

D19csb.com

DISTRICT 19 COMMUNITY SERVICES BOARD
REQUEST FOR PROPOSAL (RFP)
January 21, 2015 RFP#: PHARMSVCS030120 Pharmaceutical Services Issuing Agency: District 19 Community Services Board 20 West Bank Street, Suite 7 Petersburg, VA 23803 Using Agency And/Or Location Where Work Will Be Performed: District 19 Community Services Board 20 W. Bank Street Petersburg, VA 23803 Various Localities Initial Period Of Contract: From March 2, 2015 Through March 1, 2017 (*Renewable). *With Three (3) Successive One-Year Renewal Options
Sealed Proposals Will Be Received Until February 20, 2015 @ 3p.m. For Furnishing The
Services/Goods Described Herein.
All Inquiries For Information Should Be Directed To: Theoria M. Nixon Phone: (804) 862-8054 x3102.
IF PROPOSALS ARE MAILED, SEND DIRECTLY TO THE PROCUREMENT OFFICE AT THE ADDRESS SHOWN
ABOVE. IF PROPOSALS ARE HAND DELIVERED, THEN DELIVER TO: District 19 Community Services Board,
Attention: Purchasing Department, 20 West Bank Street, Suite 7, 3rd Floor, Petersburg, VA 23803.
In Compliance With This Request For Proposal And To All The Conditions Imposed Therein And Hereby
Incorporated By Reference, The Undersigned Offers And Agrees To Furnish The Services In
Accordance With The Attached Signed Proposal Or As Mutually Agreed Upon By Subsequent
Negotiation.
Name And Address Of Firm:
_ Date:
_ By:
(Signature In Ink) Zip Code: _ Title:
E-Mail: _
OPTIONAL PREPROPOSAL CONFERENCE: An Optional Preproposal Conference will be held at 1:00pm on February 12, 2015 in
the Board Room, Conference Room, 2nd floor at 20 W. Bank Street, Suite 6, Petersburg, VA 23803.
Note: This public body does not discriminate against faith-based organizations in accordance with the Code of Virginia, § 2.2-4343.1 or against a
bidder or offeror because of race, religion, color, sex, national origin, age, disability, or any other basis prohibited by state law relating to
discrimination in employment.
TABLE OF CONTENTS FOR RFP#: PHARMSVCS030120
CSB BACKGROUND/MISSION, CSB DATA STATEMENT OF NEEDS PROPOSAL PREPARATION AND SUBMISSION REQUIREMENTS EVALUATION AND AWARD CRITERIA REPORTING AND DELIVERY INSTRUCTIONS GENERAL TERMS AND CONDITIONS SPECIAL TERMS AND CONDITIONS METHOD OF PAYMENT PRICING SCHEDULE Attachment A-Contractor Data Sheet Attachment B-Prescription Medicines 1.0 PURPOSE
The purpose of this Request for Proposal (RFP) is to solicit sealed proposals from contractors to establish a contract through competitive negotiations with one qualified contractor to provide Pharmaceutical Services to consumers of District 19 Community Services Board (herein CSB) in accordance with the terms and conditions of the Request for Proposal. 2.0 CSB BACKGROUND/MISSION
2.1 District 19 Community Services Board (D19 CSB) is a multi-jurisdictional, community-
based organization whose mission is to improve the quality and productivity of the lives of individuals who experience, or are at risk of experiencing, mental disabilities and/or substance abuse. We are licensed by the Virginia Department of Behavioral Health and Developmental Services to provide mental health, intellectual disability, substance abuse and prevention services to the citizens of the cities of and and the counties of and Integrated services are available for adults, children and families through a screening/assessment process. Services are provided directly by staff of District 19 and through contracts with private providers in the community. We are committed to providing behavioral health services to all residents of our catchment area regardless of race, color, sex, age, religion, disabilities or national origin. The CSB serves approximately 6230 consumers annually in across three program areas, Substance Abuse Services, Mental Health Services, and Intellectual Disability Services. 2.2 The CSB is committed to providing recovery based services that are consumer centered and directed to all individuals needing services. The CSB has provided financial assistance to its consumers by obtaining pharmaceutical prescriptions from a variety of public and private resources for consumers that are indigent and without prescription medication benefits when clinically appropriate to do so. These resources include community based pharmacies and Patient Assistance Programs. 2.3 The consumers must meet certain eligibility criteria to receive pharmacy services. Included in these criteria is active "open" case with a CSB for medication management. In addition, eligible consumers must meet at least four (4) of the criteria as outlined below. Medically Indigent certified by the serving CSB, with income falls below Federal Poverty Lines = or ≤ 200% and Prior State Hospitalization, (not including Temporary Detention Order only admissions) Local Inpatient Purchase of Service, ("LIPOS"; not including temporary detention orders) Treatment in a DBHDS approved Crisis Stabilization Unit, or A Non-formulary "waiver" (on file and within date at the CRP) and/ or Medicare Eligible individuals experiencing coverage gap difficulties maybe eligible for the State Pharmacy Assistance Program.
CSB DATA
2.4 The CSB has eight (8) sites designated as delivery sites. All delivery sites must meet
regulations set by the Virginia Board of Pharmacy for the storing and distribution of pharmaceuticals in accordance with 18 VAC 110-20-710. Colonial Heights Counseling Services Dinwiddie Counseling Services 3660 Boulevard, Suite A 13902 Courthouse Road Colonial Heights, VA 23834 Dinwiddie, VA 23841 Phone: (804) 520-7210 Phone: (804) 469-3746 Fax Phone: (804) 520-8953 Fax Phone: (804) 469-3842 Emporia Counseling Services Hopewell/Prince George Counseling 215 W. Atlantic Street Emporia, VA 23847-1223 4910 Prince George Drive Phone: (434) 634-5181 Prince George, VA 23875 Fax Phone: (434) 634-4397 Phone: (804) 541-8660 Fax Phone: (804) 452-4143 Programs for Assertive Community District 19 Community Services Board Treatment (PACT) 20 W. Bank Street, Suite 6 20 West Bank Street, Suite 3 Medical Services Petersburg, VA 23803 Petersburg, VA 23803 Phone: (804) 722-4299 Phone: (804) 862-8002 Fax Phone: (804) 722-4283 Fax Phone: (804) 862-8023 Surry Counseling Services Sussex Counseling Services 474 Colonial Trail West 232 Coppahaunk Avenue Waverly, VA 23883 Phone: (757) 294-0037 Phone: (804) 834-2205 Fax Phone: (757) 294-5113 Fax Phone: (804) 834-2625 2.5 Most CSB sites operate during standard business hours, 8:00 a.m. to 5:00 p.m., five (5)
2.6 The CSB has the equivalent of 3 full time licensed prescribers, plus numerous part time
prescribers, across the Mental Health System and Substance Abuse Services. 2.7 Averaging 150 consumers per month utilizing multiple prescriptions per consumer depending on benefit coverage.
3.0 STATEMENT OF NEEDS

The Contractor shall provide the labor and resources to provide prescription drugs and delivery of these prescriptions as follows: 3.1 Shall provide pharmacy and pharmaceutical services to the CSB to include the following Provide medications, as shown in Attachment B-Prescription Medicines.
The Contractor shall receive prescription orders from the CSB by facsimile transmittal or via telephone in an emergency situation. A hard copy will follow any telephone order as specified by law. The Contractor shall provide a delivery system in which medication orders are faxed to a licensed pharmacy by the CSB staff and medications are delivered with 24-48 hours of order transmittal, excluding weekends. Provide at least daily delivery of medication upon request by CSB to select sites. No deliveries made on National and State holidays. Identify an emergency back-up system for obtaining medications after hours due to inclement weather. Ensure that all medication shall be labeled in accordance with Federal, Virginia State Law and the Virginia Board of Pharmacy regulations. Check with Medicaid and other third party insurance for client's coverage for all prescriptions forwarded for filling. Keep appropriate records on all prescriptions ordered by the CSB. Provide reports as requested by the CSB regarding utilization data, electronically if 3.1.10 Allow credit for returned medications that is unopened and still sealed. Provide a system and storage container for the return of expired and discontinued medications for credit, and destruction of unused medications. 3.1.11 Accept for destruction personal medications returned to the CSB by consumers and treatment provider. 3.1.12 Dispensing quantities of prescription medications shall not exceed a 3.1.13 Provide monitoring of medications, specifically Clozapine. 3.1.14 A specific psychotropic formulary may be required with a prior authorization 3.1.15 For non CSB prescribed medications, successful Contractor will bill the consumer's pharmacy benefit. If the consumer has no pharmacy benefit, the consumer is responsible for the cost of the prescription as there is not CSB subsidy for prescriptions ordered outside of the CSB. 3.1.16 Keep appropriate records on all prescriptions ordered by the CSB. 3.1.17 Maintain computerized patient profiles. 3.1.18 Every prescription medication package will have a label affixed, which adheres to all regulations for labeling. Prescription labels will include the consumer's name, identification number, location, date dispensed, prescription number, drug name and generic interchange information, dosage strength, quantity dispensed, directions for use (route and frequency), warnings and/or precautions, dispensing pharmacist's initials, ordering physician's name, lot number and expiration date. 3.1.19 Some oral medications may be dispensed in blister packaging when specified based on consumer needs. 3.1.20 Use liquid/disolvable psychotropic medication whenever required. 3.1.21 Provide dispensing of injectable medications in multi-dose vials, specifically Haldol Decanoate and Prolixin Decanoate. 3.1.22 Maintain consumer medication profiles. Allergies, drug interactions, duplication of therapy and contraindications require immediate notification provided by the pharmacist to the prescriber of any serious or significant issues. 3.1.23 Registered pharmacist shall be available by phone to the CSB medical staff for consultation regarding all aspects of medication. 3.1.24 The Contractor's staff shall be available for consultation with CSB staff on an as-needed basis between 8:00 a.m. and 5:00 p.m., Monday through 3.1.25 Designate an Account Manager who shall be responsible for administration of the contract and who shall be the point of contact for CSB contract administrator. 3.2 The Contractor shall work with the CSB Medical Director and CSB Nurse Manager, to review, develop, and help implement pharmacy related policies and procedures that will be in compliance with the Federal and State of Virginia Statutes as appropriate. 3.3 The Contractor shall provide and conduct a continuous monitoring system with the specific goal of improving quality of services and care provided. Medication error and omission shall be monitored and reported quarterly. 3.4 The Contractor shall maintain the following standards during the term of the contract: 3.4.1 Licensure in accordance with the State of Virginia Statutes Board of Registration in Pharmacy for a non-resident pharmacy, and or resident Pharmacy, United States Department of Justice and the Drug Enforcement Administration as a retail pharmacy and as a Controlled Substances registrant in Schedules II through VI. ) 3.4.2 Highest professional ethics and standards 3.4.3 Follow all Federal and State Laws regarding Pharmacy services, as amended; 3.4.4 Licensed by the Commonwealth of Virginia, Board of Pharmacy; 3.4.5 Compliance with Department of Behavioral Health and Developmental (DBHDS) Services Management Guidelines; 3.4.6 Certified by the Center of Medicare & Medicaid Services when eligible; 3.4.7 Compliance with Rules and Regulations to Assure the Rights of Individuals Receiving Services from Providers of Mental Health, Mental Retardation, and Substance Abuse Services or applicable state human rights regulations. 3.4.8 Pharmacists employed by the Contractor who provide contractual services to the CSB will maintain licensure in good standing, and will provide documentation of
licensure with the proposal, upon commencement of services under the
contract and annually thereafter.
3.5 Eligibility for such licensure must be submitted with the proposal and licensure must be
verified throughout the term of the Contract. An Offeror's failure to provide the documentation with the Offeror's response to the RFP will result in the disqualification of the Offeror's proposal. 3.6 The CSB's Medical staff and successful offeror team agree to notify each other, either verbally or in writing, as soon as appropriate, of extended absences of critical positions and to identify a team member who will be attending to the responsibilities usually attended to by the person in the critical position in an effort to minimize the program impact of such absences. Extended absences will be defined as two weeks or more. 3.7 The Contractor must have an emergency preparedness plan in place, to ensure that prescription medications can be provided in the event of a widespread emergency. An outline must be included in the proposal. 3.8 The CSB will evaluate the all procedures in regards to monitoring each facet of the final contract on an annual basis. 4.0 PROPOSAL PREPARATION AND SUBMISSION REQUIREMENTS
4.1 REQUEST FOR PROPOSAL RESPONSE: In order to be considered for selection, Offerors
must submit a complete response to this Request for Proposal. One (1) original and four (4) copies must be submitted to the CSB. No other distribution of the proposal shall be made by the Offeror. 4.2 PROPOSAL PREPARATION:
Proposals shall be signed by an authorized representative of the Offeror. All information requested must be submitted. Failure to submit all information requested may result in the CSB requiring prompt submission of missing information and/or giving a lowered evaluation of the proposal. Mandatory requirements are those required by law or regulation or are such that they cannot be waived and are not subject to negotiation. Proposals should be prepared simply and economically, providing a straightforward, concise description of capabilities to satisfy the requirements of the Request for Proposal. Emphasis should be placed on completeness and clarity of content. Proposals should be organized in the order in which the requirements are presented in the RFP. All pages of the proposal should be numbered. Each paragraph in the proposal should reference the paragraph number of the corresponding section of the RFP. It is also helpful to cite the paragraph number, subnumber and repeat the text of the requirement as it appears in the RFP. If a response covers more than one page, the paragraph number and subnumber should be cross-repeated at the top of the next page. The proposal should contain a table of contents, which cross-references the RFP requirements. Information which the offeror desires to present that does not fall within any of the requirements of the RFP should be inserted at an appropriate place or be attached at the end of the proposal and designated as additional material. Proposals that are not organized in this manner risk elimination from consideration if the evaluators are unable to find where the RFP requirements are specifically addressed. Each copy of the proposal should be bound or contained in a single volume where practical. All documentation submitted with the proposal should be contained in that single volume. Ownership of all data, materials and documentation originated and prepared for the CSB pursuant to the Request for Proposal shall belong exclusively to the CSB and be subject to public inspection in accordance with the Virginia Freedom of Information Act. Trade secrets or proprietary information submitted by an Offeror shall not be subject to public disclosure under the Virginia Freedom of Information Act; however, the Offeror must invoke the protection of Section 11-52D of the Code of Virginia, in writing, either before or at the time of the data is submitted. The written notice must specifically identify the data or materials to be protected and state the reasons why protection is necessary. The proprietary or trade secret material submitted must be identified by some distinct method such as highlighting or underlining and must be indicated on the specific words, figures, or paragraphs that constitute trade secret or proprietary information. The classification of an entire proposal as proprietary or trade secrets is not acceptable and will result in rejection and return of the proposal. 4.3 ORAL PRESENTATION: Offerors who submit a proposal in response to this Request for
Proposal may be required to give an oral presentation of their proposal to the CSB. This will provide an opportunity for the Offeror to clarify or elaborate on this proposal. This is a fact finding and explanation session only and does not include negotiation. The issuing agency will schedule the time and location of this presentation. Oral presentations are an option of the issuing agency and may or may not be conducted. 4.4 SPECIFIC PROPOSAL REQUIREMENTS: Proposals should be as thorough and detailed as
possible so that the CSB may properly evaluate your capabilities to provide the required services. Offerors are required to submit the following items as a complete proposal: 4.4.1 The return of the Request for Proposal cover sheet and addenda acknowledgements, if any, signed and filled out as required. Complete Contractor Data Sheet (Attachment A) A written narrative statement to include: Experience and qualifications in providing the services described within. Include copies of all applicable licenses, CV (curriculum vitae), resume, certifications, insurances, and a verifiable list of the Medicaid and Medicare in which the offeror is a provider. Specific plans for providing the proposal services including: 1. Commitment summary to provide services as described within. Proposals shall include any additional information regarding any limitations, exceptions, or exclusions or services, and a description of any assumptions made not herein addressed. 2. Ability to meet the CSB's scheduling requirements at several sites with personnel resources and present commitments. 4.5 IDENTIFICATION OF PROPOSAL ENVELOPE: If a special envelope is not furnished, or if
return in the special envelope is not possible, the signed proposal should be returned in a separate envelope or package, sealed and identified as follows: SEALED PROPOSAL
From: _
Name of Offeror
PHARMSVCS030120
Street or Box Number
Pharmaceutical Services _
City, State, Zip Code
RFP Title
Name of Purchasing Officer:
The envelope should be addressed as directed on Page 1 of the solicitation. If a proposal not contained in the special envelope is mailed, the Offeror takes the risk that the envelope, even if marked as described above, may be inadvertently opened and the information compromised which may cause the proposal to be disqualified. Proposals may be hand delivered to the designated location in the office issuing the solicitation. No other correspondence or other Proposals should be placed in the envelope. 4.6 LATE PROPOSALS: To be considered for selection, proposals must be received by the CSB
by the designated date and hour. Proposals received in the CSB office after the date and hour designated are automatically disqualified and will not be considered. The CSB is not responsible for delays in the delivery of mail by the U. S. Postal Service or private couriers. It is the sole responsibility of the Offeror to insure that his proposal reaches the CSB office by the designated date and hour. Receipt of proposals scheduled during a period of suspended CSB business operations will be rescheduled for procession at the same time on the next regular business day. 5.0 EVALUATION CRITERIA AND AWARD
5.1 EVALUATION CRITERIA: Each proposal will be evaluated by the CSB using the following
Overall qualifications and demonstrated experience and ability of the Offeror in the provision of pharmacy services Performance of the Offeror with respect to the quality and completeness of services provided including cost control measures and management operations. Quality and completeness of services to be provided including operations plans for service provision, both routine and emergency, and a system of return of medications for credit. Non-binding estimate of Professional Fees/Prescription Medicines-Attachment B Professional fees are NOT to be submitted with your proposal, but for those Offerors
selected for interview/discussion phase of proposal evaluations, the CSB will request
non-binding estimates of professional fees and will use such estimates in ranking
Offerors in accordance with the Virginia Public Procurement Act.
5.2 AWARD OF CONTRACT: The CSB may engage in individual discussions with two or more
Offerors deemed fully qualified, responsible and suitable on the basis of initial responses and with emphasis on professional competence, to provide the required services. Repetitive informal interviews shall be permissible. Such Offerors shall be encouraged to elaborate on their qualifications and performance data or staff expertise pertinent to the proposal project, as well as alternative concepts. At the discussion stage, the CSB may discuss nonbinding estimates of total project costs, including, but not limited to, life cycle costing and where appropriate, nonbinding estimates of price for services. Proprietary information from competing Offerors shall not be disclosed to the public or to the competitors. At the conclusion of the informal interviews, on the basis of evaluation factors published in the Request for Proposals and all information developed in the selection process to this point, the CSB shall select, in the order of preference, two or more Offerors whose professional qualifications and proposed services are deemed most meritorious. Negotiations shall then be conducted, beginning with the Offeror ranked first. If a contract satisfactory and advantageous to the CSB can be negotiated at a price considered fair and reasonable, the award shall be made to that Offeror. Otherwise, negotiations with the Offeror ranked first shall be formally terminated and negotiations conducted with the Offeror ranked second, and so on, until such a contract can be negotiated at a fair and reasonable price. Should the CSB determine in writing and in its sole discretion that only one Offeror is fully qualified, or that one Offeror is clearly more highly qualified and suitable than the others under consideration, a contract may be negotiated and awarded to that Offeror. If one Offeror cannot provide the total services requested, the CSB reserves the right to make a multi-award of this solicitation.
6.0 REPORTING AND DELIVERY INSTRUCTIONS

6.1 The Contractor shall provide monthly statistical reports as follows: Summary of total drug cost A list of each prescription billed, including prescriber name. 6.2 A consultant pharmacist employed by the Contractor shall conduct quarterly inspections and audits of the on-site pharmacy services for regulatory compliance, drug security, drug storage and expiration date compliance, Pharmacy Policies and Procedures. Specifications of inspection and reporting formats shall be agreed upon between the Contractor and the CSB Medical Director and CSB Nurse Manager. The results of the inspection/audits will be discussed with the CSB Medical Director and CSB Director of Nursing at the time of the inspection/audit. A written report will be submitted quarterly for quality assessment and improvement purposes. 7.0 GENERAL TERMS AND CONDITIONS
A. PROCUREMENT REGULATIONS: This solicitation is subject to the provisions of the
purchasing regulations of District 19 Community Services Board and any revisions thereto, which are hereby incorporated into this contract in their entirety. B. APPLICABLE LAWS AND COURTS: This solicitation and any resulting contract shall be
governed in all respects by the laws of the Commonwealth of Virginia and any litigation with respect thereto shall be brought in the courts of the Commonwealth. The agency and the contractor are encouraged to resolve any issues in controversy arising from the award of the contract or any contractual dispute using Alternative Dispute Resolution (ADR) procedures (Code of Virginia, § 2.2-4366). ADR procedures are described in Chapter 9 of the Vendors Manual. The contractor shall comply with all applicable federal, state and local laws, rules and regulations. C. ANTI-DISCRIMINATION: By submitting their proposals, offerors certify to the District 19
Community Services Board that they will conform to the provisions of the Federal Civil Rights Act of 1964, as amended, as well as the Virginia Fair Employment Contracting Act of 1975, as amended, where applicable, the Virginians with Disabilities Act, the American With Disabilities Act and 11-51 of the Virginia Public Procurement Act. In every contract over $10,000 the provisions in 1. and 2. below apply: During the performance of this contract, the contractors agrees as follows: a. The contractor will not discriminate against any employee or applicant for employment because of race, religion, color, sex, national origin, or disabilities, except where religion, sex or national origin is a bona fide occupational qualification reasonably necessary to the normal operation of the contractor. The contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices setting forth the provisions of this nondiscrimination clause. b. The contractor, in all solicitations or advertisements for employees placed by or on behalf of the contractor, will state that such contractors is an equal opportunity employer. c. Notices, advertisements, and solicitations placed in accordance with federal law, rule or regulation shall be deemed sufficient for the purpose of meeting these requirements. The contractor will include the provisions of 1. above in every subcontract or purchase order over $10,000, so that the provisions will be binding upon each subcontractor or vendor. D. ETHICS IN PUBLIC CONTRACTING: By submitting their proposals, offerors certify that their
proposals are made without collusion or fraud and that they have not offered or received any kickbacks or inducements from any other offeror, supplier, manufacturer or subcontractor in connection with their proposal and that they have not conferred on any public employee having official responsibility for this procurement transaction any payment, loan, subscription, advance, deposit of money, services or anything of more than nominal value, present or promised, unless consideration of substantially equal or greater value was exchanged. E. IMMIGRATION REFORM AND CONTROL ACT OF 1986: By entering into a written contract
with the District 19 Community Services Board, the Contractor certifies that the Contractor does not, and shall not during the performance of the contract for services in the Commonwealth of Virginia, knowingly employ an unauthorized alien as defined in the federal Immigration Reform and Control Act of 1986. F. DEBARMENT STATUS: By submitting their proposals, offerors certify that they are not
currently debarred by the Commonwealth of Virginia from submitting proposals on contracts for the type of services covered by this solicitation, nor are they an agent of any person or entity that is currently so debarred. G. ANTITRUST: By entering into a contract, the contractor conveys, sells, assigns, and transfers
to the District 19 Community Services Board all rights, title and interest in and to all causes of action it may now have or hereafter acquire under the antitrust laws of the United States and the Commonwealth of Virginia, relating to the particular goods or services purchased or acquired by the Commonwealth of Virginia under said contract. H. MANDATORY USE OF CSB FORM AND TERMS AND CONDITIONS:
Failure to submit a proposal on the official District 19 Community Services Board's form provided for that purpose shall be a cause for rejection of the proposal. Modification of or additions to the General Terms and Conditions of the solicitation may be cause for rejection of the proposal; however, District 19 Community Services Board reserves the right to decide, on a case by case basis, in its sole discretion, whether to reject such a proposal. CLARIFICATION OF TERMS: If any prospective offeror has questions about the specifications
or other solicitation documents, the prospective offeror should contact the Procurement and
Facilities Manager whose name appears on the face of the solicitation no later than five
working days before the due date. Any revisions to the solicitation will be made only by
addendum issued the manager.
J. PAYMENT:

1. To Prime Contractor:
a. Invoices for items ordered, delivered and accepted shall be submitted by the contractor directly to the payment address shown on the purchase order/contract. All invoices shall show the state contract number and/or purchase order number, social security number (for individual contractors) or the federal employer identification number (for proprietorships, partnerships and corporations.) b. Any payment terms requiring payment in less than 30 days will be regarded as requiring payment 30 days after invoice or delivery, whichever occurs last. This shall not affect offers of discounts for payment in less than 30 days, however. Invoices must show the contract or purchase order number assigned by the District 19 Community Services Board and shall be submitted by the contractor to the attention of Accounts Payable Department, and mailed to District 19 Community Services Board, 20 W. Bank Street, Suite 2, Petersburg, VA 23803 c. All goods or services provided under this contract or purchase order, that are to paid for with public funds, shall be billed by the contractor at the contract price, regardless of which public agency is being billed. d. The following shall be deemed to be the date of payment, the date of postmark in all cases where payment is made by mail, or the date of offset when offset proceedings have been instituted as authorized under the Virginia Debt Collection e. Unreasonable Charges. Under certain emergency procurements and for most time and material purchase, final job costs cannot be accurately determined at the time orders are placed. In such cases, contractors should be put on notice that final payment in full is contingent on a determination of reasonableness with respect to all invoiced charges. Charges which appear to be reasonable will be researched and challenged, and that portion of the invoice held in abeyance until a settlement can be reached. Upon determining that invoiced charges are not reasonable, the Commonwealth shall promptly notify the contractor, in writing, as to those charges which it considers unreasonable and the basis for the determination. A contractor may not institute legal action unless a settlement cannot be reached within thirty (30) days of notification. The provisions of this section do not relieve an agency of its prompt payment obligations with respect to those charges which are not in dispute (Code of Virginia 11-69).
2. To Subcontractors:
a. A contractor awarded a contract under this solicitation is hereby obligated: (1) To pay the subcontractor(s) within seven (7) days of the contractor's receipt of payment from the District 19 Community Services Board for the proportionate share of the payment received for work performed by the subcontractor(s) under the contract; or (2) To notify the District 19 Community Services Board and the subcontractor(s), in writing, of the contractor's intention to withhold payment and the reason. b. The Contractor is obligated to pay the subcontractor(s) interest at the rate of one percent per month (unless otherwise provided under the terms of the contract) on all amounts owed by the contract that remain unpaid seven (7) days following receipt of payment from the District 19 Community Services Board, except for amounts withheld as stated in (2) above. The date of mailing of any payment by U. S. Mail is deemed to be payment to the addressee. These provisions apply to each sub-tier contractor performing under the primary contract. A contractor's obligation to pay an interest charge to a subcontractor may not be construed to be an obligation of the District 19 Community Services Board. K. PRECEDENCE OF TERMS: Except for Paragraphs titled Applicable Law and Courts,
Compliance, Debarment Status, Mandatory Use of District 19 Community Services Board's
Forms and Terms and Conditions, and Precedence of Terms herein, which shall apply in all
instances, in the event there is a conflict between the other General Terms and Conditions
and any Special Terms and Conditions in this solicitation, the Special Terms and Conditions
shall apply.

L. QUALIFICATIONS OF OFFERORS: The District 19 Community Services Board may make
such reasonable investigations as deemed proper and necessary to determine the ability of the Offeror to perform the services and the Offeror shall furnish to the District 19 Community Services Board all such information and data for this purpose as may be requested. District 19 Community Services Board reserves the right to inspect Offeror's physical facilities prior to award to satisfy questions regarding the Offeror's capabilities. The District 19 Community Services Board further reserves the right to reject any proposal if the evidence submitted by, or investigations of, such Offeror fails to satisfy the District 19 Community Services Board that such Offeror is properly qualified to carry out the obligations of the contract and to provide the services contemplated therein. M. TESTING AND INSPECTION: The District 19 Community Services Board reserves the right to
conduct any test/inspection it may deem advisable to assure goods and services conform to the specifications. N. ASSIGNMENT OF CONTRACT: A contract shall not be assignable by the contractor in whole
or part without the written consent of the District 19 Community Services Board.
O. CHANGES TO THE CONTRACT:
Changes can be made to the contract in any of the following ways: 1. The parties may agree in writing to modify the scope of the contract. An increase or decrease in the price of the contract resulting from such modification shall be agreed to by the parties as a part of their written agreement to modify the scope of the contract. 2. The District 19 Community Services Board may order changes within the general scope of the contract at any time by written notice to the contractor. Changes within the scope of the contract include, but are not limited to, things such as services to be performed, the method of packing or shipment, and the place of delivery or installation. The contractor shall comply with the notice upon receipt. The contractor shall be compensated for any additional costs incurred as the result of such order and shall give the Purchasing Agency a credit for any savings. Said compensation shall be determined by one of the following methods: a. By mutual agreement between the parties in writing; or b. By agreeing upon a unit price or using a unit price set forth in the contract, if the work to be done can be expressed in units, and the contractor accounts for the number of units of work performed, subject to the Purchasing Agency's right to audit the contractor's records and/or to determine the correct number of units independently; or c. By ordering the contractor to proceed with the work and keep a record of all costs incurred and savings realized. A markup for overhead and profit may be allowed if provided by the contract. The same markup shall be used for determining a decrease in price as the result of savings realized. The contractor shall present the Purchasing Agency with all vouchers and records of expenses incurred and savings realized. The District 19 Community Services Board shall have the right to audit the records of the contractor, as it deems necessary to determine costs or savings. Any claim for an adjustment in price under his provision must be asserted by written notice to the Purchasing Agency within thirty (30) days from the date of receipt of the written order from the District 19 Community Services Board. If the parties fail to agree on an amount of adjustment, the question of an increase or decrease neither the existence of a claim nor a dispute resolution process, litigation or any other provision of this contract shall excuse the contractor from promptly complying with the changes ordered by the Purchasing Agency or with the performance of the contract generally. P. DEFAULT: In case of failure to deliver services in accordance with the contract terms and
conditions, the District 19 Community Services Board, after due oral or written notice, may procure them from other sources and hold the contractor responsible for any resulting additional purchase and administrative costs. This remedy shall be in addition to any other remedies, which the Commonwealth may have. Q. ANNOUNCEMENT OF AWARD: Upon the award or the announcement of the decision to
award a contract as a result of this solicitation, the District 19 Community Services Board will publicly post such notice on District 19 Community Services Board public bulletin board for a minimum of 10 days. R. DRUG FREE WORKPLACE: The contractor acknowledges, certifies and understands that the
following acts by the contractor, contractor employees, and/or agents performing services on state property are prohibited: a. The unlawful manufacture, distribution, dispensing, possession or use of alcohol or other b. Any impairment or incapacitation from the use of alcohol or other drugs (except the use of drugs for legitimate medical purposes). The contractor further acknowledges, certifies and understands that a violation of these prohibitions constitutes a breach of contract and may result in default action being taken by the District 19 Community Services Board in addition to any criminal penalties that may result from such conduct. S. NONDISCRIMINATION OF CONTRACTORS: A bidder, offeror, or contractor shall not be
discriminated against in the solicitation or award of this contract because of race, religion, color, sex, national origin, age, disability, faith-based organizational status, any other basis prohibited by state law relating to discrimination in employment or because the bidder or offeror employs ex-offenders unless the state agency, department or institution has made a written determination that employing ex-offenders on the specific contract is not in its best interest. If the award of this contract is made to a faith-based organization and an individual, who applies for or receives goods, services, or disbursements provided pursuant to this contract objects to the religious character of the faith-based organization from which the individual receives or would receive the goods, services, or disbursements, the public body shall offer the individual, within a reasonable period of time after the date of his objection, access to equivalent goods, services, or disbursements from an alternative provider.
T. AVAILABILITY OF FUNDS: It is understood and agreed between the parties herein that the
agency shall be bound hereunder only to the extent of the funds available or which may hereafter become available for the purpose of this agreement. U. AUTHORIZATION TO CONDUCT BUSINESS IN THE COMMONWEALTH: A contractor
organized as a stock or nonstock corporation, limited liability company, business trust, or limited partnership or registered as a registered limited liability partnership shall be authorized to transact business in the Commonwealth as a domestic or foreign business entity if so required by Title 13.1 or Title 50 of the Code of Virginia or as otherwise required by law. Any business entity described above that enters into a contract with a public body pursuant to the Virginia Public Procurement Act shall not allow its existence to lapse or its certificate of authority or registration to transact business in the Commonwealth, if so required under Title 13.1 or Title 50, to be revoked or cancelled at any time during the term of the contract. A public body may void any contract with a business entity if the business entity fails to remain in compliance with the provisions of this section. 8.0 SPECIAL TERMS AND CONDITIONS

A. AUDIT: The contractor shall retain all books, records, and other documents relative to this
contract for five (5) years after final payment, or until audited by the District 19 Community Services Board, whichever is sooner. The agency, its authorized agents, and/or state auditors shall have full access to and the right to examine any of said materials during said period. B. AWARD: The District 19 Community Services Board (CSB) may engage in individual
discussions with two or more Offerors deemed fully qualified, responsible and suitable on the basis of initial responses and with emphasis on professional competence, to provide the required services. Repetitive informal interviews shall be permissible. Such Offerors shall be encouraged to elaborate on their qualifications and performance data or staff expertise pertinent to the proposal project, as well as alternative concepts. At the discussion stage, the CSB may discuss nonbinding estimates of total project costs, including, but not limited to, life cycle costing and where appropriate, nonbinding estimates of price for services. Proprietary information from competing Offerors shall not be disclosed to the public or to the competitors. At the conclusion of the informal interviews, on the basis of evaluation factors published in the Request for Proposals and all information developed in the selection process to this point, the CSB shall select, in the order of preference, two or more Offerors whose professional qualifications and proposed services are deemed most meritorious. Negotiations shall then be conducted, beginning with the Offeror ranked first. If a contract satisfactory and advantageous to the CSB can be negotiated at a price considered fair and reasonable, the award shall be made to that Offeror. Otherwise, negotiations with the Offeror ranked first shall be formally terminated and negotiations begin with the Offeror ranked second, and so on, until such a contract can be negotiated at a fair and reasonable price. Should the CSB determine in writing and in its sole discretion that only one Offeror is fully qualified, or that one Offeror is clearly more highly qualified and suitable than the others under consideration, a contract may be negotiated and awarded to that Offeror. If one Offeror cannot provide the total services requested, the CSB reserves the right to make a multi-award of this solicitation. C. CANCELLATION OF CONTRACT: The District 19 Community Services Board reserves the
right to cancel and terminate any resulting contract, in part or in whole, without penalty, upon 60 days written notice to the Contractor. Any contract cancellation notice shall not relieve the Contractor of the obligation to deliver and/or perform on all outstanding orders issued prior to the effective date of cancellation. D. CONFIDENTIALITY: The Contractor assures that information and data obtained as to
personal facts and circumstances related to consumers will be collected and held confidential, during and following the term of this agreements, and will not be divulged without the individual's and the District 19 Community Services Board's written consent. Any information to be disclosed, except to the District 19 Community Services Board, must be in summary, statistical, or other form which does not identify particular individuals. E. CONTRACT MANAGEMENT AND ADMINISTRATION: A contract manager will be appointed
by the District 19 Community Services Board who will be responsible for monitoring contractor performance, resolving contractual issues, and interpreting contractual terms and conditions. Further, the Contract Manager may pursue any issue(s), relating to the contract agreement that results from this solicitation that is in the best interest of the District 19 Community Services Board. The Contract Manager is not authorized to make or authorize changes to the contract, to approve additional work or expenditures, or to change deliverables or timeframes. Requests for such changes shall be directed to the Purchasing Officer. F. CRIMINAL CONVICTIONS: By submitting their proposals, Offerors certify that they and their
employees that will be performing services under this contract are free of any criminal conviction that indicates a behavior that may pose a risk or threat to the District 19 Community Services Board. Verification of certification shall be made available to the District 19 Community Services Board upon request with ten (10) working days. G. DISPUTES: Disputes shall be communicated between Contractors's assigned coordinator and
assigned District 19 Community Services Board official, who will negotiate resolution of dispute. If the condition is not corrected, the coordinator and official shall meet with the District 19 Community Services Board's Contract Officer who will negotiate resolution of the dispute. If the condition is not corrected at the above level, a meeting shall be scheduled with the District 19 Community Services Board Executive Director or his designee by the District 19 Community Services Board Contract Officer, including all interested parties. The decision of the District 19 Community Services Board Executive Director shall be final. H. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT COMPLIANCE: The
Provider agrees to sign and Business Associate Agreement when requested by the Department in compliance with the Health Insurance Portability and Accounting Act effective April 14, 2003. Failure to execute the Business Associate Agreement may result in termination of this agreement. HIPAA PRIVACY RULE: It is the policy of District 19 Community Services Board that all
staff, students, volunteers, interns, residents, and contract workers will comply with the
HIPAA Privacy Rule, the Rules and Regulations to Assure the Rights of Individuals Receiving
Services from Providers of Mental Health, Mental Retardation and Substance Abuse
Services ("Human Rights Regulations"), and other related state and federal laws and
regulations. Violations should be reported according to the protocols established in the District 19 Community Services Board Compliance Plan. J. HUMAN RIGHTS POLICY: The contractor shall comply with and adopt the Board's Human
Rights Policy. This policy complies with the Community Human Rights Regulations promulgated in 2007 and has been approved by the State Human Rights Committee. For a copy of this policy, please contact Pamela Sweeney at (804) 862-8054, or a copy can be obtained at 20 West Bank Street, Suite 2, Petersburg, VA 23803. K. IDENTIFICATION OF PROPOSAL ENVELOPE: If a special envelope is not furnished, or if
return in the special envelope is not possible, the signed proposal should be returned in a separate envelope or package, sealed and identified as follows: SEALED PROPOSAL
Name of Offeror
_PHARMSVCS030120
Street or Box Number
Pharmaceutical Services
City, State, Zip Code
RFP Title
Name of Purchasing Officer:
The envelope should be addressed as directed on Page 1 of the solicitation. If a proposal not contained in the special envelope is mailed, the Offeror takes the risk that the envelope, even if marked as described above, may be inadvertently opened and the information compromised which may cause the proposal to be disqualified. Proposals may be hand delivered to the designated location in the office issuing the solicitation. No other correspondence or other Proposals should be placed in the envelope. L. INSPECTION OF JOB SITE: My signature on this solicitation constitutes certification that I
have inspected the job site and am aware of the conditions under which the work must be accomplished. Claims, as a result of failure to inspect the job site, will not be considered by the District 19 Community Services Board. M. MINORITY/WOMEN OWNED BUSINESSES SUBCONTRACTING AND REPORTING:
When it is practicable for any portion of the awarded contract to be subcontracted to other suppliers, the contractor is encouraged to offer such business to minority and/or women owned businesses. Names of firms may be available from the buyer and/or from the Division of Purchases and Supply. When such business has been subcontracted to these firms and upon completion of the contract, the contractor agrees to furnish the purchasing office the following information: name of firm, phone number, total dollar amount subcontracted and type of product/service provided. N. OWNERSHIP OF DOCUMENTS: Any reports, studies, photographs, negatives, or other
documents prepared by the Contractor in the performance of its obligation under this contract shall be remitted to the District 19 Community Services Board. Contractor shall not use, willingly allow or cause to have such materials used for any purpose other than performance of Contractor's obligation under this contract without prior written consent of the District 19 Community Services Board. O. PROPOSAL ACCEPTANCE PERIOD: Any proposal resulting from this solicitation shall be
valid for sixty (60) days. At the end of the 60 days the proposal may be withdrawn at the written request of the Offeror. If the proposal is not withdrawn at that time it remains in effect until an award is made or the solicitation is canceled.
P. REJECTION OF PROPOSALS: The District 19 Community Services Board reserves the right
to reject any and all proposals when such rejection is in the best interest of the District 19 Community Services Board, and to reject the proposal of an Offeror who is not in a position to perform the contract. Q. PRICE ESCALATION/DEESCALATION: Price adjustments may be permitted only for
changes in the Contractor's cost of materials not to exceed the increase in the following index/indices: Other Services category of the CPI-W section of the Consumer Price Index of the United State Bureau of Labor Statistics. No price increases will be authorized for 365
calendar days after the effective date of the contract. Price escalation may be permitted only at the end of this period and each 365 days thereafter and only where verified to the
satisfaction of the purchasing office. However, "across the board" price decreases are subject to implementation at anytime and shall be immediately conveyed to the CSB. Contractor shall give not less than 30 days advance notice of any price increase to the CSB's Nurse Manager and the purchasing office. Any approved price changes will be effective only at the beginning of the calendar month following the end of the full 30 day notification period. The Contractor shall document the amount and proposed effective date of any general change in the price of materials. Documentation shall be supplied with the Contractor's request for increase which will: (1) verify that the requested price increase is general in scope and not applicable just to the CSB; and (2) verify the amount or percentage of increase which is being passed on to the Contractor by the Contractor's suppliers. The CSB's Nurse Manager and the purchasing office will notify Contractor in writing of the effective date of any increase which it approves. However, the Contractor shall fill all purchase orders received prior to the effective date of the price adjustment at the old contract prices. The Contractor is further advised that decreases which affect the cost of
materials are required to be communicated immediately to the CSB's Nurse
and the purchasing office.
R. RENEWAL OF CONTRACT: This contract may be renewed by the District 19 Community
Services Board for a period of three (3) successive one-year periods under the terms and conditions of the original contract except as stated in 1.and 2. below. Price increase may be negotiated only at the time of renewal. Written notice of the CSB's intention to renew shall be given approximately 90 days prior to the expiration date of each contract period. 1. If the District 19 Community Services Board elects to exercise the option to renew the contract for an additional one-year period, the contract price(s) for the additional one year shall not exceed the contract price(s) of the original contract increased/decreased by more than the percentage increase/decrease of the "Other Services" category of the CPI- W section of the Consumer Price Index of the United States Bureau of Labor Statistics for the latest twelve months for which statistics are available. 2. If during any subsequent renewal periods, the District 19 Community Services Board elects to exercise the option to renew the contract, the contract prices(s) for the subsequent renewal period shall not exceed the contract price(s) of the previous renewal period increased/decreased by more than the percentage increase/decrease of the "Other Services" category of the CPI-W section of the Consumer Price Index of the United States Bureau of Labor Statistics for the latest twelve months for which statistics are available. S. SUBCONTRACTS: No portion of the work shall be subcontracted without prior written
consent of the District 19 Community Services Board. In the event that the Contractor desires to subcontract some part of the work specified herein, the Contractor shall furnish the purchasing agency the names, qualifications and experience of their proposed subcontractors. The Contractor shall, however, remain fully liable and responsible for the work to be done by his subcontractor(s) and shall assure compliance with all requirements of the contract.
T. OPTIONAL PREBID/PREPROPOSAL CONFERENCE: An optional preproposal conference
will be held at 1:00PM on February 12, 2015 at 20 West Bank Street, Petersburg, VA,
Suite 6, Second Floor, Board Room. The purpose of this conference is to allow potential
bidders an opportunity to present questions and obtain clarification relative to any facet of
this solicitation. While attendance at this conference will not be a prerequisite to submitting a
proposal, offerors who intend to submit a proposal are encouraged to attend. Bring a copy of
the solicitation with you. Any changes resulting from this conference will be issued in a
written addendum to the solicitation.

10.0 METHOD OF PAYMENT

10.1 The Contractor will submit invoices monthly. Invoices shall comprise of: the contract #,
a list of individual prescriptions filled, each prescription shall show date filled, consumer's name, prescribing physician, medication, quantity, unit price extended price, processing fee, total cost of prescription, amount billed to third parties, and net payment due from the CSB. Payment will be made to the Contractor within 30 days of receipt of invoices. Invoice(s) is to be submitted to: District 19 Community Services Board Attention: Karen Louis, RN, Nurse Manager 20 W. Bank Street, Suite #6 Petersburg, VA 23803 10.2 Offerors shall include in the Proposal a description of any significant task not listed in the Statement of Needs which they know to be necessary either as reimbursable expenses under the contract or as a service to be contracted for separately by the CSB.
11.0 PRICING SCHEDULE

Non-binding estimate of Professional Fees/Prescription Medicines-Attachment B
Professional fees are NOT to be submitted with your proposal, but for those Offerors selected for
interview/discussion phase of proposal evaluations, the CSB will request non-binding estimates
of professional fees and will use such estimates in ranking Offerors in accordance with the
Virginia Public Procurement Act.
ATTACHMENT A
CONTRACTOR DATA SHEET
Note: The following information is required as part of your response to this solicitation. Failure to complete
and provide this sheet may result in finding your bid nonresponsive.
Qualification: The vendor must have the capability and capacity in all respects to satisfy fully all of the contractual
requirements.
Vendor's Primary Contact:
Name: _ Phone: _ Years in Business: indicate the length of time you have been in business providing this type of good or service:
_Years Months
Vendor Information:
FIN or FEI Number: If Company, Corporation or Partnership Social Security Number: If Individual Indicate below a listing of at least four (4) current or recent accounts, either commercial or governmental, that your company is servicing, has serviced, or has provided similar services to. Include the length of service and the name, address, and telephone number of the point of contact. Company: Contact: _ Phone: ( _) _ Fax: ( _) Project: Dates of Service: $ Value: B. Company: Contact: _
Phone: ( _) _ Fax: ( _)
Project:
Dates of Service: _ $ Value:

C. Company: Contact: _
Phone: ( _) _ Fax: ( _)
Project:
Dates of Service: _ $ Value:
D. Company: Contact: _
Phone: ( _) _ Fax: ( _)
Project:
Dates of Service: _ $ Value:
I certify the accuracy of this information.
Signed: Title: Date: _
ATTACHMENT B
RFP# PHARMSVCS030120
PRESCRIPTION MEDICINES
"THIS APPENDIX IS NOT TO BE SUBMITTED WITH YOUR PROPOSAL"
Offerors who are selected for interviews are required to provide a non-binding estimate of cost for the following
drugs. These estimates will be utilized by the CSB for further evaluation and ranking of Offerors proposals.
Quantity:
Drug Name:
Generic Name:
Formulary:
ABILIFY 10MG TAB ABILIFY 15MG TAB ABILIFY 20MG TAB ABILIFY 30MG TAB AMANTIDINE 100MG CAPS AMITRIPTYLINE 100MG TABS AMITRIPTYLINE 10MG TABS AMITRIPTYLINE 50MG TABS AMITRIPTYLINE 75MG TABS AMITRIPTYLINE 25MG TABS ARICEPT 10MG TABS BENZTROPINE MES 1MG TABS BENZTROPINE MES 2MG TABS BUPROPRION 100MG TABS BUPROPRION 75MG TABS BUPROPRION SR 100MG TABS BUPROPRION SR 150MG TABS BUSPIRONE 10MG TABS BUSPIRONE 5MG TABS CARBAMAZEPINE 200MG TABS CAMPROL 333MG TABS CHLORPROMAZINE 100MG TABS CHLORPROMAZINE 200MG TABS CHLORPROMAZINE 25MG TABS CHLORPROMAZINE 50MG TABS CITALOPRAM 20MG TABS CITALOPRAM 40MG TABS CLOZAPINE 25MG TABS CLOZAPINE 100MG TABS CYMBALTA 20MG CAPS CYMBALTA 30MG CAPS CYMBALTA 60MG CAPS DIPHENHYDRAMINE 25MG CAPS DIPHENHYDRAMINE 50MG CAPS DIVALPROEX 250MG TAB DIVALPROEX 500MG TABS DIVALPROEX ER 250MG TABS DIVALPROEX ER 500MG TABS DOXEPIN 100MG CAPS DOXEPIN 10MG CAPS DOXEPIN 25MG CAPS DOXEPIN 50MG CAPS Quantity:
Drug Name:
Generic Name:
Formulary:
DOXEPIN 75MG CAPS EFFEXOR XR 150MG CAP SA EFFEXOR XR 37.5MG CAP SA EFFEXOR XR 75MG CAP SA FLUOXETINE 10MG CAP FLUOXETINE 20MG CAP FLUOXETINE 40MG CAP FLUPHENAZINE 10MG TAB FLUPHENAZINE 1MG TAB FLUPHENAZINE 2.5MG TAB FLUPHENAZINE 5MG TAB FLUVOXAMINE 100MG TAB GABAPENTIN 100MG CAP GABAPENTIN 600MG TAB GABAPENTIN 800MG TAB HALOPERIDOL 0.5MG TAB HALOPERIDOL 1MG TAB HALOPERIDOL 2MG TAB HALOPERIDOL 5MG TAB HALOPERIDOL DEC 100MG/ML HALOPERIDOL DEC 50MG/ML HYDROXYZINE PAM 25MG CAP HYDROXYZINE PAM 50MG CAP HYDROXYZINE HCL 25MG TAB HYDROXYZINE HCL 50MG TAB LAMOTRIGINE 100MG TAB LAMOTRIGINE 150MG TAB LAMOTRIGINE 200MG TAB LAMOTRIGINE 25MG TAB LEXAPRO 10MG TABS LEXAPRO 20MG TABS LITHIUM CARB 300MG CAP LOXAPINE 5MG CAPS LOXAPINE 10MG CAPS LOXAPINE 25MG CAPS LOXAPINE 50MG CAPS NAMENDA 5MG TABS NAMENDA 10MG TABS NORTRIPTYLINE 10MG CAPS NORTRIPTYLINE 25MG CAPS MIRTAZAPINE 30MG TAB MIRTAZIPINE 45MG TAB Quantity:
Drug Name:
Generic Name:
Formulary:
OXCARBAZEPINE 300MG TAB OXCARBAZEPINE 600MG TAB PAROXETINE 20MG TAB PAROXETINE 30MG TAB PAROXETINE 40MG TAB PERPHENAZINE 16MG TABS PERPHENAZINE 2MG TABS PERPHENAZINE 4MG TABS PERPHENAZINE 8MG TABS PROPRANOLOL 20MG TABS PROPRANOLOL 40MG TABS PROPRANOLOL 80MG TABS RISPERDAL CONSTA 12.5MG RISPERDAL CONSTA 25MG SYR RISPERDAL CONSTA RISPERDAL CONSTA 50MG SYR RISPERIDONE 1MG TAB RISPERIDONE 2MG TAB RISPERIDONE 3MG TAB RISPERIDONE 4MG TAB SEROQUEL 100MG TAB SEROQUEL 200MG TAB SEROQUEL 25MG TAB SEROQUEL 300MG TAB SERORQUEL 400MG TAB SEROQUEL 50MG TAB SEROQUEL XR 50MG TABS SEROQUEL XR 150MG TABS SEROQUEL XR 200MG TABS SERTRALINE 100MG TAB SERTRALINE 50MG TAB STRATTERA 100MG CAP STRATTERA 25MG CAP STRATTERA 40MG CAP SRATTERA 60MG CAP STRATTERA 80MG CAP THIOTHIXENE 10MG CAP THIOTHIXENE 1MG CAP THIOTHIXENE 2MG CAP THIOTHIXENE 5MG CAP TOPIRAMATE 100MG TAB TOPIRAMATE 200MG TAB TOPIRAMATE 25MG TAB TRAZODONE 100MG TAB TRAZODONE 50MG TAB TRIFLUOPERAZINE 10MG TAB TRIFLUOPERAZINE 2MG TAB TRIFLUOPERAZINE 5MG TAB TRIHEXYPHENIDYL 2MG VALPROIC ACID 250MG CAPS VENLAFAXINE 75MG TABS ZYPREXA 10MG TAB ZYPREXA 15MG TAB ZYRPEXA 2.5MG TAB Quantity:
Drug Name:
Generic Name:
Formulary:
ZYPREXA 20MG TAB ZYPREXA 7.5MG TAB ALPRAZOLAM 0.25MG TAB ALPRAZOLAM 0.5MG TAB ALPRAZOLAM 1MG TAB ALPRAZOLAM 2MG TAB CLONAZEPAM 0.5MG TAB CLONAZEPAM 1MG TAB CLONAZEPAM 2MG TAB DIAZEPAM 5MG TAB DIAZEPAM 10MG TAB LORAZEPAM 0.5MG TAB LORAZEPAM 1MG TAB LORAZEPAM 2MG TAB TEMAZEPAM 15MG CAPS TEMAZEPAM 30MG CAPS Name And Address Of Firm: _ (Signature In Ink) _ (Please Print) _

Source: http://d19csb.com/assets/docs/rfp/RFP-PHARMACEUTICAL-SVCS-022820.pdf