UF BPA Template in Adobe PDF format - Tricare
UF BPA Template in Adobe PDF format - Tricare
UF BPA Template in Adobe PDF format - Tricare
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BY: (signature) __________________________________ Date_____________________Name _______________________________________Title ________________________________________[Name of COMPANY] _____________________________________________________13. (To be completed by Contract<strong>in</strong>g Officer)A Uniform Formulary (<strong>UF</strong>) Blanket Purchase Agreement (<strong>BPA</strong>) is hereby established between theCompany and the Department of Defense for the pharmaceutical agents and applicable prices quoted<strong>in</strong> the attached Table 1, based on the f<strong>in</strong>al decision of the Director, TMA to [check all that apply]:____ Include the pharmaceutical agent(s) on the Uniform Formulary____ Include the pharmaceutical agent(s) on the Basic Core Formulary____ Include the pharmaceutical agent(s) on the Extended Core FormularyBY: _____________________________________ _______________Name: Bruce MittererDate <strong>UF</strong> decision madeTMA Contract<strong>in</strong>g OfficerForm Revised 06/23/10
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