CRITICAL MEDICAL SUPPLIES PROCUREMENT FORM

* Denotes a required field

​​​


Company Name *
Commonwealth of PA Supplier *
PA Vendor (Supplier) Number
Country *
Address 1 *
Address 2
City *
State *
County
Zip *
Non US Address
Contact First Name *
Contact Last Name *
Contact Email *
Confirm Email *
Contact Phone Number *
Company Website *
Provider Classification *
Company Country of Origin *
Surgical/Procedure Masks
1Quantity Available
1Price Per Unit (US $)
1Date Available
1Product Country of Origin
N95/N99 Form Fitting Respirators
2Quantity Available
2Price Per Unit (US $)
2Date Available
2Product Country of Origin
Face masks with integrated shield
3Quantity Available
3Price Per Unit (US $)
3Date Available
3Product Country of Origin
Powered Air Purifying Respirator, PAPRs
4Quantity Available
4Price Per Unit (US $)
4Date Available
4Product Country of Origin
Alcohol Based Hand Rub
5Quantity Available
5Price Per Unit (US $)
5Date Available
5Product Country of Origin
Ventilators with PEEP Functionality
6Quantity Available
6Price Per Unit (US $)
6Date Available
6Product Country of Origin
Ventilator Circuits
7Quantity Available
7Price Per Unit (US $)
7Date Available
7Product Country of Origin
Endotracheal Tubes
8Quantity Available
8Price Per Unit (US $)
8Date Available
8Product Country of Origin
Hospital Gowns
9Quantity Available
9Price Per Unit (US $)
9Date Available
9Product Country of Origin
UVT 3mL with flocked flex minitip
10Quantity Available
10Price Per Unit (US $)
10Date Available
10Product Country of Origin
Nasopharyngeal (NP) flocked swabs and viral transport media tubes (1-3 mL)
11Quantity Available
11Price Per Unit (US $)
11Date Available
11Product Country of Origin
Roche MagNA Pure 96 DNA and Viral NA Small Volume Kits
12Quantity Available
12Price Per Unit (US $)
12Date Available
12Product Country of Origin
Roche MagNA Pure 96 System Fluid and Tips
13Quantity Available
13Price Per Unit (US $)
13Date Available
13Product Country of Origin
Roche MagNA Pure 96 External Lysis Buffer
14Quantity Available
14Price Per Unit (US $)
14Date Available
14Product Country of Origin
Biomerieux NuciSENS EasyMAG extraction system and supplies
15Quantity Available
15Price Per Unit (US $)
15Date Available
15Product Country of Origin
wfbit
wfstatus
wfdgscommoditymanager
Additional Information
Attachments