KEMENTERIAN KESEHATAN RI
DIREKTORAT JENDERAL PELAYANAN KESEHATAN BALAI BESAR KESEHATAN PARU MASYARAKAT SURAKARTAJl. Profesor dr. R. Soeharso Nomor 28 Surakarta 57144 Telepone/Faksimile (0271) 713055, 720002 Laman : www.bbkpmska.com; Pos-el (E-mail) : [email protected]
PENGUMUMAN PEMENANG LELANG
PENGADAAN ITEMIZED OBAT-OBATAN NON E-CATALOG BBKPM SURAKARTA TAHUN 2017 Nomor : 1939/Obat/Pokja-ULP/VI/2017
Dengan ini diberitahukan bahwa setelah diadakan evaluasi penawaran dan evaluasi kualifikasi sesuai dengan peraturan yang berlaku, maka Pokja Pengadaan Barang/Jasa Belanja Non Modal ULP Balai Besar Kesehatan Paru Masyarakat Surakarta Tahun Anggaran 2017 telah menetapkan pemenang Pelelangan Pengadaan Itemized Obat-Obatan Non E-Catalog BBKPM Surakarta Tahun 2017 dengan nilai HPS sebesar Rp 836.752.875,- sebagai berikut :
Terlampir
Masa sanggah dari tanggal 07 Juni 2017 s/d 08 Juni 2017, secara elektronik melalui Aplikasi SPSE atas penetapan pemenang kepada Pokja Pengadaan Barang/Jasa Belanja Non Modal ULP Balai Besar Kesehatan Paru Masyarakat Surakarta.
Surakarta, 07 Juni 2017 Pokja Pengadaan Barang/Jasa Belanja Non Modal ULP BBKPM Surakarta
Ketua,
Tri Yanta, SKM, M.Kes
Nomor : 1939/Obat/Pokja-ULP/VI/2017
Tanggal : 07 Juni 2017 Calon Pemenang 1
Nama Penyedia : PT. Sukses Mandiri Farma
Alamat : Gronong Rt.02, Ds.Sidodadi, Masaran, Sragen
Harga Penawaran Total : Rp.
505.374.850,-Harga Penawaran Total terkoreksi : Rp.
505.374.850,-Harga Penawaran item yang lulus : Rp.
505.374.850,-Harga Negosiasi yang disepakati : Rp. 504.749.850
,-Dengan item barang yang dimenangkan :
NO NAMA ITEM OBAT JUMLA H SATUA N HPS PENAWARAN PT. SUKSES MANDIRI FARMA SETELAH NEGOSIASI HARGA ITEM SATUAN TERENDA H JUMLAH HARGA (RP) KETERANGA N PERUSAHAA N PENAWAR TERENDAH HARGA SATUAN (RP) JUMLAH HARGA (RP) HARGA SATUAN (RP) JUMLAH HARGA (RP) 1 AB Vask 10 mg 380 tablet 10,120 3,845,600 10,120 3,845,600 10,120 3,845,600 LULUS PT.SUKSES MANDIRI FARMA 2 Aclam tablet 100 tablet 13,200 1,320,000 13,200 1,320,000 13,200 1,320,000 LULUS PT.SUKSES MANDIRI FARMA 3 Amadiab 2 mg 1,000 tablet 4,400 4,400,000 4,400 4,400,000 4,400 4,400,000 LULUS PT.SUKSES MANDIRI FARMA 4 Asam Traneksamat 500 mg 5,000 tablet 2,690 13,450,00 0 1,850 9,250,000 1,850 9,250,000 LULUS PT.SUKSES MANDIRI FARMA 5 Cefat 500 1,200 kapsul 10,615 12,738,00 0 10,615 12,738,00 0 10,615 12,738,00 0 LULUS PT.SUKSES MANDIRI FARMA
6 Cefila 100 800 kapsul 19,250 15,400,00 0 19,250 15,400,00 0 19,250 15,400,00 0 LULUS PT.SUKSES MANDIRI FARMA 7 Cefila 200 500 kapsul 30,250 15,125,00 0 30,250 15,125,00 0 30,250 15,125,00 0 LULUS PT.SUKSES MANDIRI FARMA 8 Cefila sirup kering 100
mg/5 ml 60 botol 85,800 5,148,000 85,800 5,148,000 85,800 5,148,000 LULUS PT.SUKSES MANDIRI FARMA 9 Cefxon injeksi 1 g 60 vial 209,00 0 12,540,00 0 209,00 0 12,540,00 0 209,000 12,540,00 0 LULUS PT.SUKSES MANDIRI FARMA 10 Cepraz injeksi 1 g 60 vial 154,00 0 9,240,000 154,00 0 9,240,000 154,000 9,240,000 LULUS PT.SUKSES MANDIRI FARMA 11 Ciflos 500 mg 300 tablet 13,200 3,960,000 13,200 3,960,000 13,200 3,960,000 LULUS PT.SUKSES MANDIRI FARMA 12 Cravox 500 mg 800 tablet 35,200 28,160,00 0 35,200 28,160,00 0 35,200 28,160,00 0 LULUS PT.SUKSES MANDIRI FARMA 13 Cravox infus 500 mg 40 botol 242,00 0 9,680,000 242,00 0 9,680,000 242,000 9,680,000 LULUS PT.SUKSES MANDIRI FARMA 14 Dom 10 500 tablet 3,630 1,815,000 3,630 1,815,000 3,630 1,815,000 LULUS PT.SUKSES MANDIRI FARMA 15 Dom suspensi 20 botol 41,250 825,000 41,250 825,000 41,250 825,000 LULUS PT.SUKSES MANDIRI FARMA 16 Extropect sirup 70 botol 26,400 1,848,000 26,400 1,848,000 26,400 1,848,000 LULUS PT.SUKSES MANDIRI FARMA 17 Fastor 20 60 tablet 12,100 726,000 12,100 726,000 12,100 726,000 LULUS PT.SUKSES MANDIRI FARMA 18 Forasma 500 tablet 1,320 660,000 1,320 660,000 1,320 660,000 LULUS PT.SUKSES MANDIRI FARMA 19 Galflux 1,000 tablet 3,960 3,960,000 3,960 3,960,000 3,960 3,960,000 LULUS PT.SUKSES MANDIRI FARMA
20 Getidin injeksi 25 100 ampul 20,900 2,090,000 20,900 2,090,000 20,900 2,090,000 LULUS MANDIRI FARMA 21 Goforan injeksi 1 g 50 vial 157,30 0 7,865,000 157,30 0 7,865,000 157,300 7,865,000 LULUS PT.SUKSES MANDIRI FARMA 22 Goron 25 mg 200 tablet 1,700 340,000 1,700 340,000 1,700 340,000 LULUS PT.SUKSES MANDIRI FARMA 23 Imunos Plus sirup
50 botol 88,000 4,400,000 88,000 4,400,000 88,000 4,400,000 LULUS PT.SUKSES MANDIRI FARMA 24 Imunos Plus tablet
900 tablet 9,130 8,217,000 9,130 8,217,000 9,130 8,217,000 LULUS PT.SUKSES MANDIRI FARMA 25 Imunos sirup 15 botol 63,250 948,750 63,250 948,750 63,250 948,750 LULUS PT.SUKSES MANDIRI FARMA 26 Lacedim injeksi 1 g 60 vial 231,00 0 13,860,00 0 231,00 0 13,860,00 0 231,000 13,860,00 0 LULUS PT.SUKSES MANDIRI FARMA 27 Lameson 125 100 vial 95,700 9,570,000 95,700 9,570,000 95,700 9,570,000 LULUS PT.SUKSES MANDIRI FARMA 28 Lameson 4 1,000 tablet 3,355 3,355,000 3,355 3,355,000 3,355 3,355,000 LULUS PT.SUKSES MANDIRI FARMA 29 Lapicef 500 1,000 tablet 10,450 10,450,00 0 10,450 10,450,00 0 10,450 10,450,00 0 LULUS PT.SUKSES MANDIRI FARMA 30 Lapicef sirup kering 125
mg/5 ml 60 botol 46,200 2,772,000 46,200 2,772,000 46,200 2,772,000 LULUS PT.SUKSES MANDIRI FARMA 31 Lapifed sirup 300 botol 22,000 6,600,000 22,000 6,600,000 22,000 6,600,000 LULUS PT.SUKSES MANDIRI FARMA 32 Lapiflox 500 mg 200 tablet 13,200 2,640,000 13,200 2,640,000 13,200 2,640,000 LULUS PT.SUKSES MANDIRI FARMA 33 Lapisiv sirup 200 botol 19,250 3,850,000 19,250 3,850,000 19,250 3,850,000 LULUS PT.SUKSES MANDIRI FARMA
34 Lapisiv tablet 4,300 tablet 1,100 4,730,000 1,100 4,730,000 1,100 4,730,000 LULUS PT.SUKSES MANDIRI FARMA 35 Lasal 2 tablet 6,000 tablet 1,155 6,930,000 1,155 6,930,000 1,155 6,930,000 LULUS PT.SUKSES MANDIRI FARMA 36 Lasal Expectorant sirup
300 botol 37,950 11,385,00 0 37,950 11,385,00 0 37,950 11,385,00 0 LULUS PT.SUKSES MANDIRI FARMA 37 Lasgan 30 1,000 kapsul 13,200 13,200,00 0 13,200 13,200,00 0 13,200 13,200,00 0 LULUS PT.SUKSES MANDIRI FARMA 38 Lefos 500 mg tab 300 tablet 36,300 10,890,00 0 36,300 10,890,00 0 36,300 10,890,00 0 LULUS PT.SUKSES MANDIRI FARMA 39 Lefos infus 500 mg 50 botol 280,50 0 14,025,00 0 280,50 0 14,025,00 0 280,500 14,025,00 0 LULUS PT.SUKSES MANDIRI FARMA 40 Lefos infus 750 mg 30 botol 319,00 0 9,570,000 319,00 0 9,570,000 319,000 9,570,000 LULUS PT.SUKSES MANDIRI FARMA 41 Lesipar 800 tablet 3,630 2,904,000 3,630 2,904,000 3,630 2,904,000 LULUS PT.SUKSES MANDIRI FARMA 42 Meloksikam 15 mg 4,200 tablet 930 3,906,000 875 3,675,000 875 3,675,000 LULUS PT.SUKSES MANDIRI FARMA 43 Myonep 50 mg 100 tablet 4,400 440,000 4,400 440,000 4,400 440,000 LULUS PT.SUKSES MANDIRI FARMA 44 Nonemi 2,600 tablet 1,430 3,718,000 1,430 3,718,000 1,430 3,718,000 LULUS PT.SUKSES MANDIRI FARMA 45 Nucef 100 kapsul 1,200 kapsul 20,350 24,420,00 0 20,350 24,420,00 0 20,350 24,420,00 0 LULUS PT.SUKSES MANDIRI FARMA 46 Nufit sirup 20 botol 60 ml 63,250 1,265,000 63,250 1,265,000 63,250 1,265,000 LULUS PT.SUKSES MANDIRI FARMA 47 Nufit tablet 500 tablet 7,600 3,800,000 7,600 3,800,000 7,600 3,800,000 LULUS PT.SUKSES MANDIRI FARMA
48 Nystin 100.000 IU/ml suspensi 10 botol 12 ml 38,500 385,000 38,500 385,000 38,500 385,000 LULUS MANDIRI FARMA 49 Pehadoxin Forte 2,600 tablet 700 1,820,000 700 1,820,000 700 1,820,000 LULUS PT.SUKSES MANDIRI FARMA 50 Pro TB 4 6,000 tablet 5,500 33,000,00 0 5,500 33,000,00 0 5,500 33,000,00 0 LULUS PT.SUKSES MANDIRI FARMA 51 Pro TB Kid (Pro TB 3)
2,800 tablet 4,700 13,160,00 0 4,700 13,160,00 0 4,700 13,160,00 0 LULUS PT.SUKSES MANDIRI FARMA 52 Pulmicort respules 0,5 mg/ml @ 2ml 2,100 ampul 21,200 44,520,00 0 21,200 44,520,00 0 21,200 44,520,00 0 LULUS PT.SUKSES MANDIRI FARMA 53 Stenirol 8 tab 3,000 tablet 5,060 15,180,00 0 5,060 15,180,00 0 5,060 15,180,00 0 LULUS PT.SUKSES MANDIRI FARMA 54 Stenirol injeksi 150 vial 88,000 13,200,00 0 88,000 13,200,00 0 88,000 13,200,00 0 LULUS PT.SUKSES MANDIRI FARMA 55 Teranol injeksi 30 mg/ml 30 ampul 35,750 1,072,500 35,750 1,072,500 35,750 1,072,500 LULUS PT.SUKSES MANDIRI FARMA 56 Tiriz 10 mg 700 tablet 3,960 2,772,000 3,960 2,772,000 3,960 2,772,000 LULUS PT.SUKSES MANDIRI FARMA 57 Tiriz oral drops 10 mg/ml
100 botol 20 ml 66,000 6,600,000 66,000 6,600,000 66,000 6,600,000 LULUS PT.SUKSES MANDIRI FARMA 58 Vipalbumin 3,000 kapsul 6,050 18,150,00 0 6,050 18,150,00 0 6,050 18,150,00 0 LULUS PT.SUKSES MANDIRI FARMA 59 Xidane licaps 600 kapsul 7,600 4,560,000 7,600 4,560,000 7,600 4,560,000 LULUS PT.SUKSES MANDIRI FARMA 60 Zibramax 500 mg 600 tablet 36,300 21,780,00 0 36,300 21,780,00 0 36,300 21,780,00 0 LULUS PT.SUKSES MANDIRI FARMA
Surakarta, 07 Juni 2017
Pokja Pengadaan Barang/Jasa Belanja Non Modal ULP BBKPM Surakarta Ketua,
Tri Yanta, SKM, M.Kes
