B.1c_485362 - Enclosure C. AMS-Form-043 Quote Sheet.docx
DOCX document 76 KB Posted
- Attached to
- Ultra-High Vacuum Suitcase
- Solicitation number
- 485362
- Issued by
-
Department of Energy Office of Science
About this file
This is an AMS-Form-043 Quotation/Proposal Pricing Sheet for Brookhaven National Laboratory's Request for Quotation No. 485362 for an Ultra-High Vacuum Suitcase. The form is a template requiring offerors to submit pricing information in U.S. dollars, inclusive of all taxes, fees, customs, duties, and other charges, with a price validity period of 60 days. Delivery terms must specify either DAP (Delivered at Place) or FOB Destination, with payment terms of Net 30 days for large or foreign businesses and Net 10 days for small businesses.
Offerors must complete required fields including company name, authorized signature, SAM registration confirmation, and current representations and certifications. The form requires identification of whether the item is commercial or non-commercial under FAR 2.101, confirmation of ability to meet the delivery timeline, and if applicable, country of origin, HTS code, and export control point of contact information. By signing, the offeror acknowledges agreement to BSA's requirements, delivery schedule, and terms and conditions. The solicitation is managed by Brookhaven Science Associates, LLC on behalf of the U.S. Department of Energy, with Andrew S. Pascoe identified as the buyer/contract specialist.
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Text version
PROCUREMENT AND PROPERTY MANAGEMENT DIVISION
BROOKHAVEN NATIONAL LABORATORY
Managed by Brookhaven Science Associates, LLC under contract to the U.S. Department of Energy
ACQUISITION MANAGEMENT SYSTEM FORM
Form No. AMS-Form-043
Revision: 2.0
Effective Date: 9/15/2026
APPROVED BY:
Dedra Blood
Quotation/Proposal Pricing Sheet
| Reference: | BSA Request for Quotation/Proposal No. 485362 |
| Description: Ultra-High Vacuum Suitcase |
Attention: Buyer/Contract Specialist: Andrew S. Pascoe
To whom it may concern: In compliance with your letter of solicitation dated 13 November 2026, we submit our Quotation/Proposal No. ___________________________
Total Price* $_____________ *Must be in U.S. Dollars and inclusive of all taxes, fees, customs, duties and other charges.
This price shall remain firm for 60 days.
Delivery Terms are: [Insert either DAP or FOB Destination] Payment terms are Net 30 (Large or Foreign Businesses), Net 10 (Small Businesses) Days.
Country of Origin or Place of Manufacture: [insert place] *Item HTS CODE: [insert HTS code]
*Company’s Export Control Point of Contact (POC): [insert POC] *Phone #: [insert phone #] *Email Address: [insert email address] *Required if country of origin or manufacture is located outside of the U.S.
Concurrence:
By signing this Quotation/Proposal Pricing Sheet, our firm hereby acknowledges and agrees to BSA's requirements and delivery schedule and agrees to provide the resources necessary to meet BSA's delivery schedule. We affirm we are registered in SAM and our representations and certifications as well as our small business size status (if applicable) are current and complete. Additionally, please certify the following:
Item commercial status. Check one of the following by clicking the ☐ next to the associated option:
☐ Commercial item as defined in FAR 2.101 ☐ Non-commercial item
Can you meet delivery timeline? If yes, check this box: ☐ If not, please provide your forecasted delivery date: [insert delivery date]
Notice is hereby provided that BSA may disclose offeror proposals to U.S. Government personnel for review. In such case, BSA will furnish the proposal to the Government with any confidentiality legends included by the Offeror, but BSA is not responsible for any subsequent disclosure by the U.S. Government.
Certification: By signing this Quotation/Proposal Pricing Sheet, our firm hereby acknowledges and agrees to BSA's Terms and Conditions, as incorporated into the solicitation and attached documents.
| Company ____________________ |
| Signature __________________ |
| Email Address ________________ |
| Typed Name __________________ |
| SAM UEI #___________________ |
| Title _________________________ |
| Telephone No.(___)____________ |
| Date _________________________ |
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