B1. Amendment 1 Enclosure B AMS-043.pdf
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- Solicitation number
- AH478133
- Issued by
-
Department of Energy Office of Science
About this file
This is a Quotation Pricing Sheet template issued by Brookhaven National Laboratory (BNL), managed by Brookhaven Science Associates, LLC under contract to the U.S. Department of Energy. The form (AMS-Form-043, Revision 0.1) was approved on December 14, 2020, and serves as a standardized template for vendors to submit pricing in response to BNL requests for quotation.
The document references BSA Request for Quotation No. AH478133 for DUNE AB EC Kemet components with a "No Substitutes" specification. The line items specify nine distinct products: five line items for KEMET C2225C392JGGACTU capacitors (ranging from 45,500 to 46,000 each), three line items for KEMET C2220C562JFGACTU capacitors (ranging from 29,500 to 77,500 each), and one line item for KEMET R76UR31004030J resistors (1,232 units). All quantities are listed in units of each (EA). The template includes blank fields for unit prices and merchandise amounts to be completed by the responding vendor. Pricing terms specify a firm fixed price valid for 60 days, with FOB Destination, Freight Prepaid, and Net 30 Days payment terms. By signing the form, vendors acknowledge agreement with BNL's requirements, terms and conditions, and delivery schedule. The document requires vendor information including company name, address, contact person, telephone number, signature, and authority information.
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Text version
Enclosure B
Date Printed 5/11/2026 1 of 3 Date Approved 12/14/2020
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 No. 0.1
APPROVED BY:
L. McKnight / 12/14/2020
PPM Manager/Date Quotation Pricing Sheet
Reference: BSA Request for Quotation No. AH478133 DUNE AB EC Kemet *No Substitutes*
Brookhaven National Laboratory Brookhaven Science Associates, LLC P.O. Box 5000 – Bldg. 101 Upton, NY 11973
Attention: Aaron Hagler Buyer I
To whom it may concern:
In compliance with your letter of solicitation dated 5/11/2026, we submit our Quotation No.
___________________________ dated _______________, for [DUNE AB EC Kemet *No Substitutes*].
Line Item Description QTY UOM
Unit Price Merchandise Amount
1 KEMET C2225C392JGGACTU 45500.0000 EA
2 KEMET C2225C392JGGACTU 46000.0000 EA
3 KEMET C2225C392JGGACTU 45500.0000 EA
4 KEMET C2225C392JGGACTU 46000.0000 EA
5 KEMET C2225C392JGGACTU 46000.0000 EA
6 KEMET C2220C562JFGACTU 29500.0000 EA
7 KEMET C2220C562JFGACTU 77500.0000 EA
8 KEMET C2220C562JFGACTU 72000.0000 EA
9 KEMET R76UR31004030J 1232.0000 EA
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Aaron Hagler Highlight
Aaron Hagler Highlight
Aaron Hagler Highlight
Date Printed 5/11/2026 2 of 3 Date Approved 12/14/2020
Total Firm Fixed Price $_____________
Lead Time ______________
Country of Origin _________________
This price shall remain firm for [60] days.
The terms of delivery and payment terms are FOB Destination, Freight Prepaid, Net 30 Days.
Concurrence:
By signing this Quotation Pricing Sheet, our firm hereby acknowledges and agrees to BSA's requirements, terms and conditions, and delivery schedule, and agrees to provide the resources necessary to meet BSA's delivery schedule.
Company _____________________ Signature _____________________
Address ______________________ Typed Name __________________
______________________________ Title _________________________
Telephone No. (___)______________ Date _________________________
Date Printed 5/11/2026 3 of 3 Date Approved 12/14/2020
Concurrence:
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