Attachment 3_Offer Information and Pricing Form_RFP 23-057-S.pdf

OFFEROR INFORMATION AND PRICING FORM

P R I N C E T O N P L A S M A P H Y S I C S L A B O R A T O R Y 1 0 0 S T E L L A R A T O R R D . • P . O . B O X 4 5 1 • P R I N C E T O N • N J • 0 8 5 4 3

TO: PRINCETON UNIVERSITY

PRINCETON PLASMA PHYSICS LABORATORY

ATTENTION: PPPL PROCUREMENT

SUBJECT: REQUEST FOR PROPOSAL (RFP) 23-057-S FOR STATEMENT OF WORK for “Variable Phase Controller for the Neutral Beam High Voltage System”; UI: 20221011; CAT: A2; Revision: 0; Dated: November 1, 2022.

OFFEROR NAME:

BUSINESS ADDRESS:

PART I:

A. OUR FIRM PROPOSES THE FOLLOWING PRICING AS INDICATED BELOW FOR

The performance of the requirements of RFP 23-057-S we submit a TOTAL price of $ _____________________.

Item Description Quantity Cost per piece

Total Cost

DESIGN, FABRICATION, AND

TESTING OF THE VARIABLE

PHASE CONTROLLER

1 $ $

PART II: Please indicate, by checking the appropriate box, if your Firm has provided GSA or EDU Pricing:(if applicable)

______ GSA Contract pricing Suppliers Quote, is based on the GSA Contract Number:

_____________________. Prices Quoted are net of GSA discounts and the terms and conditions of this GSA contract will apply in lieu of PPPL’s terms and conditions if supplier is awarded an order.

Please attached your contract to the pricing forms.

______ PRICE DISCOUNTS: Princeton University is an Accredited Institution of higher learning in the State of New Jersey and manages and operates PPPL under Prime Contract DE-AC02- 09CH11466 with the US Department of Energy. Based on this dual status, PPPL may qualify for academic and/or federal government prices/discounts. Supplier shall quote based on the most favorable discount program available to PPPL. The undersigned hereby certifies that the quoted prices are not in excess of prices charged to any other similar customer for same or similar items/quantities.

OFFEROR INFORMATION AND PRICING FORM

P R I N C E T O N P L A S M A P H Y S I C S L A B O R A T O R Y 1 0 0 S T E L L A R A T O R R D . • P . O . B O X 4 5 1 • P R I N C E T O N • N J • 0 8 5 4 3

PART III: ACCEPTANCE OF SAMPLE TERMS AND CONDITIONS.

1. Please initial the applicable statement below in the space provided (initial one statement only):

I hereby affirm that I have reviewed the terms and conditions set forth in the Sample Subcontract Agreement contained in Section II of the Subject RFP and will accept the terms and conditions set forth therein without exception if a Subcontract is awarded to my firm.

Or

I have reviewed the terms and conditions set forth in the Sample Subcontract Agreement contained in Section II of the Subject RFP. In the event that my firm is selected for award of a Subcontract, I request that the exceptions and/or proposed revisions set forth in the attached sheet(s) be considered by PPPL. I understand that my proposal may be considered to be non-responsive depending on the extent and nature of the proposed exceptions/revisions and my firm’s willingness to discuss or negotiate these proposed exceptions/revisions with PPPL

2. ________ I affirm that I have registered on Princeton Prime.

3. We acknowledge receipt of the following Amendments (if applicable):

Amendment Number Date of Amendment

4. The following individual(s) are authorized to conduct discussions and provide information related to this proposal on behalf of the Offeror:

NAME: NAME:

TITLE: TITLE:

PHONE: PHONE:

EMAIL: EMAIL:

By submission of this signed Offeror Information and Pricing Form, the undersigned hereby certifies that the information provided is current, accurate, and complete as of the date submitted. The Offeror agrees that this proposal will remain valid for 90 days from the closing date specified for this RFP.

Signature of Authorized Individual

Typed Name

Title

Date

AFFIX

CORPORATE

SEAL