B.1 Enclosure 6 Proposal Pricing Sheet.docx
DOCX document 26 KB Posted
- Attached to
- HRD Shield Enclosure
- Solicitation number
- 479913
- Issued by
-
Department of Energy Office of Science
About this file
This is a Proposal Pricing Sheet template for the HRD Shield Enclosure procurement (RFP No. 479913) issued by Brookhaven Science Associates, LLC on behalf of Brookhaven National Laboratory under the Department of Energy. The solicitation requires offerors to submit pricing for four deliverables: BSA receipt and acceptance of the Preliminary Design Review, receipt and acceptance of the Final Design Review, receipt and acceptance of the beamline shielding enclosures, and installation and acceptance of the beamline shielding enclosures. The total price must be submitted in U.S. dollars and must be inclusive of all taxes, fees, customs, duties, and other charges, with the price remaining firm for 180 days.
Offerors must specify delivery terms (either FOB Destination or Freight Prepaid DAP) and payment terms (Net 30 Days for large businesses or Net 10 Days for small businesses). The template requires identification of country of origin or place of manufacture and, if applicable outside the U.S., an export control point of contact with associated contact information and HTS code. Offerors must certify their commercial status (standard catalog item, modified catalog item, or non-commercial item), confirm their ability to meet the delivery timeline, and acknowledge their current SAM registration and representations and certifications. All proposals must be signed by an authorized company representative and submitted to Jayce M. Blood, Subcontracts Manager, at Brookhaven National Laboratory.
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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 No. 0.1
APPROVED BY:
L. McKnight / 12/14/2020
PPM Manager/Date
Proposal Pricing Sheet
| Reference: | BSA Request for Proposal No. 479913 |
| HRD Shield Enclosure |
Brookhaven National Laboratory Brookhaven Science Associates, LLC P.O. Box 5000 – Bldg. 101 Upton, NY 11973
| Attention: | Jayce M. Blood |
| Subcontracts Manager |
To whom it may concern:
In compliance with your letter of solicitation dated [insert date], we submit our Proposal No. ___________________________ dated _______________, for the HRD Shield Enclosure.
| No. |
| Description |
| Amount |
| 1. |
| BSA receipt and acceptance of the Preliminary Design Review. |
| 2. |
| BSA receipt and acceptance of the Final Design Review. |
| 3. |
| BSA receipt and acceptance of the beamline shielding enclosures. |
| 4. |
| Installation and acceptance by BSA of the beamline shielding enclosures. |
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 180 days.
The terms of delivery: [input either FOB Destination or Freight Prepaid DAP]
The payment terms: [input Net 30 Days for large business or Net 10 Days for small business.]
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 Proposal 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. 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:
☐ Standard catalog item ☐ Modified catalog item ☐ 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.
| Company _____________________ |
| Signature _____________________ |
| Address ______________________ |
| Typed Name __________________ |
| SAM UEI #____________________ |
| Title _________________________ |
| Telephone No.___(___)__________ |
| Date _________________________ |
Date Printed 8/5/2026 1 of 1 Date Approved 12/14/2020
File details come from the government source that posted it. Updated .