B.1c_476546 - Enclosure C. AMS-Form-043 Quote Sheet.docx
DOCX document 24 KB Posted
- Solicitation number
- 476546
- Issued by
-
Department of Energy Office of Science
About this file
This is an Acquisition Management System (AMS) Form 043 quotation pricing sheet template for Brookhaven National Laboratory's Request for Quotation No. 476546. The solicitation seeks pricing for a Scanning Electrochemical Microscope (SECM) System and an associated Data Acquisition Computer, with quotes to be submitted to Andrew S. Pascoe, Contracts Specialist, at Brookhaven National Laboratory in Upton, New York. Quoters must provide unit prices and extended amounts for each line item, with all pricing to be expressed in U.S. dollars and inclusive of taxes, fees, customs, duties, and other charges.
The quotation pricing sheet specifies standard commercial terms including Net 30 payment terms for large or foreign businesses and Net 10 for small businesses, with delivery terms to be specified as either DAP (Delivered at Place) or FOB Destination. Vendors must identify the country of origin or place of manufacture and provide firm pricing for a specified number of days. If the country of origin or manufacture is located outside the United States, vendors must provide export control information including a designated point of contact, phone number, and email address. The form requires vendor concurrence and signature, confirming the firm's acknowledgment of BSA's requirements, terms and conditions, and delivery schedule.
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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
Quotation Pricing Sheet
| Reference: | BSA Request for Quotation No. 476546 |
| Scanning Electrochemical Microscope (SECM) System |
Brookhaven National Laboratory Brookhaven Science Associates, LLC P.O. Box 5000 – Bldg. 101 Upton, NY 11973
| Attention: | Andrew S. Pascoe |
| Contracts Specialist |
To whom it may concern:
In compliance with your letter of solicitation dated [insert date], we submit our Quotation No. ___________________________ dated _______________, for the Scanning Electrochemical Microscope (SECM) System.
| Line |
| Description |
| Quantity |
| UoM |
| Unit Price |
| Extended Amount |
| 1 |
| Scanning Electrochemical Microscope (SECM) System |
| 1 |
| Each |
| 2 |
| Data Acquisition Computer |
| 1 |
| Each |
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 [fill in # days] days.
The terms of delivery terms: [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 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 5/13/2026 1 of 1 Date Approved 12/14/2020
File details come from the government source that posted it. Updated .