B1. Enclosure B AMS-043.pdf
PDF 148 KB Posted
- Attached to
- DUNE AB EC Molex*No Substitutes*
- Solicitation number
- AH478143
- Issued by
-
Department of Energy Office of Science
About this file
This is a Quotation Pricing Sheet (AMS-Form-043) issued by Brookhaven National Laboratory, managed by Brookhaven Science Associates, LLC under contract to the U.S. Department of Energy. The document serves as a template for suppliers to submit pricing for BSA Request for Quotation No. AH478557 for DUNE AB EC Molex components with no substitutes permitted.
The procurement requires 555,418 units (EA) of MOLEX 47615-0001 connectors. Suppliers must provide a total firm fixed price, lead time, and country of origin. Pricing terms specify FOB Destination with Freight Prepaid and Net 10 Days payment terms. The quoted price shall remain firm for 60 days from the quotation date. By signing the form, the supplier acknowledges and agrees to BSA's requirements, terms and conditions, delivery schedule, and commits to provide necessary resources to meet the delivery timeline. The form was approved on 12/14/2020 and printed on 5/11/2026. Contact information is provided for Aaron Hagler, Buyer I, at Brookhaven National Laboratory in Upton, New York.
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Other files
| File | Type | Posted |
|---|---|---|
| B1. Enclosure A Draft PO.pdf | ||
| B1. AH478143.pdf | ||
| BSA_Commercial_Product_Rev24.pdf |
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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. AH478557 DUNE AB EC Molex *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 Molex *No Substitutes*].
Line Item Description QTY UOM Unit Price Merchandise Amount
1 MOLEX 47615-0001 555,418 EA
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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 10 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:
File details come from the government source that posted it. Updated .