B1. Enclosure C- Quote Pricing Sheet_AMS Form 043.docx
DOCX document 77 KB Posted
- Attached to
- Electron Gun Pulser
- Solicitation number
- 481376
- Issued by
-
Department of Energy Office of Science
About this file
This is a quotation and proposal pricing sheet template for Brookhaven National Laboratory's procurement of an Electron Gun Pulser under Request for Quotation/Proposal No. 481376. The form requires offerors to submit a milestone-based payment structure with total pricing in U.S. dollars inclusive of all taxes, fees, customs, duties, and other charges, with the price remaining firm for 90 days. Delivery terms are specified as FOB Destination or Delivered at Place (DAP), with payment terms of Net 30 days for large or foreign businesses and Net 10 days for small businesses. The required 22-week delivery timeline begins after receipt of award.
Offerors must complete the pricing sheet with company information, including SAM registration and UEI number, and certify whether the Electron Gun Pulser qualifies as a commercial or non-commercial item. Export control requirements apply if the country of origin or place of manufacture is located outside the United States, requiring designation of an export control point of contact with phone number and email address. The form includes acknowledgment of BSA's terms and conditions, delivery schedule requirements, and consent to disclosure of proposals to U.S. Government personnel for review. The solicitation is managed by the Department of Energy Office of Science through Brookhaven Science Associates, LLC, with Marie J. Williams designated as the buyer/contract specialist.
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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: 2.0
Effective Date: 9/15/2026
APPROVED BY:
Dedra Blood
Quotation/Proposal Pricing Sheet
| Reference: | BSA Request for Quotation/Proposal No. 481376 |
| Description: Electron Gun Pulser |
Attention: Buyer/Contract Specialist: Marie J. Williams
To whom it may concern: In compliance with your letter of solicitation dated [insert date], we submit our Quotation/Proposal No. 481376: Electron Gun Pulser.
Milestone Payment Structure to be filled in:
| Item |
| Milestone |
| Amount |
| Cumulative Amount |
| 1 |
| Delivery and BSA Acceptance of the Electron Gun Pulser |
| $________ |
| $________ |
Total
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 90 days.
Select: Delivery is FOB Destination or Delivered at Place (DAP)
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/Proposal Pricing Sheet, our firm hereby acknowledges and agrees to BSA's requirements 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:
☐ Commercial item as defined in FAR 2.101 ☐ Non-commercial item
Can you meet delivery timeline of 22 weeks after receipt of award? 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.
Certification: By signing this Quotation/Proposal Pricing Sheet, our firm hereby acknowledges and agrees to BSA's Terms and Conditions, as incorporated into the solicitation and attached documents.
| Company ____________________ |
| Signature __________________ |
| Email Address ________________ |
| Typed Name __________________ |
| SAM UEI #___________________ |
| Title _________________________ |
| Telephone No.(___)____________ |
| Date _________________________ |
Date Printed 9/17/2026 1 of 1 image1.png
File details come from the government source that posted it. Updated .