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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. 469885 |
| Rentals of a fully compliant shielded, re-usable multi-use type A SMAC containers and transportation system for recurring shipments of radioactive waste from BNL to a designated disposal facility to include decontamination and demobilization. The services are estimated at one times annually. | |
Brookhaven National Laboratory Brookhaven Science Associates, LLC P.O. Box 5000 – Bldg. 101 Upton, NY 11973
| Attention: | Mark Brock |
| Subcontracts Supervisor |
To whom it may concern:
In compliance with your letter of solicitation dated [insert date], we submit our Quotation No. ___________________________ dated _______________, for the referenced Combined Synopsis/Request for Quote.
Note: Line Items 1a, 2a, 3a, and 7 are prefilled for estimating purposes only. Actuals will be paid on the contract.
| Item |
| Base Year through XXXX |
| Amount |
| Cumulative Amount |
| 1 |
| Mobilize Empty Clean Container from Alaron, Wampum PA to BNL NY |
| $ |
| $ |
| 1a |
| Miles from Alaron, Wampum, PA to Brookhaven Labs, Brookhaven, NY |
| 395 |
| $130.35 |
| 2 |
| Load Class 7 Rad Shipment form BNL NY to NNSS Mercury NV |
| $ |
| $ |
| 2a |
| Miles from BNL Upton, NY to NNSS Mercury, NV |
| 2605 |
| $859.65 |
| 3 |
| Demobilize Empty Rad contaminated container, Mercury NV to Alaron, Wampum PA |
| $ |
| $ |
| 3a |
| Miles from Mercury, NV to Alaron, Wampum, PA |
| 2280 |
| $752.40 |
| 4 |
| SMAC Survey per container |
| $ |
| $ |
| 6 |
| SMAC Daily Use fee @($$Fill in) per day, up to 30 days and not to exceed 30 days per roundtrip and demobilization. |
| $ |
| $ |
| 8 |
| Cancelation Fee with less than 72 Hours notice |
| $ |
| $ |
| Item |
| Option Year 1 Year through XXXX |
| Amount |
| Cumulative Amount |
| 1 |
| Mobilize Empty Clean Container from Alaron, Wampum PA to BNL NY |
| $ |
| $ |
| 1a |
| Miles from Alaron, Wampum, PA to Brookhaven Labs, Brookhaven, NY |
| 395 |
| $130.35 |
| 2 |
| Load Class 7 Rad Shipment form BNL NY to NNSS Mercury NV |
| $ |
| $ |
| 2a |
| Miles from BNL Upton, NY to NNSS Mercury, NV |
| 2605 |
| $859.65 |
| 3 |
| Demobilize Empty Rad contaminated container, Mercury NV to Alaron, Wampum PA |
| $ |
| $ |
| 3a |
| Miles from Mercury, NV to Alaron, Wampum, PA |
| 2280 |
| $752.40 |
| 4 |
| SMAC Survey per container |
| $ |
| $ |
| 6 |
| SMAC Daily Use fee @($$Fill in) per day, up to 30 days and not to exceed 30 days per roundtrip and demobilization. |
| $ |
| $ |
| 8 |
| Cancelation Fee with less than 72 Hours notice |
| $ |
| $ |
| Item |
| Milestone Option Year 2 through XXXX |
| Amount |
| Cumulative Amount |
| 1 |
| Mobilize Empty Clean Container from Alaron, Wampum PA to BNL NY |
| $ |
| $ |
| 1a |
| Miles from Alaron, Wampum, PA to Brookhaven Labs, Brookhaven, NY |
| 395 |
| $130.35 |
| 2 |
| Load Class 7 Rad Shipment form BNL NY to NNSS Mercury NV |
| $ |
| $ |
| 2a |
| Miles from BNL Upton, NY to NNSS Mercury, NV |
| 2605 |
| $859.65 |
| 3 |
| Demobilize Empty Rad contaminated container, Mercury NV to Alaron, Wampum PA |
| $ |
| $ |
| 3a |
| Miles from Mercury, NV to Alaron, Wampum, PA |
| 2280 |
| $752.40 |
| 4 |
| SMAC Survey per container |
| $ |
| $ |
| 6 |
| SMAC Daily Use fee @($$Fill in) per day, up to 30 days and not to exceed 30 days per roundtrip and demobilization. |
| $ |
| $ |
| 8 |
| Cancelation Fee with less than 72 Hours notice |
| $ |
| $ |
| Item |
| Milestone Option Year 3 through XXXX |
| Amount |
| Cumulative Amount |
| 1 |
| Mobilize Empty Clean Container from Alaron, Wampum PA to BNL NY |
| $ |
| $ |
| 1a |
| Miles from Alaron, Wampum, PA to Brookhaven Labs, Brookhaven, NY |
| 395 |
| $130.35 |
| 2 |
| Load Class 7 Rad Shipment form BNL NY to NNSS Mercury NV |
| $ |
| $ |
| 2a |
| Miles from BNL Upton, NY to NNSS Mercury, NV |
| 2605 |
| $859.65 |
| 3 |
| Demobilize Empty Rad contaminated container, Mercury NV to Alaron, Wampum PA |
| $ |
| $ |
| 3a |
| Miles from Mercury, NV to Alaron, Wampum, PA |
| 2280 |
| $752.40 |
| 4 |
| SMAC Survey per container |
| $ |
| $ |
| 6 |
| SMAC Daily Use fee @($$Fill in) per day, up to 30 days and not to exceed 30 days per roundtrip and demobilization. |
| $ |
| $ |
| 8 |
| Cancelation Fee with less than 72 Hours notice |
| $ |
| $ |
Total Price of all years $Fill in
This price shall remain firm for [fill in # days] days.
The terms of delivery and payment terms are FOB Destination, Net [insert 10 or 30] 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 12/3/2025 1 of 1 Date Approved 12/14/2020
Department of Energy Office of Science