B1 Enclosure C AMS Form 043 Quotation Pricing Sheet.docx
DOCX document 27 KB Posted
- Attached to
- Analytical Services
- Solicitation number
- BSA478026-Solicitation
- Issued by
-
Department of Energy Office of Science
About this file
This is an Acquisition Management System (AMS) Form 043 Quotation/Proposal Pricing Sheet template for Brookhaven Science Associates (BSA) Request for Quotation No. 478026 for Analytical Services. Quoters must complete Enclosure C1 Fee Schedule, which requires pricing for three and seven, fourteen, and thirty-day turnaround times (TAT) across all service categories for the base year and four optional years. The pricing sheet specifies that 24-48 hour turnaround percentages, preparation costs, and compound costs will not be included in the total evaluated price for LPTA evaluation purposes. Quoters must provide a total firm price in U.S. dollars inclusive of all taxes, fees, customs, duties, and other charges, valid for 90 days, with delivery FOB Destination Freight Prepaid and payment terms of Net 30 for large or foreign businesses and Net 10 for small businesses.
The form requires offerors to acknowledge BSA's requirements, terms, conditions, and delivery schedule; confirm current SAM registration and current representations and certifications; and certify their ability to meet timelines specified in the Statement of Work Section 7 regarding Deliverables, Reporting Results, and Electronic Data Management. Quoters must provide company information, contact details, SAM UEI number, authorized signature, and typed name. The form notes that BSA may disclose proposals to U.S. Government personnel for review and will furnish proposals with any confidentiality legends, though BSA is not responsible for subsequent government disclosure. The contact for questions is Buyer/Contract Specialist Mark Brock.
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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:
PPM Manager/Date
Quotation/Proposal Pricing Sheet
| Reference: | Brookhaven Science Associates (BSA) Request for Quotation/Proposal No. 478026 |
| Description: Analytical Services |
Attention: Buyer/Contract Specialist: Mark Brock
To whom it may concern: In compliance with your letter of solicitation dated [insert date], we submit our Quotation/Proposal No. ___________________________ .
Complete RFQ Enclosure C1 Fee Schedule. Fill in TAB’s “Format for Fee Schedule” and “Full Data Price Sheet.” For the “Full Data Price Sheet” fill in prices for the 3 Day TAT, 7 Day TAT, 14 Day TAT, and 30 Day TAT for all categories. Fill in pricing for each option period. Add up pricing for all TATS and place total price below.
Note: Enclosure C1 Fee Schedule: the pricing for the “24-48hr turn around %” and the “Preparation Cost” and the “Compound Cost” (found at the bottom of each page in Enclosure C1 Fee Schedule) will not be added to the TAT pricing and will not be evaluated in the LPTA total evaluated price.
Note: The last TAB “Historical Quantities” provides the average quantity samples over the last 5 years.
Base Year $_____________ Opt Yr 1 $_____________ Opt Yr 2 $_____________ Opt Yr 3 $_____________ Opt Yr 4 $_____________
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.
Delivery is FOB Destination, Freight Prepaid.
Payment terms are Net 30 (Large or Foreign Businesses), Net 10 (Small Businesses) Days.
*Phone #: [insert phone #] *Email Address: [insert email address]
Company Address: [insert address]
Concurrence:
By signing this Quotation/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:
Can you meet timelines listed in the SOW, Section 7, Deliverables, Reporting Results and Electronic Data Management? If yes, check this box: ☐
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 __________________ |
| Email Address ________________ |
| Typed Name __________________ |
| SAM UEI #___________________ |
| Title _________________________ |
| Telephone No.(___)____________ |
| Date _________________________ |
Date Printed 9/28/2026 1 of 1 Date Approved 12/14/2020
File details come from the government source that posted it. Updated .