C. Quotation Pricing Sheet AMS 43.docx

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High Power Motor Control System
Solicitation number
MH476893
Issued by

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This is a Quotation Pricing Sheet template (Form AMS-043) issued by Brookhaven National Laboratory, managed by Brookhaven Science Associates, LLC under Department of Energy contract. The form is designed for vendors to submit pricing quotations in response to Request for Quotation (RFQ) No. MH476893 for a High Power Motor Control System.

The solicitation requires quotation of three line items: (1) Qty. 1 AB 20F1AND302JN0NNNNN Powerflex 753 AC Package D Drive with specific wiring diagram for plant configuration (PN: M7077824, UPC: 88950855482); (2) Qty. 1 AB 20-HIM-A6 packaged series A (PN: M3459606, UPC: 82091995996); and (3) Qty. 1 AB 20-750-2262D-2R IO card for Powerflex 750 Input/Output Module 120VAC (PN: M3459607, UPC: 88495106253). Quotations must be submitted to mhoward@bnl.gov with the completed pricing sheet and Draft PO (Enclosure A). Pricing terms are FOB Destination with Net 10 Days payment terms. Vendors must certify acknowledgment of BSA's requirements, terms and conditions, and delivery schedule. The quotation pricing sheet template requires vendors to specify country of manufacture, lead time, total price, and price validity period.

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Other files

File Type Posted
RFQ-MH 476893.pdf PDF
A. Draft PO MH476893.pdf PDF
E. W-9 Form - For information only.pdf PDF
Attachment 1 to Enclosure A - BNL QA-101.pdf PDF
B. AMS 50 Reps and Certs - For information only.pdf PDF
D. Vendor ACH Athorization Form - For information only.pdf PDF
F. W-8 Form - For information only.pdf PDF

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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.: MH476893

Brookhaven National Laboratory Brookhaven Science Associates, LLC P.O. Box 5000 – Bldg.

Upton, NY 11973

Attention:

To whom it may concern:

In compliance with your letter of solicitation dated ___________________, we submit our Quotation No.

___________________________ dated _______________, for _____________________________________.

Country of Manufacture: ______________

Lead Time: _________________

Total Price $_____________

This price shall remain firm for _________________days.

The terms of delivery and payment terms are FOB Destination, 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 3/23/2026 1 of 1 Date Approved 12/14/2020

File details come from the government source that posted it. Updated .