Enclosure 2 - AMS Form 043 Pricing Sheet.docx

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Transition Radiation Tracker Support RFQ
Solicitation number
457907
Issued by

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This is a pricing sheet template (AMS Form 043) for Brookhaven National Laboratory's Request for Quotation No. 457907 for Transition Radiation Tracker Support. The form is managed by Brookhaven Science Associates, LLC under contract to the U.S. Department of Energy.

The form requires vendors to submit their total price quote which must remain firm for 90 days, with delivery terms of FOB Destination. Vendors must acknowledge BSA's requirements, terms, conditions, and delivery schedule, confirm their SAM registration status, and provide their UEI number. The form includes fields for company information, authorized signature, and contact details. Questions about the RFQ should be directed to Lisa C. Gonzales, Contracts Specialist, by January 21, 2025.

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Other files

File Type Posted
1. RFQ Letter 457907.pdf PDF
Enclosure 5 - Form W-9 (2024).pdf PDF
Enclosure 1 - Draft Award 457907 w Appendices.pdf PDF
Enclosure 3 - AMS-FORM-050 - Annual Representations and Certifications - Rev1.0.pdf PDF
Enclosure 6 - Form W-8 (Foreign Vendor).pdf PDF
Enclosure 4 - Vendor ACH Authorization Form.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. 457907 Transition Radiation Tracker Support

Brookhaven National Laboratory Brookhaven Science Associates, LLC P.O. Box 5000 – Bldg. 902B Upton, NY 11973

Attention:Lisa C. Gonzales
Contracts Specialist

To whom it may concern:

In compliance with your letter of solicitation dated _____, we submit our Quotation No. ___________________________ dated _______________, for Transition Radiation Tracker Support for Brookhaven Science Associates, LLC.

Total Price……………………………………………………………… $_____________

This price shall remain firm for Ninety (90) days.

The terms of delivery and payment terms are FOB Destination, Net (TBD) 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. We affirm we are registered in SAM and our representations and certifications as well as our small business size status are current and complete. The UEI number associated with our SAM profile is: _________.

Company _____________________
Signature _____________________
Address ______________________
Typed Name __________________
______________________________
Title _________________________
Telephone No.___(___)__________
Date _________________________

Date Printed 1/14/2025 1 of 1 Date Approved 12/14/2020

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