Enclosure 2 - AMS Form 043 Pricing Sheet.docx
DOCX document 26 KB Posted
- Solicitation number
- 455740
- Issued by
-
Department of Energy Office of Science
About this file
This is a pricing sheet template (AMS Form-043) for RFQ 455740 issued by Brookhaven National Laboratory for HVAC and Power Rental equipment. The form requires vendors to provide daily, weekly, and monthly rental rates for three specific items: three units of 50-ton AC with generator, one unit of 75-ton AC with generator, and one unit of 80-ton chiller with generator. All units must include necessary ancillary items for proper functioning.
The pricing sheet includes terms for FOB Destination delivery, requires 120-day price firmness, and necessitates vendor registration in SAM with a valid UEI number. The form is managed by Brookhaven Science Associates, LLC under contract to the U.S. Department of Energy, with Lisa C. Gonzales serving as the Senior Contracts Specialist. Vendors must also include pickup/delivery costs and can add additional pricing categories as needed. The form requires company information, authorized signature, and confirmation of agreement to BSA's requirements, terms, conditions, and delivery schedule.
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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:
L. McKnight / 12/14/2020
PPM Manager/Date
Quotation Pricing Sheet
| Reference: | BSA Request for Quote No. 455740 |
| HVAC and Power Rental |
Brookhaven National Laboratory Brookhaven Science Associates, LLC P.O. Box 5000 – Bldg. 902B Upton, NY 11973
| Attention: | Lisa C. Gonzales |
| Sr. Contracts Specialist |
To whom it may concern:
In compliance with your letter of solicitation dated [insert date], we submit our Quotation No. dated , for HVAC and Power Rental.
Item Description
Quantity
Daily Rate
Weekly Rate
Monthly Rate
50 Ton AC w/ Generator (and all needed ancillary items for proper functioning)
75 Ton AC w/ Generator (and all needed ancillary items for proper functioning)
80 Ton Chiller w/ Generator (and all needed ancillary items for proper functioning)
Pickup and Delivery
Miscellaneous / Additional (Offeror is to add any additional categories as needed)
TOTAL PRICE:
This price shall remain firm for (120) days.
The terms of delivery and payment terms are FOB Destination, Net (TBD) Days.
Concurrence:
By signing this 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:
Address Line 2:
Title:
Telephone No.:
Date:
Date Printed 1/30/2025 1 of 1 Date Approved 12/14/2020
File details come from the government source that posted it. Updated .