Enclosure 2 - AMS Form 043 Pricing Sheet.docx
DOCX document 28 KB Posted
- Solicitation number
- 473142
- Issued by
-
Department of Energy Office of Science
About this file
This document is an Acquisition Management System (AMS) Form 043 Pricing Sheet for a Request for Quotation (RFQ) 473142 issued by Brookhaven National Laboratory (BNL). The solicitation is for a noise cancellation system to reduce background electromagnetic fields for a new scanning transmission electron microscope (STEM) at the Molecular Foundry at Lawrence Berkeley National Laboratory (LBL). The procurement is classified under NAICS code 334519 with a size standard of 600 employees, and is being conducted as a full and open competition.
The pricing sheet allows vendors to quote for a dual cancellation system and installation services, with pricing to remain firm for 90 days. Delivery terms are FOB Destination with payment terms to be determined. Vendors must be registered in the System for Award Management (SAM) and confirm their small business status. The solicitation is issued by the Department of Energy Office of Science through Brookhaven Science Associates, LLC, with the goal of optimizing the performance of scientific equipment through electromagnetic noise reduction.
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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 Quotation No. 473142 to furnish all labor, services, materials, and equipment to reduce the background electromagnetic fields via noise cancellation system at Lawrence Berkeley National Laboratory (LBL).
Brookhaven National Laboratory Brookhaven Science Associates, LLC P.O. Box 5000 – Bldg. 101W2 Upton, NY 11973
| Attention: | Sandra Moran |
| Contracts Specialist |
To whom it may concern:
In compliance with your letter of solicitation dated _____, we submit our Quotation No. ___________________________ dated _______________, for labor, services, materials, and equipment to reduce the background electromagnetic fields via noise cancellation system at Lawrence Berkeley National Laboratory (LBL).
| Item |
| Product/Service |
| Description |
| Sales Price |
| 1 |
| Dual Cancellation System |
| 2 |
| Installation Services |
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 1/15/2026 1 of 1 Date Approved 12/14/2020
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