Enclosure 2 - AMS Form 043 Pricing Sheet.docx
DOCX document 29 KB Posted
- Attached to
- RFQ 471924 DUNE VD Warm Bias SHV Cables
- Solicitation number
- 471924
- Issued by
-
Department of Energy Office of Science
About this file
This is an Acquisition Management System (AMS) Form 043 Pricing Sheet template for Brookhaven Science Associates, LLC (BSA), the operator of Brookhaven National Laboratory under a U.S. Department of Energy contract. The form is designed to collect quotation pricing for Request for Quotation (RFQ) No. 471924 regarding DUNE FD-VD CRP FC Bias SHV Warm Cables.
The requirement involves four cable configurations with specific quantities: 170 units of 14-meter DUNE VD warm CRP/FC bias SHV cables (DFDVD-HV-WSHV-14), 120 units of 18-meter cables (DFDVD-HV-WSHV-18), 180 units of 26-meter cables (DFDVD-HV-WSHV-26), and 140 units of 30-meter cables (DFDVD-HV-WSHV-30). Vendors are required to provide unit pricing for each cable type and calculate a total overall price. Quotations must remain firm for 90 days, with delivery and payment terms to be determined. Vendors must acknowledge BSA's requirements, terms, conditions, and delivery schedule; confirm current SAM registration and representations and certifications; and provide their Unique Entity Identifier (UEI) number. Questions regarding the RFQ should be directed to Lisa C. Gonzales, Contracts Specialist, at lgonzales@bnl.gov.
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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. 471924 DUNE FD-VD CRP FC Bias SHV Warm Cables
Brookhaven National Laboratory Brookhaven Science Associates, LLC P.O. Box 5000 – Bldg. 101 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 the DUNE FD-VD CRP FC Bias SHV Warm Cables for Brookhaven Science Associates, LLC.
| Description |
| Qty |
| Unit Price |
| Cumulative Total |
DFDVD-HV-WSHV-14
DUNE VD warm CRP/FC bias SHV cables, 14m long
DFDVD-HV-WSHV-18
DUNE VD warm CRP/FC bias SHV cables, 18m long
DFDVD-HV-WSHV-26
DUNE VD warm CRP/FC bias SHV cables, 26m long
DFDVD-HV-WSHV-30
DUNE VD warm CRP/FC bias SHV cables, 30m long
Total Overall Price……………………………………………………………… $_____________
This price shall remain firm for Ninety (90) days.
The terms of delivery and payment terms are TBD, 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: _________. Comment by Gonzales, Lisa: Please add UEI number here
| Company _____________________ |
| Signature _____________________ |
| Address ______________________ |
| Typed Name __________________ |
| ______________________________ |
| Title _________________________ |
| Telephone No.___(___)__________ |
| Date _________________________ |
Date Printed 8/1/2026 1 of 1 Date Approved 12/14/2020
File details come from the government source that posted it. Updated .