Enclosure (2) Pricing Sheet 457974.pdf

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NSLSII Calibration Plate for Fizeau Interferometer
Solicitation number
PB457974
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This is a Quotation Pricing Sheet template (Form No. AMS-Form-043) issued by Brookhaven National Laboratory's Procurement and Property Management Division for RFQ No. 457974, regarding an NSLS-II Calibration Plate for Fizeau Interferometer.

The form requires vendors to submit pricing for one calibration plate with FOB Destination Freight Prepaid terms to Brookhaven National Laboratory in Upton, NY. The price must remain firm for 60 days, with quotations due in response to a solicitation dated January 14, 2025. Vendors must provide company information, signatures, and their SAM.gov UEI number while acknowledging agreement to BSA's requirements, terms, conditions, and delivery schedule. The form was approved by PPM Manager Don Rawlings on 3/24/10 and is managed by Brookhaven Science Associates, LLC under contract to the U.S. Department of Energy.

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Attachment (A) SOW_Calibration_plate.pdf PDF
457974 RFQ Letter.pdf PDF
Draft PO457794.pdf PDF

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Enclosure 2

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

APPROVED BY:

Don Rawlings/ 3/24/10

PPM Manager/Date

Quotation Pricing Sheet

Reference: BSA Request for Quotation No. 457974

NSLS-II Calibration Plate for Fizeau Interferometer

Brookhaven National Laboratory

Brookhaven Science Associates, LLC

P.O. Box 5000 – Bldg. 902B

Upton, L.I., NY 11973

Attention: Philip J. Bernath, Contracts Administrator

In compliance with your letter of solicitation dated January 14, 2025, we submit our Quotation No.______________ dated _______________, for the NSLS-II Calibration Plate for Fizeau Interferometer.

Item Description Qty Total Price

1. Calibration Plate for Fizeau Interferometer 1ea. __________

This price shall remain firm for 60 days.

The terms of delivery and payment terms are FOB Destination Freight Prepaid, Brookhaven National Laboratory, Upton, Long Island, New York.

Concurrence:

By signing this Quotation Pricing Sheet our firm hereby acknowledges and agrees to BSA's requirements, terms and conditions, and delivery schedule, and agree to provide the resources necessary to meet BSA's delivery schedule.

Company _____________________ Signature _____________________

Address ______________________ Typed Name __________________

______________________________ Title _________________________

Telephone No.:(___)_____________ Date _________________________

SAM.gov UEI No.: ____________________

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