Enclosure (2) Quotation Pricing Sheet AMS-Form-043.pdf
PDF 75 KB Posted
- Attached to
- ANT Zone Plates and Spatial Resolution Standards
- Solicitation number
- RFQ_463091
- Issued by
-
Department of Energy Office of Science
About this file
This document is a Quotation Pricing Sheet (AMS-Form-043) from Brookhaven National Laboratory for ANT Zone Plates and Spatial Resolution Standards. The solicitation (Request for Quotation No. 461513) involves purchasing seven different Zone Plates and two Imaging Test Patterns, with each item priced separately and including delivery. The pricing sheet is managed by Brookhaven Science Associates, LLC under contract to the U.S. Department of Energy, with the document approved on 12/14/2020 and printed on 5/15/2025.
The form requires the vendor to complete company details, signature, and contact information, and includes key provisions such as affirming SAM registration, current representations and certifications, and agreement to BSA's requirements and delivery schedule. The pricing remains firm for 90 days, and the quotation is to be submitted to Eric Nagel, Sr. Contracts Specialist, at Brookhaven National Laboratory in Upton, NY. The document provides a template for vendors to submit their detailed pricing for the specified scientific equipment.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Date Printed 5/15/2025 1 of 2 Date Approved 12/14/2020
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. 461513
ANT Zone Plates and Spatial Resolution Standards
Brookhaven National Laboratory
Brookhaven Science Associates, LLC
P.O. Box 5000 – Bldg. 902B
Upton, NY 11973
Attention: Eric Nagel
Sr. Contracts Specialist
In compliance with your letter of solicitation, we submit our Quotation No._______________ dated
_______________, for ANT Zone Plates and Spatial Resolution Standards for Brookhaven National Labs.
Contractor UEI number associated with SAM profile: _________________________
Includes everything as detailed in the Statement of Work and Specs Package (Attachments A and B):
Description
Zone Plate 1 (Including Delivery) $__________
Zone Plate 2 (Including Delivery) $__________
Zone Plate 3 (Including Delivery) $__________
Zone Plate 4 (Including Delivery) $__________
Zone Plate 5 (Including Delivery) $__________
Zone Plate 6 (Including Delivery) $__________
Zone Plate 7 (Including Delivery) $__________
Imaging Test Pattern 1 (Including Delivery) $__________
Imaging Test Pattern 2 (Including Delivery) $__________
Total: $__________
This price shall remain firm for 90 days.
Date Printed 5/15/2025 2 of 2 Date Approved 12/14/2020
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 (if applicable) are current and complete.
Company _____________________ Signature _____________________
Address ______________________ Typed Name __________________
______________________________ Title _________________________
Telephone No.___(___)__________ Date _________________________
File details come from the government source that posted it. Updated .