Enclosure (2) Quotation Pricing Sheet AMS-Form-043.pdf
PDF 148 KB Posted
- Attached to
- Custom Positioning System
- Solicitation number
- RFQ_466136
- 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 a Custom Positioning System solicitation. The Request for Quotation (RFQ No. 466136) is issued by Brookhaven Science Associates, LLC, managed under contract with the U.S. Department of Energy Office of Science. The pricing sheet is designed for potential contractors to submit their quotation for a custom positioning system, with the submitted price to remain firm for 90 days. The document requires the contractor to acknowledge BSA's requirements, terms, conditions, and delivery schedule, and affirm registration in the System for Award Management (SAM) with current representations and certifications.
The form is structured to capture key vendor information, including company name, address, signature, contact details, and a space for the total pricing of the Custom Positioning System (including delivery). The document was approved on 12/14/2020 by L. McKnight, the PPM Manager, and is part of Brookhaven National Laboratory's Procurement and Property Management Division's acquisition management system. The form indicates that detailed specifications for the positioning system are included in Attachments A, B, and C, which are referenced but not part of this specific document.
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Text version
Date Printed 8/5/2025 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. 466136 Custom Positioning System
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 Custom Positioning System 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, B and
C):
Description
Custom Positioning System (Including Delivery) $__________
This price shall remain firm for 90 days.
Date Printed 8/5/2025 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 _________________________
Concurrence:
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