Enclosure (2) Quotation Pricing Sheet AMS-Form-043.pdf
PDF 150 KB Posted
- Attached to
- Waveguide Adapters
- Solicitation number
- RFQ_475777
- Issued by
-
Department of Energy Office of Science
About this file
This is a Quotation Pricing Sheet template for Brookhaven National Laboratory's Request for Quotation No. 475777 for Waveguide Adapters. The form is issued by Brookhaven Science Associates, LLC (BSA), which manages the laboratory under contract to the U.S. Department of Energy. Contractors are required to submit pricing for waveguide adapters including shipping costs under two delivery scenarios: normal delivery schedule (20 weeks after contract award) and an expedited delivery schedule with annotated revised timeline in weeks. The pricing submission must include the contractor's UEI number associated with their SAM profile and confirmation that all pricing includes everything detailed in the Statement of Work and technical drawings.
Contractors submitting quotations must acknowledge and agree to BSA's requirements, terms, conditions, and delivery schedule, and certify that they are registered in SAM with current representations, certifications, and small business size status (if applicable). The submitted price remains firm for 90 days from the quotation date. The form requires contractor company information, contact address, authorized signature, typed name, title, telephone number, and quotation date. The quotation should be submitted to Eric Nagel, Contracts Administrator, at Brookhaven National Laboratory, P.O. Box 5000, Building 902B, Upton, NY 11973.
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Text version
Date Printed 3/20/2026 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. 475777
Waveguide Adapters
Brookhaven National Laboratory
Brookhaven Science Associates, LLC
P.O. Box 5000 – Bldg. 902B
Upton, NY 11973
Attention: Eric Nagel
Contracts Administrator
In compliance with your letter of solicitation, we submit our Quotation No._______________ dated
_______________, for Waveguide Adapters for Brookhaven National Labs.
Contractor UEI number associated with SAM profile: _________________________
Includes everything as detailed in the Statement of Work and technical drawings
Description
Waveguide Adapters (total with shipping at normal delivery schedule) $__________
Waveguide Adapters (total to include shipping at expedited* delivery schedule) $__________
*Note: Annotate revised delivery schedule based on weeks. SOW normal schedule is 20 weeks after contract award.
This price shall remain firm for 90 days.
Date Printed 3/20/2026 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 _________________________
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