Enclosure 3 - AMS Form 043 Pricing Sheet.docx
DOCX document 29 KB Posted
- Solicitation number
- 467862
- Issued by
-
Department of Energy Office of Science
About this file
This document is a Quotation Pricing Sheet for PCB Assembly Services issued by Brookhaven Science Associates, LLC (BSA) at Brookhaven National Laboratory. The solicitation (Reference Number 467862) seeks pricing for printed circuit board assemblies in two phases: Phase I with 25 units and Phase II with 2,095 units. The pricing sheet requires vendors to submit their total price, which will remain firm for 90 days, and indicates that delivery and payment terms are yet to be determined (TBD). Vendors must be registered in the System for Award Management (SAM) and provide their Unique Entity Identifier (UEI) number.
The solicitation is issued by the Department of Energy Office of Science and is managed by Brookhaven Science Associates under a prime contract with DOE. Potential vendors are instructed to direct any questions about the Request for Quote to Lisa Gonzales via email at lgonzales@bnl.gov. The document was approved on 12/14/2020 and includes a template for vendors to complete their quote, company details, and signature, with a printed date of 10/2/2025.
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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. 467862 PCB Assembly Service
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 PCB Assembly Services for Brookhaven Science Associates, LLC.
| Description |
| Qty |
| Unit Price |
| Total |
| Phase 1 – Print Circuit Board Assemblies |
| 25 |
| Optional Phase II – Print Circuit Board Assemblies |
| 2,095 |
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 10/2/2025 1 of 1 Date Approved 12/14/2020
File details come from the government source that posted it. Updated .