Enclosure C 398033 QPS.pdf

ENCLOSURE C

Date Printed 6/14/2021 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. 398033 Ultrasonic Flow Meter

Brookhaven National Laboratory Brookhaven Science Associates, LLC P.O. Box 5000 – Bldg. 902 Upton, NY 11973

Attention: Rosemary Mata Buyer To whom it may concern:

In compliance with your letter of solicitation dated June 14, 2021, we submit our Quotation No.

___________________________ dated _______________, for [Ultrasonic Flow Meter].

Item Description Qty UOM Unit Price Merchandise Amount

Ultrasonic Flow Meter 10.00 EA

PLUG: MICRO-DC:

FEMALE 10.00 EA

Total Price $__________________ Lead Time ____________________

This price shall remain firm for [60] days.

The terms of delivery and payment terms are FOB Destination, Net 30 Days.

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ENCLOSURE C

Date Printed 6/14/2021 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.

Company _____________________ Signature _____________________

Address ______________________ Typed Name __________________

______________________________ Title _________________________

Telephone No.___(___)__________ Date _________________________

Concurrence: