Enclosure C_AMS Form 043 Quotation Pricing Sheet.docx
DOCX document 24 KB Posted
- Solicitation number
- BSA467122
- Issued by
-
Department of Energy Office of Science
About this file
This document is a Quotation Pricing Sheet for Brookhaven National Laboratory (BNL) solicitation BSA467122, seeking one (1) EIGER2 XE 4M vacuum specific design (101419) or equivalent and one (1) Vacuum-Feedthrough-Set (202869) or equivalent. The procurement is managed by Brookhaven Science Associates, LLC under contract to the U.S. Department of Energy, with pricing to be submitted on this standardized form that includes three milestone payment stages: initial material receipt, detector acceptance, and BNL site testing.
The pricing sheet requires vendors to specify their total price, manufacturing location, delivery terms (FOB Destination or DAP), payment terms (Net 10 or 30 Days), and maintain price firmness for a specified number of days. Vendors must provide a report with serial numbers of detector sensor modules, photo evidence, and test results upon delivery. The document is dated 8/28/2025 with an original approval on 12/14/2020, and the solicitation is specifically from the Department of Energy Office of Science.
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Other files
| File | Type | Posted |
|---|---|---|
| RFQ 467122.pdf | ||
| Enclosure A Draft PO_Contract.pdf | ||
| Enclosure F_W9 Form.pdf | ||
| Enclosure B_AMS-FORM-050.pdf | ||
| Enclosure D_AMS-Form-001.docx | DOCX document | |
| Enclosure E_ACH Authorization Form.pdf | ||
| Enclosure G_W8 Form.pdf |
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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. 467122 |
| One (1) EIGER2 XE 4M vacuum specific design (101419) or (equivalent) and one (1) Vacuum-Feedthrough-Set (202869) or (equivalent). |
Brookhaven National Laboratory Brookhaven Science Associates, LLC P.O. Box 5000 – Bldg. 101 Upton, NY 11973
| Attention: | Mark Brock |
| Subcontracts Supervisor |
To whom it may concern:
In compliance with your letter of solicitation dated [insert date], we submit our Quotation No. ___________________________ dated _______________, for the referenced Combined Synopsis/Request for Quote.
| Item |
| Milestone |
| Amount |
| Funded Amount |
| 1 |
| Receipt and BSA acceptance of material Cost - must provide a report with the serial numbers of the detector sensor modules, along with photo evidence and test results. |
| 2 |
| Receipt and BSA acceptance of Detector a EIGER2 XE 4M vacuum specific design (101419) or (Equivalent) and Vacuum-Feedthrough-Set (202869) or (Equivalent) |
| 3 |
| Receipt and BSA acceptance of BNL Site Testing |
Total Price $_____________
This price shall remain firm for [fill in # days] days.
The terms of delivery and payment terms are [insert FOB Destination or DAP], Net [insert 10 or 30] Days.
Place of Manufacture: [insert place of manufacture].
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 _________________________ |
Date Printed 8/28/2025 1 of 1 Date Approved 12/14/2020
File details come from the government source that posted it. Updated .