Enclosure C- AMS Form 043 Quotation Pricing Sheet.docx
DOCX document 26 KB Posted
- Attached to
- Femtosecond Laser System
- Solicitation number
- 475610
- Issued by
-
Department of Energy Office of Science
About this file
This is a Quotation/Proposal Pricing Sheet (AMS Form 043) for Brookhaven National Laboratory's Request for Quotation No. 475610 regarding a Femtosecond Laser System. The form serves as a template for vendors to submit pricing and compliance information in response to the solicitation. Vendors must provide a total price in U.S. dollars inclusive of all taxes, fees, customs, duties, and other charges, specify the price firm period, and confirm delivery terms of FOB Destination with payment terms of Net 30 days for large or foreign businesses and Net 10 days for small businesses.
Vendors are required to identify the country of origin or place of manufacture and, if applicable outside the U.S., provide export control information including a designated point of contact, phone number, and email address. Respondents must certify their SAM registration status, confirm current representations and certifications, and identify whether the laser system is a standard catalog item, modified catalog item, or non-commercial item. Vendors must confirm their ability to meet the delivery timeline or provide an alternative forecasted delivery date. By signature, the vendor acknowledges agreement to all BSA requirements, terms, conditions, and delivery schedules. The form includes a notice that BSA may disclose proposals to U.S. Government personnel for review, with BSA not responsible for subsequent government disclosure.
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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:
PPM Manager/Date
Quotation/Proposal Pricing Sheet
| Reference: | BSA Request for Quotation/Proposal No. 475610 |
| Description: Femtosecond Laser System |
Attention: Buyer/Contract Specialist: Marie J. Williams
To whom it may concern: In compliance with your letter of solicitation dated [insert date], we submit our Quotation/Proposal No. 475610: Femtosecond Laser System.
Total Price* $_____________ *Must be in U.S. Dollars and inclusive of all taxes, fees, customs, duties and other charges.
This price shall remain firm for [insert number of days] days.
Delivery is FOB Destination.
Payment terms are Net 30 (Large or Foreign Businesses), Net 10 (Small Businesses) Days.
Country of Origin or Place of Manufacture: [insert place] *Item HTS CODE: [insert HTS code]
*Company’s Export Control Point of Contact (POC): [insert POC] *Phone #: [insert phone #] *Email Address: [insert email address] *Required if country of origin or manufacture is located outside of the U.S.
Concurrence:
By signing this Quotation/Proposal 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. Additionally, please certify the following:
Item commercial status. Check one of the following by clicking the ☐ next to the associated option:
☐ Standard catalog item ☐ Modified catalog item ☐ Non-commercial item
Can you meet delivery timeline? If yes, check this box: ☐ If not, please provide your forecasted delivery date: [insert delivery date]
Notice is hereby provided that BSA may disclose offeror proposals to U.S. Government personnel for review. In such case, BSA will furnish the proposal to the Government with any confidentiality legends included by the Offeror, but BSA is not responsible for any subsequent disclosure by the U.S. Government.
| Company ____________________ |
| Signature __________________ |
| Email Address ________________ |
| Typed Name __________________ |
| SAM UEI #___________________ |
| Title _________________________ |
| Telephone No.(___)____________ |
| Date _________________________ |
Date Printed 4/6/2026 1 of 1 Date Approved 12/14/2020
File details come from the government source that posted it. Updated .