Enclosure C- AMS Form 043 Quotation Pricing Sheet.docx
DOCX document 27 KB Posted
- Attached to
- FXI and ISR Mirror Bender Upgrade Package
- Solicitation number
- 475273
- 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 procurement of new bender systems for the FXI-ISR beamlines. The solicitation, numbered 475273, is managed by the Procurement and Property Management Division and directed to the attention of Buyer Marie J. Williams. Offerors must provide pricing structured across three milestones: delivery and acceptance of the Final Design Review Report, delivery and acceptance of the Equipment and Documentation Package, and acceptance of Equipment Installation and Testing. The total quoted price must be provided in U.S. dollars and remain firm for 90 days, with delivery on an FOB Destination basis and payment terms of Net 30 days for large or foreign businesses and Net 10 days for small businesses.
Offerors must complete required fields including country of origin, HTS code, and export control point of contact information if manufacturing occurs outside the United States. Vendors must certify their commercial status (standard catalog item, modified catalog item, or non-commercial item) and confirm their ability to meet the delivery timeline. All responding companies must be registered in SAM with current representations, certifications, and small business size status if applicable. The form includes a standard confidentiality notice indicating that BSA may disclose proposals to U.S. Government personnel for review, with any confidentiality legends provided by the offeror included but BSA assuming no responsibility 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. 475273 |
| Description: New Bender Systems for FXI-ISR |
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. 475273: New Bender Systems for FXI-ISR.
Milestone Payment Structure to be filled in:
| Item |
| Milestone |
| Amount |
Cumulative Amount
| 1 |
| Delivery and BSA Acceptance of the Final Design Review Report |
| $__________ |
| $__________ |
| 2 |
| Delivery and BSA Acceptance of Equipment and Documentation Package |
| $__________ |
| $__________ |
| 3 |
| BSA Acceptance of Equipment Installation and Testing |
| $__________ |
| $__________ |
| Total |
| $__________ |
| $__________ |
Total Quoted Price* $_____________ *Must be in U.S. Dollars and inclusive of all taxes, fees, customs, duties and other charges.
This price shall remain firm for 90 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 6/10/2026 1 of 1 Date Approved 12/14/2020
File details come from the government source that posted it. Updated .