Enclosure C. Quotation Pricing Sheet.pdf
PDF 150 KB Posted
- Attached to
- SXN Zone Plates and Spatial Resolution Standards
- Solicitation number
- RFQ_463440
- Issued by
-
Department of Energy Office of Science
About this file
This document is a Quotation Pricing Sheet for Brookhaven National Laboratory's Request for Quotation (RFQ) No. 463440 for SXN Zone Plates and Spatial Resolution Standards. The pricing sheet details a procurement for three specific items: two sets of Zone Plate 1, two sets of Zone Plate 2, and one Hybrid Ultra-High Resolution X-ray Sample, all including delivery. The document is part of an acquisition managed by Brookhaven Science Associates, LLC under contract to the U.S. Department of Energy, with the pricing to remain firm for 90 days. The form requires vendor acknowledgment of BSA's requirements, terms, conditions, and delivery schedule, and confirmation of SAM registration and current representations and certifications.
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Text version
Date Printed 6/5/2025 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. 463440 SXN Zone Plates and Spatial Resolution Standards
Brookhaven National Laboratory Brookhaven Science Associates, LLC P.O. Box 5000 – Bldg. 902B Upton, NY 11973
Attention: Crystal Lopez Contract Specialist
In compliance with your letter of solicitation, we submit our Quotation No._______________ dated _______________, for SXN Zone Plates and Spatial Resolution Standards for Brookhaven National Lab.
Contractor UEI number associated with SAM profile: _________________________
Includes everything as detailed in the Statement of Work and Specs Package (Attachments A and B):
Description Qty:
Zone Plate 1 (Including Delivery) x2 $__________ Zone Plate 2 (Including Delivery) x2 $__________ Hybrid Ultra-High Resolution X-ray Sample x1 $__________ (Including Delivery)
Total: $__________
This price shall remain firm for 90 days.
Date Printed 6/5/2025 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. 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.
Company _____________________ Signature _____________________
Address ______________________ Typed Name __________________
______________________________ Title _________________________
Telephone No.___(___)__________ Date _________________________
Concurrence:
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