Enclosure (C) Quotation Pricing Sheet AMS-Form-043.pdf
PDF 213 KB Posted
- Attached to
- Standard Rittal Equipment Racks
- Solicitation number
- 464517
- Issued by
-
Department of Energy Office of Science
About this file
This document is a Quotation Pricing Sheet (AMS-Form-043) from Brookhaven National Laboratory for ANT Z Resolution Test Patterns. The solicitation (Request for Quotation No. 466177) is for 10 units, with pricing to remain firm for 90 days. The document is managed by Brookhaven Science Associates, LLC under contract to the U.S. Department of Energy, with the form approved by L. McKnight on 12/14/2020.
The pricing sheet requires potential contractors to complete their company details, acknowledge BSA's requirements and delivery schedule, and confirm SAM registration. The form includes spaces for company name, address, signature, typed name, title, and date, with the contractor affirming their representations, certifications, and small business size status are current and complete. The document is intended for vendors to submit their quotation for the specified test patterns, with all details to be included as per the Statement of Work and Specs Package (Attachments A and B).
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Date Printed 7/3/2025 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. 466177 ANT Z Resolution Test Patterns
Brookhaven National Laboratory Brookhaven Science Associates, LLC P.O. Box 5000 – Bldg. 902B Upton, NY 11973
Attention: Yanice Kirkendall Contracts Specialist
In compliance with your letter of solicitation, we submit our Quotation No._______________ dated _______________, for ANT Z Resolution Test Patterns for Brookhaven National Labs.
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 10 (including delivery)
Total: $__________
This price shall remain firm for 90 days.
Date Printed 7/3/2025 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:
File details come from the government source that posted it. Updated .