Enclosure (C) Quotation Pricing Sheet AMS-Form-043.pdf
PDF 353 KB Posted
- Attached to
- Laterally Graded Multilayer Mirror
- Solicitation number
- 465356
- Issued by
-
Department of Energy Office of Science
About this file
This document is a Quotation Pricing Sheet (AMS-Form-043) issued by Brookhaven National Laboratory for a Laterally Graded Multilayer Mirror procurement. The solicitation (Request for Quotation No. 465356) is managed by Brookhaven Science Associates, LLC under contract to the U.S. Department of Energy. The form provides a template for vendors to submit pricing information, with provisions for the vendor to acknowledge BSA's requirements, terms, conditions, and delivery schedule. The pricing sheet requires vendors to confirm their SAM registration, representations, certifications, and small business size status, with a pricing commitment that remains firm for 90 days. The document is addressed to Yanice Kirkendall, Contracts Specialist, and was approved on 12/14/2020 with a revision number of 0.1.
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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. 465356
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 Laterally Graded Multilayer Mirror 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
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:
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