Enclosure C - Quotation Pricing Sheet.pdf
PDF 177 KB Posted
- Attached to
- Laser Amplifier System
- Solicitation number
- 472310
- Issued by
-
Department of Energy Office of Science
About this file
This is a Quotation Pricing Sheet (AMS-Form-043) issued by Brookhaven National Laboratory, managed by Brookhaven Science Associates, LLC under contract to the U.S. Department of Energy. The form serves as a template for vendors to submit pricing quotations in response to BSA Request for Quotation No. 472310 for the fabrication of a laser amplifier module.
The solicitation requires vendors to provide pricing for three line items: (1) one laser amplifier unit, (2) electrical and mechanical components necessary for operation of the laser amplifier (quantity 1), and (3) one electronics rack. Vendors must submit a total overall price and indicate unit prices for each item. The quotation pricing shall remain firm for ninety (90) days from submission. Delivery and payment terms are FOB Destination with Net payment terms to be determined (TBD). Vendors submitting quotations must acknowledge compliance with BSA's requirements, terms, conditions, and delivery schedule, and affirm current registration in SAM with a valid UEI number. The quotation submission should be directed to Blake Clemmer, Contracts Specialist, at Brookhaven National Laboratory, P.O. Box 5000, Building 101, Upton, NY 11973. The form was approved on December 14, 2020.
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Text version
Date Printed 1/23/2026 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. 472310 – Fabrication of Laser Amplifier
Brookhaven National Laboratory Brookhaven Science Associates, LLC P.O. Box 5000 – Bldg. 101 Upton, NY 11973
Attention: Blake Clemmer Contracts Specialist To whom it may concern:
In compliance with your letter of solicitation dated _____, we submit our Quotation No. ___________________________ dated _______________, for Fabrication of Laser Amplifier Module for Brookhaven Science Associates, LLC.
Description Qty Unit Price Total
1. Laser Amplifier 1
2. Electrical and mechanical components necessary for operation of laser amplifier 1
3. Electronics rack 1
Total Overall Price……………………………………………………………… $_____________
This price shall remain firm for Ninety (90) days.
The terms of delivery and payment terms are FOB Destination, Net (TBD) Days.
Date Printed 1/23/2026 2 of 2 Date Approved 12/14/2020
0BConcurrence:
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 are current and complete. The UEI number associated with our SAM profile is: (Insert Number Here).
Company _____________________ Signature _____________________
Address ______________________ Typed Name __________________
______________________________ Title _________________________
Telephone No.___(___)__________ Date _________________________
Concurrence:
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