Enclosure C - Quotation Pricing Sheet.pdf
PDF 179 KB Posted
- Attached to
- VD CE Box Production
- Solicitation number
- 472282
- Issued by
-
Department of Energy Office of Science
About this file
This is a Quotation Pricing Sheet for a Request for Quotation (RFQ) issued by Brookhaven National Laboratory (managed by Brookhaven Science Associates, LLC under contract to the U.S. Department of Energy). The RFQ, referenced as BSA Request for Quotation No. 472282, solicits pricing for PCB Assembly Services specifically for the production of DUNE FD-VD CE Boxes. The procurement is structured in two phases: Phase 1 requires 25 pre-production units for final validation and fit-check, and Option 2 requires 2,100 production units contingent upon successful Phase 1 qualification. Quotations must include unit pricing and total overall pricing for all quantities. The price quoted must remain firm for ninety (90) days, with delivery and payment terms specified as FOB Destination with Net payment terms to be determined.
Responding vendors must acknowledge agreement with all BSA requirements, terms, conditions, and delivery schedule, and must confirm current registration in SAM (System for Award Management) with valid representations and certifications. Vendors are required to provide their UEI (Unique Entity Identifier) number associated with their SAM profile and must certify their small business size status is current and complete. The quotation form requires the vendor's company name, address, telephone number, authorized signature, typed name of signatory, title, and date of submission. The form was approved on December 14, 2020, by L. McKnight, PPM Manager, with a revision number of 0.1 (AMS-Form-043).
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Text version
Date Printed 2/5/2026 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. 472282 – VD CE Box Production
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 PCB Assembly Services for Brookhaven Science Associates, LLC.
Description Qty Unit Price Total
1. DUNE FD-VD CE Boxes - Phase 1 – Pre- Production units for final validation and fit-check 25
2. DUNE FD-VD CE Boxes – Option 2 – Production units following successful Phase 1 qualification 2,100
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 2/5/2026 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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