B.1 Enclosure 3 – AMS Form 043, Proposal Pricing Sheet.pdf
PDF 410 KB Posted
- Attached to
- Forward Hadronic Calorimeter Absorber Structures
- Solicitation number
- MB457842
- Issued by
-
Department of Energy Office of Science
About this file
This is a Proposal Pricing Sheet template for Brookhaven National Laboratory, issued under BSA Request for Proposal No. 457842. The form is managed by Brookhaven Science Associates, LLC under contract to the U.S. Department of Energy and serves as the pricing submission vehicle for vendors responding to this solicitation.
The solicitation requires proposals for LFHCAL Modules with Steel Absorber Modules. The pricing structure includes a Base Award for 8M Modules with separate unit price and total price fields, and Option 1 comprising 216 units of 8M Modules and 72 units of 4M Modules, each with specified unit prices and a total option price. Vendors must provide their UEI number from SAM.gov and country of origin. Quoted prices must remain firm for 120 days, with delivery and payment terms specified as FOB Destination, Net 10 Days. The form requires vendor company information, authorized signature, typed name, title, telephone number, date of submission, and an anticipated HTS code if applicable. By executing the form, vendors acknowledge agreement to BSA's requirements, terms and conditions, delivery schedule, and commit to providing necessary resources to meet the specified delivery timeline.
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Text version
Date Printed 8/14/2024 1 of 1 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 Proposal Pricing Sheet
Reference: BSA Request for Proposal No. 457842
Brookhaven National Laboratory Brookhaven Science Associates, LLC Upton, NY 11973
Attention:
To whom it may concern:
In compliance with your letter of solicitation dated_____________________, we submit our Proposal No.
___________________________ dated _______________, for LFHCAL Modules with Steel Absorber Modules. Our
UEI number from SAM.gov is _____________________. Country of origin _______________________.
Base Award: 8M Modules Unit Price $______________
Base Award Total Price $_________________
Option 1: 216 8M Unit Price $_______________ and 72 4M Modules Unit Price $________________
Option 1 Total Price $______________
This price shall remain firm for 120 days. The terms of delivery and payment terms are FOB Destination, Net
10 Days.
Date Printed 8/14/2024 2 of 2 Date Approved 12/14/2020
Concurrence: Anticipated HTS Code (if applicable):__________________
By signing this Proposal 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.
Company _____________________ Signature _____________________
Address ______________________ Typed Name __________________
______________________________ Title _________________________
Telephone No.___(___)__________ Date _________________________
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