PurchaseRequisitionWorksheet_Keyence.pdf
PDF 93 KB Posted
- Attached to
- FBO Posting For Fluorescence Microscope Federal contract opportunity
- Solicitation number
- 75N94022Q00129
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| FBO_For_Fluorescence_Microscope.pdf | ||
| Streamlined_Acquisition_Plan_-_All-in-one_Fluorescence_Microscope.pdf | ||
| Keyence_Quotation_12435887_NIH_5625FL.pdf | ||
| EntityInformation-20220608-125742.pdf | ||
| JA_Simplified_All-in-one_Fluorescence_Microscope.docx | DOCX document |
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Text version
Purchase Request POTS Number : 22-002578 Vendor Confirmation # :
Credit Card Reference # :
NBS Order No : N/A
1. Requester Requester's Name Jung Hoon SHIN
Date Needed
2. Recommended Sources
Name of First Vendor
Keyence Corporation of America
Phone No.
Company Clerk's Name
3. Ordering Information 4. Totals
Item No
Exp Type
Cat # CAN - Task Catalog No
DESCRIPTION QTY Unit of Issue LIST PRICE DISC. PRICE ESTIMATED
PRICE
1 N/A 8027391- 2022.100
BZ-X810 BZX Microscope Head 1.00 EACH $36,400.00 $36,400.00 $36,400.00
2 N/A 8027391- 2022.100
BZ-
X800LE
BZX Microscope Contro (See page 3)
1.00 EACH $12,500.00 $12,500.00 $12,500.00
3 N/A 8027391- 2022.100
BZ
SUPPOR
T
PACKAG
E
BZ Support Package 1.00 EACH $3,000.00 $3,000.00 $3,000.00
4 N/A 8027391- 2022.100
BZ-H4XD BZX Multi-Stack Modul (See page 3)
1.00 EACH $41,600.00 $41,600.00 $41,600.00
5 N/A 8027391- 2022.100
BZ-H4A BZX Analyzer Software 1.00 EACH $7,500.00 $7,500.00 $7,500.00
6 N/A 8027391- 2022.100
OP-
87762
BZX DAPI Filter 1.00 EACH $1,850.00 $1,850.00 $1,850.00
7 N/A 8027391- 2022.100
OP-
87763
BZX GFP Filter 1.00 EACH $1,850.00 $1,850.00 $1,850.00
8 N/A 8027391- 2022.100
OP-
87765
BZX Texas Red Filter 1.00 EACH $1,850.00 $1,850.00 $1,850.00
9 N/A 8027391- 2022.100
OP-
87766
BZX Cy5 Filter 1.00 EACH $1,850.00 $1,850.00 $1,850.00
10 N/A 8027391- 2022.100
BZ-PA02 Plan Apochromat 2x 1.00 EACH $1,300.00 $1,300.00 $1,300.00
Total List : $109,700.00 Total : $109,700.00
Total Item : 16 please continue to page 3 Grand Total List Price: $122,220.00 Grand Total : $122,220.00
888-539-3623 /
AO Approved by Christie Charles Date :6/8/2022 6:49:11 AM
Approved by Veronica Alvarez Date:6/7/2022 1:05:57 PM
Submitted by Jung Hoon SHIN
Instructions:
The Requester completes Sections 1, 2, and 3. The completes the rest of the form.Buyer
Date Submitted:
06/07/2022
CAN O.C Code
Delivery Point Phone No.
Bldg/Room: 5625FL/TS32A 301-443-3772 6/14/2022
N/A8027391/142949 Organization
HN55L NIAAA OD OFC DIR
Decal/Cost Adjust. Needed
Requester's Signature Internal Approval Internal Approval(signature) (signature)
(Provide three sources, if possible. Competition is required for open market and non-mandatory FSS orders over $3,000)
Name of Second Vendor
Name of Third Vendor
Phone No.
Company Clerk's Name
Phone No.
Company Clerk's Name
EIN FSS No.
EIN FSS No.
EIN FSS No.
5. Ordering Mechanism BPA Call (OM)NIH Stock Requisition External To/Do Purchase Cards/Convenience Checks
Cust Code: 15002
N/A Date:N/A
Internal Approval (signature)
Page 1 of 4NIH 1861-1 (Rev. 3/08) FRONT See Reverse
Date Ordered : Buyer's Name
Christie HALCOMB
NBS Order No.
N/A
For radioisotope orders only :
Complete Form NIH 88-1, "Request for Purchase and Use of Radioactive Materials."
Clearance no. of approved radioisotope purchaser
BPA/IDC Source No. Competition Required ? Clearances Required ? Clearances Obtained ?
Yes No Yes No Yes No
6. Mandatory Source Availability
Are any of the items available from these sources? If “yes,” and you are not using the mandatory source, explain why in Item 7.
YES NO
NIH Surplus
NIH Required Source (MAPB, Glassware, etc)
NIH/GSA Stock
YES NO
UNICOR
Blind/Severely
Mandatory FSS Schedules
7. Justification for Not Selecting Mandatory Source
Compatibility with existing equipment.
Other
Mandatory FSS vendor is unacceptable because:
NIH stock item is unacceptable because:
NIH Stores out of stock and urgently needed.
Explain :
Explain :
(specify) :
8. Justification for Sole-source or Other than Small Business on Either Open Market or Non-mandatory FSS
Sole-source: Proprietary data/patent, etc. (FAR 6.302-1.)
Other
Small business is unable to deliver within required timeframe.
Sole-source: Urgent and compelling requirement. (FAR 6.302-2.)
Sole-source: Quality of product required for on-going experiments. (FAR 6.302-1.)
Explain :
Explain :
(specify) :
Explain :
Explain :
Unable to locate small business source(s) for item(s). Explain :
9. Competition (For open market and non-mandatory FSS orders over $3,000.)
Vendor 1
List Price Discount Price Phone No.
Comments
Date Called Company Clerk's Name
Vendor 2
List Price Discount Price Phone No.
Comments
Date Called Company Clerk's Name
Vendor 3 10. Price Reasonableness (Check all that apply.)
YES NO
OPEN-MARKET Supplies
NIH/GSA Self Service
SF 44
Internal To/Do
Purchase Card(s)GSA Fedstrip
BPA Call (FSS) Purchase Order(s)
See section 11 Required Sources list
Page 2 of 4NIH 1861-1 (Rev. 3/08) BACK See Reverse
List Price Discount Price Phone No.
Comments
Date Called Company Clerk's Name
Lowest price quoted.
Comparison with prices on previous buys where price analysis performed.
Other
Previous order no. Date
(specify) :
Item List
Item No
Exp Type
Cat # CAN - Task Catalog
DESCRIPTION QTY Unit of Issue
LIST PRICE DISC.
PRICE
ESTIMATED
PRICE
1 N/A 8027391- 2022.100
BZ-X810 BZX Microscope Head 1.00 EACH $36,400.00 $36,400.00 $36,400.00
2 N/A 8027391- 2022.100
BZ-
X800LE
BZX Microscope Controller 1.00 EACH $12,500.00 $12,500.00 $12,500.00
3 N/A 8027391- 2022.100
BZ
SUPPOR
T
PACKAG
E
BZ Support Package 1.00 EACH $3,000.00 $3,000.00 $3,000.00
4 N/A 8027391- 2022.100
BZ-H4XD BZX Multi-Stack Module 1.00 EACH $41,600.00 $41,600.00 $41,600.00
5 N/A 8027391- 2022.100
BZ-H4A BZX Analyzer Software 1.00 EACH $7,500.00 $7,500.00 $7,500.00
6 N/A 8027391- 2022.100
OP-
87762
BZX DAPI Filter 1.00 EACH $1,850.00 $1,850.00 $1,850.00
7 N/A 8027391- 2022.100
OP-
87763
BZX GFP Filter 1.00 EACH $1,850.00 $1,850.00 $1,850.00
8 N/A 8027391- 2022.100
OP-
87765
BZX Texas Red Filter 1.00 EACH $1,850.00 $1,850.00 $1,850.00
9 N/A 8027391- 2022.100
OP-
87766
BZX Cy5 Filter 1.00 EACH $1,850.00 $1,850.00 $1,850.00
10 N/A 8027391- 2022.100
BZ-PA02 Plan Apochromat 2x 1.00 EACH $1,300.00 $1,300.00 $1,300.00
PA Notes : NA
Requester Notes : 1. Please see the quote attached (quote#: 12435887).
2. Please provide the shipping address as below:
Hoon Shin Building 35, Room 1B-415 Bethesda, MD 20814
3. And add a memo to contact Hoon Shin (410-926-4696) before delivery. Thanks.
Justification : LNCB at NIAAA performs fluorescence imaging experiments of whole brain tissues on multiple slides. This All-in-one Fluorescence Miscroscope by Keyence will (1) provide simple setup and easy operation with excellent imaging quality, (2) save lab space since it comes with a built-in darkroom, and (3) enable us to perform a batch acquisition and analysis of large data sets from multiple slides, thereby saving time.
YES NO
UNICOR, NIH FSS BPA, FSSI, GSA Advantage or GWAC's
YES NO
NIH OM BPA
The Open Market
Ability One Programs
11.Required Sources for Services
Page 3 of 4NIH 1861-1 (Rev. 3/08) BACK See Reverse
11 N/A 8027391- 2022.100
BZ-PA10 Plan Apochromat 10x 1.00 EACH $2,400.00 $2,400.00 $2,400.00
12 N/A 8027391- 2022.100
BZ-PA20 Plan Apochromat 20x 1.00 EACH $2,600.00 $2,600.00 $2,600.00
13 N/A 8027391- 2022.100
BZ-PA40 Plan Apochromat 40x 1.00 EACH $4,300.00 $4,300.00 $4,300.00
14 N/A 8027391- 2022.100
972326 Win10 PC for BZ-X800 1.00 EACH $2,300.00 $2,300.00 $2,300.00
15 N/A 8027391- 2022.100
972072B 23" MONITOR 1.00 EACH $700.00 $700.00 $700.00
16 N/A V119 8027391- 2022.100
Shipping and handling 1.00 EACH $220.00 $220.00 $220.00
Total List Price
$122,220.00 Total : $122,220.00
Page 4 of 4NIH 1861-1 (Rev. 3/08) BACK
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