Enclosure C. AMS Form 043 Quotation Pricing Sheet.docx
DOCX document 23 KB Posted
- Attached to
- 471600 - RFI Dilution Refrigerator
- Solicitation number
- RFQ_471600
- Issued by
-
Department of Energy Office of Science
About this file
This document is a Quotation Pricing Sheet template (AMS Form 043) issued by Brookhaven National Laboratory's Procurement and Property Management Division for use in responding to requests for quotation. The form is a standardized template designed to collect pricing and company information from vendors submitting quotations in compliance with Brookhaven Science Associates' (BSA) solicitations. Respondents are required to complete fields including the RFQ reference number, quotation number and date, product or service name, place of manufacture, total price, and price validity period in days. The template establishes standard terms of FOB Destination with Net 30 Days payment terms.
By signing the form, vendors acknowledge and agree to BSA's requirements, terms and conditions, and delivery schedule, and commit to providing necessary resources to meet delivery obligations. The form requires company name, signature, address, typed name, title, telephone number, and date from the submitting firm's authorized representative. This template is applicable to the RFQ 471600 for a Dilution Refrigerator for Superconducting Quantum Circuits (DRSQ) for the Co-design Center for Quantum Advantage (C2QA) at Brookhaven National Laboratory, which falls under the Department of Energy Office of Science.
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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. |
Brookhaven National Laboratory Brookhaven Science Associates, LLC P.O. Box 5000 – Bldg.
Upton, NY 11973
| Attention: |
To whom it may concern:
In compliance with your letter of solicitation dated [insert date], we submit our Quotation No. ___________________________ dated _______________, for [fill in name of procurement].
Place of Manufacture: ________________
Total Price $_____________
This price shall remain firm for [fill in # days] days.
The terms of delivery and payment terms are FOB Destination, Net 30 Days.
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.
| Company _____________________ |
| Signature _____________________ |
| Address ______________________ |
| Typed Name __________________ |
| ______________________________ |
| Title _________________________ |
| Telephone No.___(___)__________ |
| Date _________________________ |
Date Printed 2/2/2026 1 of 1 Date Approved 12/14/2020
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