Request for Quote (RFQ): 474164-Two (2) Custom-Engineered 1000 W Electric Heaters

Form / Attachment / Pricing Sheet

This document, AMS-FORM-050, is an "Annual Representations & Certifications" form required by Brookhaven National Laboratory (BNL/BSA). It is used to gather essential registration data and additional representations and certifications from Offerors who intend to provide goods or services in support of a U.S. Government (USG) Contract.

• Section A.1: Business Information: Collects basic business name, address, contact information, and Unique Entity Identifier (UEI) from SAM.gov. It also asks for NAICS code and physical/performance location details.
• Section A.2: Applicable Only to Small Business Offerors: Requires small businesses to certify their status and select relevant subcategories (e.g., Woman-Owned, HUBZone, 8(a)). It references FAR 52.219-1 for Small Business Program Representations.
• Section B: Additional Representations and Certifications: Includes various FAR clauses covering topics such as:
  • FAR 52.203-11: Certification and Disclosure Regarding Payments to Influence Certain Federal Transactions.
  • FAR 52.204-10: Reporting Executive Compensation and First-Tier Subcontract Awards.
  • FAR 52.209-5: Certification Regarding Responsibility Matters.
  • FAR 52.209-7: Information Regarding Responsibility Matters.
  • FAR 52.222-22: Previous Contracts and Compliance Reports.
  • FAR 52.222-25: Affirmative Action Compliance.
  • FAR 52.225-1 & 52.225-9: Buy American Supplies/Construction Materials.
• Section C: Authorized Signature of Offeror: Requires the Offeror's authorized representative to certify the accuracy of the information provided.

This form is critical for any Offeror seeking to do business with BNL/BSA under a USG contract. Bidders must accurately complete all relevant sections to demonstrate their eligibility, compliance, and business status. Failure to complete this form correctly may result in the Offeror not being considered a small business or potentially being deemed non-responsible. The information provided here is relied upon by BSA for award decisions and may be subject to public reporting.

Contract / Statement of Work (SOW)

This document outlines a contract for the provision of two (2) custom-engineered 1000 W electric heaters for the Brookhaven National Laboratory (BNL) Cryogenics Department. These heaters are intended to provide an artificial thermal load for the helium liquefier and support liquid helium flow regulation.

• Two (2) Electric Heaters:

  • Rated at 1000 W each, 120VAC.
  • Outer Diameter not exceeding 1.22" (31 mm).
  • Incorporate two DT670-CU-Curve C Lakeshore cryogenic temperature diodes per heater.
  • Low heat flux through finned surfaces (must accommodate <0.50 W/cm²).
  • Include a 2.75-inch ConFlat stainless steel non-rotating flange for dewar attachment.
  • MSLD-He leak-tight to better than 5×10-6 mbar·L/sec.
  • Separate hermetically sealed connectors for diodes and heater wiring, rated for pressure differential up to 5 bars.
  • 5-meter internal power and diode sensor cables.
  • Manufacturing per UL61010-1 requirements.

• Documentation:

  • Complete technical drawings for the heaters.
  • Installation and operation manuals for the heaters.

• Contract Type: Firm Fixed Price

• Contract Number: 474164

• Period of Performance: Effective from the date executed by both parties, remaining in effect through twelve (12) weeks After Contract Award (ACA).

• Overall Value: To Be Determined (TBD)

• Deliverables Due:

  • Custom-engineered 1000 W electric heaters: 12 Weeks ACA (each)
  • Complete technical drawings: 12 Weeks ACA
  • Installation and operation manuals: 12 Weeks ACA

• Payment: Made upon receipt and approval of properly certified invoices, contingent upon receipt and acceptance of deliverables.

• Invoicing: Directed to BSA's Accounts Payable Department via electronic or regular mail. Electronic submission preferred in PDF format to apinvoices@bnl.gov.

Not specified in this document.

• The contract is between the Contractor and Brookhaven Science Associates, LLC (BSA), acting under a Prime Contract with the U.S. Department of Energy (DOE).
• Exhibit A details the Statement of Work (SOW).
• Exhibit B outlines BNL Supplier Quality Assurance Requirements (BNL-QA-101).
• Specific freight terms (FOB BSA National Laboratory) and labeling, packing, and notification requirements are detailed.
• Authorized representatives for both BSA and the Contractor are identified.

Form / Attachment / Pricing Sheet

This document is a "Quotation Pricing Sheet" (Form No. AMS-Form-043, Revision No. 0.1) used by potential bidders to submit pricing information for the "Two 1000W Electric Heaters for New Helium Liquefier" requirement (Reference: BSA Request for Quotation No. 474164).

• Quotation Number and Date: Fields to be filled in by the bidder.
• Item Description: "Custom-engineered 1000 W electric heater".
• Quantity: Specified as 1 for each heater.
• Unit Price: Field for bidder to enter.
• Total Price: Field for bidder to calculate and enter.
• Price Firmness: Price must remain firm for 90 days.
• Delivery and Payment Terms: FOB Destination, Net TBD Days.
• Company Information: Fields for company name, signature, address, typed name, title, telephone number, and date.
• SAM Registration Affirmation: Bidders must affirm they are registered in SAM, have current representations and certifications, and provide their UEI number.

This form is essential for bidders responding to RFQ No. 474164. It requires bidders to provide specific pricing for the requested electric heaters, confirm delivery and payment terms, and attest to their SAM registration status. Completing and submitting this form accurately is a key part of the quotation submission process.

Form / Attachment / Pricing Sheet

This document is a Vendor ACH Authorization Form required by Brookhaven National Laboratory (BNL)/Brookhaven Science Associates (BSA), managed under contract with the U.S. Department of Energy. It is used to authorize electronic payments via Automated Clearing House (ACH).

• Vendor Information: Requires Vendor/Company Name or DBA, Vendor Number (if applicable), and Tax ID Number (TIN).
• Depository Information: Requires Financial Institution name, Routing/Transit/ABA Number, and Checking Account Number.
• Authorization: A statement authorizing BNL/BSA to initiate ACH credit entries or correcting entries to the specified account. The authorization remains in effect until written notification to terminate or modify is received by BNL/BSA.
• Authorized Representative Information: Requires the name of the authorized representative, their email, phone number, signature, and the date.

Vendors responding to opportunities managed by BNL/BSA may be required to complete and submit this form to facilitate electronic payments. It is crucial for bidders to accurately provide their banking and company information to ensure timely and correct payment processing if awarded a contract.

Form / Attachment / Pricing Sheet

This document is IRS Form W-9, Request for Taxpayer Identification Number and Certification. It is used by U.S. persons (including resident aliens) to provide their correct Taxpayer Identification Number (TIN) to a requester who is required to file an information return with the IRS. This form is essential for vendors to provide their TIN to the government entity issuing the contract or payment, ensuring accurate tax reporting and avoiding backup withholding.

• Part I: Taxpayer Identification Number (TIN): Requires the vendor to enter their Social Security Number (SSN) or Employer Identification Number (EIN).
• Part II: Certification: The vendor certifies that the TIN provided is correct, that they are not subject to backup withholding, that they are a U.S. citizen or other U.S. person, and that FATCA reporting exemptions are correct (if applicable).
• Lines 1-7: Fields for name, business name, address, city, state, ZIP code, and account numbers.
• Taxpayer Classification: Section 3a requires the vendor to select their federal tax classification (e.g., Individual/sole proprietor, C corporation, S corporation, Partnership, LLC, Trust/estate).

Vendors must complete and submit this form accurately to receive payments and avoid penalties such as backup withholding. Failure to provide a correct TIN or to properly certify the information can lead to delays in payment or other adverse tax consequences. This form is a standard requirement for doing business with the U.S. government.

Form / Attachment

This document is IRS Form W-8BEN-E, "Certificate of Status of Beneficial Owner for United States Tax Withholding and Reporting (Entities)." It is used by foreign entities to establish their status as beneficial owners of U.S. income and to claim foreign status and any applicable reduced rate of, or exemption from, U.S. tax withholding.

• Part I: Identification of Beneficial Owner: Collects basic identifying information about the entity, including its name, country of incorporation, and Chapter 3 and Chapter 4 (FATCA) statuses.
• Part II: Disregarded Entity or Branch Receiving Payment: Used if the entity is a disregarded entity or a branch of a foreign financial institution (FFI).
• Part III: Claim of Tax Treaty Benefits: Allows the entity to claim benefits under a U.S. income tax treaty.
• Subsequent Parts (IV-XXIX): These parts allow the entity to certify its specific status as a type of foreign financial institution (FFI) or non-financial foreign entity (NFFE), such as a sponsored FFI, certified deemed-compliant FFI, excepted NFFE, etc. This is crucial for determining U.S. tax withholding and reporting obligations.
• Part XXX: Certification: The final section where the beneficial owner certifies the accuracy of the information provided.

If this opportunity involves payments to foreign entities, bidders may be required to obtain and process this form from their foreign subcontractors or partners to ensure compliance with U.S. tax withholding regulations. Understanding the entity's Chapter 4 status (FATCA status) is particularly important for withholding agents. This form helps identify the entity's tax residency and any treaty benefits it may claim, which can affect the amount of tax to be withheld.

Solicitation / RFP / RFQ

This solicitation (RFQ 474164) is for the procurement of two (2) custom-engineered 1000 W electric heaters. The North American Industry Classification System (NAICS) Code is 333414, Heating Equipment (Except Warm Air Furnaces) Manufacturing, with a size standard of 500 employees. The procurement is being solicited for full and open competition.

• Two (2) custom-engineered 1000 W electric heaters.

• Items must be in strict accordance with the attached Draft Contract 474164 (Enclosure A).

• Contract Type: Firm Fixed Price (FFP).

• Anticipated Delivery Date: 12 Weeks after contract award.

• Quotes shall remain valid for 90 days.

• Payment Terms: TBD.

• Freight Terms: FOB Destination, Freight Prepaid.

• Submission Method: Email only.

• Quote Due Date & Time: 27 March 2026.

• Questions Due Date: 19 March 2026.

• Award Basis: Lowest total price from a responsive and responsible Offeror meeting all technical requirements.

• Evaluation: Quotes must include all necessary descriptive information to demonstrate how the proposed item meets all requirements. Exceptions to terms and conditions may result in non-responsiveness.

• Full and open competition.

• Offerors must be registered in the System for Award Management (SAM) and have a Unique Entity ID (UEI #). Foreign vendors are not required to register in SAM but must complete AMS-Form-050 (Enclosure B).

• Offerors must affirm their Representations and Certifications and size status are accurate and up to date in SAM.gov.

• Subject to FAR Part 25, Buy American Act. Offerors must provide country of manufacture if foreign end products are proposed.

• Enclosures include: Draft Contract 474164, AMS Form 050 Reps and Certs, AMS Form 043 Quotation Pricing Sheet, Vendor ACH Authorization Form, W-9 Form (Domestic Vendors), and W-8 Form (Foreign Vendors).