Waveguide Adapters

Form / Attachment / Pricing Sheet

This document is a DRAFT Purchase Order (PO) from Brookhaven National Laboratory (BNL) to "ANY VENDOR" for a "2400M0173 Rev. B / 704 MHz Waveguide Adapter Assy". It outlines the terms and conditions for this specific purchase.

• PO Number: BNL-0000475777
• Vendor: ANY VENDOR
• Item: 2400M0173 Rev. B / 704 MHz Waveguide Adapter Assy
• Payment Terms: Net 30
• Freight Terms: FOB Destination, Frt Prepaid
• Ship Via: UPS-GROUND
• Contractual Representative: Eric Nagel
• Technical Representative: Jesse Fite
• Attachments: Statement of Work (Attachment 1), Technical Drawings (Attachment 2)
• Quality Assurance: References BNL-QA-101 and requires conformance to specified quality paragraphs.
• Shipping Requirements: Includes specific instructions for packing slips, shipment declarations, and delivery locations.
• Invoicing: Electronic submission preferred to APinvoices@bnl.gov.

This document details the specific item being procured, delivery and invoicing instructions, and quality assurance requirements. Vendors should review the terms, conditions, and attached documents (SOW, Technical Drawings) to understand the full scope of the purchase and ensure compliance.

Statement of Work (SOW) / Performance Work Statement (PWS)

This Statement of Work (SOW) outlines the requirements for the procurement of 704 MHz Waveguide Adapters for the Electron-Ion Collider (EIC) at Brookhaven National Laboratory (BNL). These adapters are crucial for testing the power handling capabilities of high-power fundamental power coupler designs used in the EIC's electron storage ring (ESR) and hadron storage ring (HSR).

• Manufacture, inspect, test, and deliver two (2) 704 MHz Waveguide Adapters.

• Ensure the final product is tuned to 704.0 MHz +/- 0.2 MHz with an S21 of –0.03 dB or better.

• Comply with applicable specifications, referenced documents, and instructions.

• Technical performance requires tuning to 704.0 MHz +/- 0.2 MHz with an S21 of –0.03 dB or better.

• "Witness" points: BSA reserves the right to designate manufacturing, inspection, and test operations as witness points, requiring ten (10) working days' notice from the Contractor.

• The SOW is effective as of January 28, 2026.

• Deliverables are due 20 weeks ARO (After Receipt of Order).

• Contractor Responsibilities: Furnish all equipment, materials, tools, facilities, and labor. Supply tooling, fixtures, and test equipment.

• Government Furnished Material: BSA will provide measurement adapters for each end of the assembly.

• Documentation: Retain records of inspections and tests for a minimum of three (3) years. Records must be available to BSA upon request.

• Environment, Safety and Health (ESH): Design and build equipment in accordance with ESH requirements.

• Marking and Serialization: Components must be marked per applicable drawings/specifications. Serialization is required for traceability and must be agreed upon prior to marking.

• Packaging: Adapters must be protected against weather, dust, shock, and impacts. Containers must be braced, labeled, palletized, and include forklift access provisions.

• Quality Assurance: Maintain a documented quality assurance system meeting ISO-9001 standards. BSA representatives will have facility access. Compliance with BNL-QA-101 is required.

• Configuration Management: Maintain a configuration control system and notify BSA of any significant changes affecting form, fit, function, reliability, safety, or interchangeability.

• Repairs: Any failures or required repairs must be immediately reported to BSA. Repairs require BSA approval and are at the Contractor's expense.

1. End Item Documentation
2. Delivery of Equipment

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 for "Waveguide Adapters" in response to Brookhaven National Laboratory's solicitation (BSA Request for Quotation No. 475777).

• Fields for pricing of Waveguide Adapters at both normal and expedited delivery schedules.
• A note specifying that the SOW normal schedule is 20 weeks after contract award and that revised delivery schedules should be annotated.
• A statement that the submitted price will remain firm for 90 days.
• A section for "Concurrence" where the bidder acknowledges and agrees to BSA's requirements, terms, conditions, and delivery schedule, and affirms their SAM registration and current representations/certifications.

Bidders must complete and submit this form with their quotation. It requires them to provide specific pricing for the requested items and delivery options. The concurrence section is critical, as signing it signifies agreement to the solicitation's terms and conditions. This document directly impacts proposal preparation and is essential for a compliant bid.

Form / Attachment / Pricing Sheet

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

• Section A.1: Business Information: Collects basic business name, address, contact information, and Unique Entity Identifier (UEI) from SAM.gov. It also captures NAICS code and physical business location.
• Section A.2: Applicable Only to Small Business Offerors: Requires small business offerors to certify their business size and status via SAM.gov and includes detailed representations regarding various small business categories (e.g., Woman-Owned, Service-Disabled Veteran-Owned, HUBZone).
• Section B: Additional Representations and Certifications: Includes clauses related to:
  • 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 (e.g., debarment, suspension, delinquent taxes).
  • FAR 52.209-7: Information Regarding Responsibility Matters (administrative/criminal proceedings).
  • FAR 52.222-22: Previous Contracts and Compliance Reports.
  • FAR 52.222-25: Affirmative Action Compliance.
  • FAR 52.225-1/9: 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 vendor seeking to do business with BNL/BSA under USG contracts. Bidders must accurately complete all relevant sections to demonstrate their eligibility, compliance, and status (especially regarding small business categories). Failure to provide accurate information or complete the form as required may result in the offer not being considered or the bidder being deemed non-responsible. The information provided here is essential for the government's evaluation and award process.

Form / Attachment / Pricing Sheet

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 entities to certify their status for U.S. tax withholding and reporting purposes, particularly concerning FATCA (Foreign Account Tax Compliance Act) and Chapter 4 status.

• Part I: Identification of Beneficial Owner: Collects basic identification information about the entity, including its name, country of incorporation, and Chapter 3 and Chapter 4 statuses.
• Parts II-XXIX: These sections allow the entity to detail its specific status, such as a disregarded entity, claim tax treaty benefits, or certify various "deemed-compliant" or "excepted" statuses under FATCA (e.g., Participating FFI, Nonreporting IGA FFI, Active NFFE, Passive NFFE).
• Part XXX: Certification: Contains the final certification by the beneficial owner, attesting to the accuracy of the information provided and its status as a non-U.S. person.

This form is crucial for any entity that may receive payments from a U.S. source. Bidders who are entities (not individuals) will need to complete and submit this form to the withholding agent (the entity making the payment) to certify their foreign status and potentially claim reduced withholding tax rates under tax treaties or specific exemptions under FATCA. Failure to provide a correct and complete Form W-8BEN-E can result in backup withholding at the highest applicable rate.

Solicitation / RFP / RFQ

This is a Combined Synopsis/Solicitation (RFQ) for non-commercial products, specifically Waveguide Adapters. Brookhaven Science Associates (BSA), operating Brookhaven National Laboratory for the U.S. Department of Energy, is soliciting quotes for these items as outlined in the Draft Purchase Order (Enclosure 1).

• Offerors shall furnish all labor, services, materials, and equipment in strict accordance with the attached Draft Purchase Order and its attachments.

• Alternate products offered must have equivalent or greater performance parameters than specified. Documentation must be provided to demonstrate equivalency.

• The procurement is subject to the FAR Part 25, Buy American Act. Offerors must state if proposed items are domestic end products and provide the country of manufacture if foreign end products are proposed.

• Contract Type: Firm-Fixed Price.

• Anticipated Delivery Date: 20 Weeks after contract award.

• Payment Terms: Net 30.

• Freight Terms: FOB Destination, Freight Prepaid.

• Quotations must be received by BSA no later than 31 March 2026, 5 pm EST.

• Award will be made to the responsive and responsible Offeror submitting the lowest total price who meets all technical requirements.

• Offerors taking exceptions to BSA terms & conditions or failing to provide all requirements may be deemed non-responsive.

• Email submissions are required and must include the signed Quotation Pricing Sheet (Enclosure 2).

• Questions must be submitted via email; replies will be provided in writing.

• NAICS Code: 334419, Size Standard: 750 Employees.

• Procurement is for full and open competition.

• Offerors must be registered in the System for Award Management (SAM) with a Unique Entity ID (UEI #).

• Foreign vendors are not required to be registered in SAM but must fill out AMS-Form-050 (Enclosure 3).

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

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) to the vendor's bank account.

• 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 correct 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 Brookhaven National Laboratory/Brookhaven Science Associates may be required to complete and submit this form to facilitate electronic payments if awarded a contract. It is essential for understanding the payment process and providing the necessary banking details.

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 entities that are required to file information returns with the IRS. This includes reporting payments made to the vendor, such as interest, dividends, or other income.

• Part I: Taxpayer Identification Number (TIN): Requires the individual or entity to provide their Social Security Number (SSN) or Employer Identification Number (EIN).
• Part II: Certification: Requires the individual or entity to certify that the TIN provided is correct, that they are not subject to backup withholding, and that they are a U.S. citizen or other U.S. person.
• Lines 1-7: Collects name, business name (if applicable), address, city, state, ZIP code, and optional account numbers.
• Line 3a & 3b: Used to determine federal tax classification (individual, corporation, partnership, etc.) and to indicate foreign partners/owners for flow-through entities.
• Line 4: Allows for exemption codes for backup withholding and FATCA reporting.

Vendors responding to this opportunity will likely be required to complete and submit this Form W-9 to the government contracting agency. Failure to provide a correct TIN can result in backup withholding of payments. Bidders should ensure they accurately fill out the form with their correct legal name and TIN as registered with the IRS.