ORDER FOR SUPPLIES OR SERVICES

I
PAGE
PAGES
3
IMPORTANT: Mark all packages and papers with contract and/or order numbers. I
1
1. DATE OF ORDER 2. CONTRACT NO. (If any) 6. SHIP TO:
07/12/2011
a. NAME OF CONSIGNEE
3. ORDER NO. 14. REQUISITION/REFERENCE NO.
DEPUTY ADMINSTRATOR
AG-4740-P-11-0055/0001 530692
5. ISSUING OFFICE (Address correspondence to) b. STREET ADDRESS
ADMINISTRATIVE STAFF 1400 INDEPENDENCE AVE SW, ROOM 2641
3275 APPLING ROAD, ROOM 2
MEMPHIS TN 38133-2701
c. CITY
I d. STATE I; e. ZIP CODE
WASHINGTON
DC 20250-6456
7. TO: f. SHIP VIA
a. NAME OF CONTRACTOR
SOUDER BETANCES
8. TYPE OF ORDER
b. COMPANY NAME
IK] a. PURCHASE D b. DELIVERY
c. STREET ADDRESS REFERENCE YOUR:
AND ASSOCIATES
Except for billing instructions on the
5448 N KIMBALL AVE
reverse, this delivery order is subject
to instructions contained on this side
363743331 A
only of lhis form and is issued
Please furnish lhe following on lhe terms subject to the terms and conditions
and conditions specified on both sides of of the above-numbered contract.
d. CITY
I e. STATE I f. ZIP CODE
this order and on the attached stieet, if any,
inCluding delivery as indicated.
CHICAGO
IL 606254620
9. ACCOUNTING AND APPROPRIATION DATA
10. REQUISITIONING OFFICE
See Schedule
IAS
11. BUSINESS ClASSIFICATION (Check appropriate box{es))
12. F.O.B. POINT
IZ] a. SMALl 0 b. OTHER THAN SMAll 0 c. DISADVANTAGED D g. SERVICE·
Destination
DISABLED
D d. WOMEN-OWNED De. HUBZone D f. EMERGING SMALL VETERAN-
BUSINESS OWNED
13. PlACE OF
14. GOVERNMENT B/l NO. 15. DELIVER TO F.O.B. POINT 16. DISCOUNT TERMS
ON OR BEFORE (Date)
a. INSPECTION
I b. ACCEPTANCE 07/25/2011
Destination Destination
NET/30
17. SCHEDULE (See reverse for Rejections)
QUANTITY UNIT QUANTITY
ITEM NO.
SUPPLIES OR SERVICES ORDERED UNIT PRICE AMOUNT ACCEPTED
(a)
(b) (c) (d)
Tax ID Number: 36-3743331
DUNS NuroPer : Not Available
THIS ORDER IS MODIFIED TO CHANGE THE
TRAINING DATE FROM JULY 25, 2011 TO AUGUST
Continued ...
18. SHIPPING POINT
19. GROSS SHIPPING WEIGHT
21 . MAIL INVOICE TO:
a. NAME
SEND INVOICE TO CONSIGNEE (BLOCK 6)
SEE BILLING
INSTRl/CTIONS
b. STREET ADDRESS ------
ON REVERSE
(or P.O. Box)
------
------
c. CITY

------
22. UNITED STATES OF AMERICA

BY (Signature)
AUTHORIZED FOR LOCAL REPRODUCTION
I
PREVIOUS EDITION NOT USABLE
(e) (f) (g)
20. INVOICE NO. 17(h)
TOTAL
(Cont.
pages)
$0.00

17(i)
GRAND
TOTAL
e. ZIP CODE
$0 . 00

------
23. NAME (7yped)
BEVERLY S. BROWN
TITLE: CONTRACTING/ORDERING OFFICER
OPTIONAL FORM 347 (Rev. 3120051
P11t9Cribed by GSA/FAR 48 CFR
Obtained via FOIA by Judicial Watch, Inc.
ORDER FOR SUPPLIES OR SERVICES
SCHEDULE -CONTINUATION
IMPORTANT· Mark all paCkages and papers with contract and/or on:tar numbers
DATE OF ORDER ~ C O N T R A C T NO.
o7 11212ou I
ITEM NO. SUPPLIES/SERVICES
001
002
(A) (B)
30 , 2011 . ALL OTHER TERMS AND CONDITIONS
REMAIN THE SAME .
!Admin Office :
ADMINI STRATIVE STAFF
3275 APPLING ROAD, ROOM 2
MEMPHIS TN 38133-2701
Period of Performance : 07/25/2011 to
07/25/2011
Change Item 001 to read as follows(amount
shown is the obligated amount) :
CULTURAL TRANSFORMATION TRAINING
AUGUST 30 , 2011
MEMPHI S, TENNESSEE
AMS , COTTON AND TOBACCO PROGRAMS
Product / Service Code : U008
Pr oduct/Se rvice Description :
TRAINING/CURRICULUM DEVELOPMENT
Accounting Info :
Agency Code (4) : 02 Program Code
(25) : 100039991 BOC : 2523 Sub BOC
(2) : ZZ Cost Org (7) : ZZZZZZZ Job
Code (8) : ZZZZZZZZ Sub Cost Org (2) :
ZZ Budget Yr Start (2) : ZZ Budget Yr
End (2) : ZZ Fund (6) : ZZZZZZ Budget
Org (7) : ZZZZZZZ Sub Budget Org (2) :
ZZ Report Category (4) : zzzz
Funded: $0 . 00
Change Item 002 to read as follows(amount
shown is the obligated amount) :
TRAVEL EXPENSES FOR THE CULTURAL
TRANSFORMATION TRAINING CLASS IN MEMPHIS ,
TENNESSEE ON AUGUST 30 , 2011
Product / Service Code : U008
Product/Service Description :
TRAINING/ CURRICULUM DEVELOPMENT
Accounting Info :
Agency Code (4) : 02 Program Code
Continued •..
QUANTITY UNIT
ORDERED
(C) (D)
NSN 7540-01·152-8082
TOTAL CARRIED FORWARD TO 1ST PAGE (ITEM 17(H))
50:HII-101
UNIT
PRICE
(E)
'
ORDER NO.
AG-4740-P-11-0055/0001
AMOUNT
(F)
0. 00
0. 00
QUANTITY
ACCEPTED
(G)
OPllONAL FORM 348iR&v. 6195)
,_by GSA
FAR (48 CFR) 53.21' 3{c)
Obtained via FOIA by Judicial Watch, Inc.
ORDER FOR SUPPLIES OR SERVICES
SCHEDULE- CONTINUATION
IMPORTANT· Mark all packages and papers with contract and/or order numbers
DATE OF ORDER ! CONTRACT NO.
07/12/2011
ITEM NO. SUPPLIES/SERVICES QUANTITY
ORDERED
(A) (B) (C)
(25) : 100039991 BOC: 2111 Sub BOC
(2) : ZZ Cost Org (7) : zzzzzzz Job
Code (8) : ZZZZZZZZ Sub Cost Org (2) :
ZZ Budget Yr Start (2) : ZZ Budget Yr
End (2) : ZZ Fund (6) : ZZZZZZ Budget
Org (7) : ZZZZZZZ Sub Budget Org (2) :
ZZ Report Category ( 4) : zzzz
Funded: $0 . 00
UNIT
(D)
TOTAL CARRIED FORWARD TO 1ST PAGE (ITEM 17(H))
NSN 7540.01-152-1)082
503-48-101
UNIT
PRICE
(E)
I ORDER NO.
AG-4740-P-11- 0055/0001
AMOUNT
(F)
QUANTITY
ACCEPTED
(G)
OPTIONAL fORM 348 (Rev. 8195)
Ptoocrit>e<j .. GSA
FAR (48 CFR) 53.:213(c)
Obtained via FOIA by Judicial Watch, Inc.
Obtained via FOIA by Judicial Watch, Inc.
Obtained via FOIA by Judicial Watch, Inc.
Obtained via FOIA by Judicial Watch, Inc.

Sign up to vote on this title
UsefulNot useful