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~ I. ORDER NUMBER FORM CD-404-EF (09-97) SUPPLY, EQUIPMENT OR SERVICE ORDER Use thiS Order U.8.
~
I. ORDER NUMBER
FORM CD-404-EF
(09-97)
SUPPLY, EQUIPMENT OR SERVICE ORDER
Use thiS Order
U.8.
DEPAR'l'MEN'l OF
COMMERCE
Number for
43-YA-BC-14378I
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10
2. CONlRACT ORDERED AGAINST
Specific Provisiolll Apply
3. P1,IR.CHASE
4; DIlUVERY
5. ORDER DATE
the
'pRDER'
ORDER
Procuremenl
7. SUB
8. DATE PRINTED
PAG!!
I
OF
2
NONE
X
0111212001
Olllce.
NONE
0211012005
This Ref_
No.
must appeor on aU
invoices IIld
packaB", Frciaht
13. CONTACT:
chars-
over SI 00
NONE
BUREAU OF THE CENSUS
FINANCE DMSION
ROOM 3546, BUILDING 3
I3LTEL:~
requira a BiD of
Wing.
WASHINGTON DC 20233-4400
I3b.FAX:~
14.
IS.
16.
11.
18.
19.
20.
IJNI!
DESCRIPTION
DEUVEIlY
QUANTITY
UNIT
UNIT PRICE
AMOUNT
ITEM
DATE
ISSUE
CONTRACTOR TO PERFORM NECESSARY ACTlVITlES IN
SUPPORT OF TIffi CENSUS 2000 PUBUCITY OFFICE'S
ACIlVITlES RELATING TO POST DECENNIAL DATA
DISSEMINATION AS OUTLINED IN TIlE ATTACHED
STATEMENT OF WORK.
0913012001
JB
13,600.0000
13,600.00
PERIOD OF PERFORMANCE: JANUARY 15,2000 THROUGH
SEPTEMBER 30,2001
CENSUS CONTACT: KIMBERLY CREWS 301-457-8565;
JENNIFER MARKS
301-457·3135
The following terms IIld
U.s. DEPARTMENT OF COMMERCE - TERMS AND CONDmONS
IS well IS any on all8ched sheets, apply when this documcrJt is used IS. purc:hase order.lflhis doCW'OOlll is IIS<d IS. deIiveIy order, it is subject 10 ,he lerms IIld conditions of
!he contract referenced in BIoclt 12 of !he order. 52.252-2
incorponted by Reference (Apr 84). This COIIIJ1Ict incorpontes!he IOUowing
by reference, with !he same force IIld elfect IS iflhey were
Biven in full'
Upon request. !he ConlJll<lins ()IIicer wiD mak_ fuU text I.a;lable.
NOTI::
NOTI:2
NOTI:3
NOTI:4
NOTI: S
NOTI:6
FUll TEXT CLAUSES ARE AVAILABLE AT 1ITIl':/IWWW.ARNET.GOVIFARlFARQUERYFRAME.HTML
INVOICE MUS? COINOOE WITH UNE I1EMS ON PURCHASE ORDER
INSTRUCTIONS FOR SUBMlTI1NG INVOICES ARE ATTACHED
CONTRACTOR SHAlL AllOW nm GOVT 30 DAYS FROM DEUVERY TO INSPECT &: ACCEPT
CONTRACTOR AGREES TO INVOICE NO LESS mAN 30 DAYS AFffiR DEUVERY
52.246-2 INSPECTON OF SUPPLIES - FIXED PRICE
21.
ORDERED BY (NAME AND TITLE)
PAMILLER
PURCHSGAGT
$13,600.00
26.
CONTRACTING/ORDERING OFFICER SIGNATIJRE
27.
DATI: SIGNED
28. PROMPT PAYMENT
29. SHIP VIA
LACATTERTON
Y
0111212001
N/A
30.
SHIP TO
(INCLUDE ON SHIPPING LABEL)
3 I. ISSUING
OFFICE
(DO NOT SHIP OR BILL TO nus ADDRESS)
REFERENCE ORDER NO.: OBLlG-200 1-43781-0-0
BOC MAIN RECEIVING DOCK
ROOM 1203A, FOB 4
4700 SILVER HILL ROAD
BUREAU OF THE CENSUS
ACQUlSmON BRANCH, ROOM G-312-3
4700 SILVER HILL ROAD
Attn:
S J CLEVINGER
SUITLAND, MD 20746
SUITLAND MD 20746
Pbone:
FOIUI cD-404-EF 109-97) I. ORDER NUMBER SUPPLY; EQUIPMENT OR SERVICE ORDER \ u. 8. DEPAR2'K£1l'r OF
FOIUI cD-404-EF
109-97)
I. ORDER NUMBER
SUPPLY; EQUIPMENT OR SERVICE ORDER
\
u. 8. DEPAR2'K£1l'r OF COHHBRCE
43-YA-BC-143781
(COll'rlIlOATIOIl
811:&£2'1
32. SUPPUER
33. ISSUING OFFICE
5.
ORDER DATE
18. DATE PRINTED
PAGE
2
OF
I
1 PATRICIA D WATSON
BUREAU OF TIlE CENSU~
0111212001
02/1012005
34.
35.
36.
37.
38.
39.
40.
41.
UNI!
MDL
QTY
QTY
PINAL
FULL ACCOUNTING a.ASSIFICATION
D1ST%
AMOUNT
ITEM
RECVD
04 6741000-000 20 04-03-08-000 11-04-0006-00-00-00-00 25-20-04-00 000000
100%
13.600.00
42.
43.
44.
45.
46. SIUP TO ADDRESS
42.
43.
44.
45.
46. SIUP TO ADDRESS
UNl!
MDL
QTY
RECRMNG
(lNO-UDE Il1!FERI!NCR ORDER NO.
UNI!
MOL
QTY
RIlCI!MNG
(INCLUDE REFERRNCI! ORDER NO.
ITEM
OFFlCRCODE
ON SIpPPING LABEL)
ITEM
OmCRCODB
ON
SIUPPlNG LABEL)
47.
48.
49.
50.
UNE
REQUlsmON NUMBER
REQUlsmON DESCRIPTION
REQUlsmONER INFORMATION
ITEM
21505-0
CONTRACTOR TO PERFORM NECESSARY ACTNITlES IN
SUPPORT OF TIlE CENSUS
S J CLEVINGER (W)301-763-2990 Lac: FB 3 Rm: 2705
52.
RECEIPT SIGNATURE" TITLE
53.
RECEIPT DATE
i!!!llli·:~I:III.II:llii!::I!:I:!I:iII151. TYPE SIUPMENT
ACCEPTANCE:
I CERTIFY 1lIAT ARTICLES AND/OR SERVICES
ANNOTATED
54.
ACCEPTANCE SIGNATURE &: TITLE
55.
ACCEPTANCE DATE
ABOVE HAVE BEEN RECEIVED,INSPECTED AND ACCEPTED AS COMPLYING
WI11I THIS ORDER. AS OF 1lIE DATE SHOWN.