FORM CD-404-EF (09-97)

II.S. DEPARTMENT OF COHHERCE

I SUPPLY, EQUIPMENT OR SERVICE ORDER use~de<
Number for
1.0RDERNUMBER
43-YA-BC-598966
t-------,-- --I.------..,..----,-----r-__
2. CONTRACT ORDERED AGAINST
----r:-:::==-------iinquiries 10
3. PURCHASE 4. DEUVERY S. ORDER DATE . SOURCE lhe
PAGE I OP 2 Specific Provisions Apply ORDER ORDER Procurement 7. SUB rs, DATE PRINTED
NONE X 0111312005 0fIice. NONE 02/1012005
9. SUPPUER'S ADDRESS 31320 : ~

o. I099 TAX: MISC This Reference Order 12. BIUlNG ADDRESS

~
.~ REFERENCE ORDER NO.: OBUG-2oo5-98966-0-o
LAB TECH SYSTEMS
3822 DUNSINANE DR III. EMPLOYER I.D. .
No.
IIlU5l appear on IU
invoices and BUREAU OPTIIE CENSUS
13. CONTACT: packases. Preillht FINANCE DMSION
SILVER SPRING MD 20906 c:IIIlge ovcrS100
NONE requi= I BiU of ROOM 3546, BUILDING 3
Lading.
131.1l!L: 301-438-8270
WASHINGTON DC 20233-4400
13b. PAX: 301-438-8540

14. IS. 16. 17. 18. 19. 20.

UNE DESCRIPT10N DEUVERY QUANllTY UNIT UNIT PRICE AMOUNT
ITEM DATE ISSUE

1 CONTRACTOR TO PROVIDE MAINTENANCE SERVICES FOR 1213112005 m 2,500.0000 2,500.00

REPAIR, SERVICE AND DESIGN OF BROADCAST HARDWARE
IN TIIE PUBLIC INFORMATION OFFICE DIGITAL EDITING
FACILITIES AND SUPPLY OF MATERIALS (HARDWARE,
SOFIWARE AND EQUIPMENT) FOR USE IN CREATION OF
BROADCAST AND IN-HOUSE VIDEO, RADIO AND
PHOTOORAPHY PROORAMS. INCLUDES OTIIER DIRECT
COSTS.

PERIOD OF PERFORMANCE: JANUARY 1,2005 THROUGH

DECEMBER 31, 2005. _

TASK MANAGER: MIKE MORGAN - 301-763-3045

ALTERNATE TASK MANAGER: TOM WEBSTER - 301-763-3053

U.S. DIJ'ARTMt:NT OP COMMERCE - TERMS AND CONDmONS

The following lams Ind conditions .. well .. lay on ltuchcd.'-so IPPIy wheo Ibis document is used .. I purchase order. Iflhis documeDl is used .. I delivery order, it is subject 10 Ihc tams and condilioos of
!he contract rekrenced in Block 12 oflhc order. 52.252-2 Clauses incorporated by Refer""'" (Apr 84). This conlnlCl incorporateslhc fi:Jlowmg cla.... by refer""",. with !he same mr.. and elfeot .. iflbey were
given in ruu text. Upon r_~ Ihc CnnlnCling 0fIicer wiU make rua text available.

NOTE: FULL TEXT CLAUSES ARE AVAILABLE AT HITP:/IWWW.ARNET.GOVIfAIlfFARQUERYFRAME.HTML

NOTE 2 INVOICE MUST COINCIDE Willi UNE ITEMS ON PURCHASE ORDER
NOTE 3 INSTRUCTIONS FOR SUBMITrnlG INVOICES ARE AITACHED
NOTE 4 COIITRACTOR SHAll AlLOW TIlE GOVT 30 DAYS FROM DEUVERY TO INSPECT &. ACCEPT
NOTES COIITRACTOR AGREES TO fNVOICE NO LESS THAN 30 DAYS AFTER DEUVERY
NOTE 6 32.246-2 INSPECTON OF SUPPLIES - FIXED PRICE

21. ORDERED BY (NAME AND TITLE)

PAMILLER
PURCHSGAGT
26. CONTRACTfNGIORDERING OmCER SIGNATURE
22. FOR fNQUlRIES CALL 23. FOB POINT
301-763-3547 DESTIN

27. DATE SIGNED

~D~'::= 11
128. PROMPT PAYMENT"'i"I29~.S~HIP:::-:V1~A------1
$2,500.00

LAVANCE
1 0111312005 I Y NIA
30. SHIP TO (INCLUDE ON SHIPPING LABEL) 31. ISSUING OmCE (DO NOT SHIP OR BILL TO 11i3S ADDRESS)
OBLlG-200S-98966-0-0
REFERENCE ORDER NO.:
BOC MAIN RECEIVING DOCK BUREAU OF THE CENSUS
ROOM 1203A, FOB 4 ACQUISmON BRANCH, ROOM G-312-3
4700 SILVER HILL ROAD 4700 SILVER HILL ROAD
AItn: P H DUNTON
SUITLAND, MD 20746 SUITLAND MD 20746

Pbone:
FORM CD-404-EF (09-97) I. ORDER NUMBER
U. S. DEl'AR'!ME1lT OF COHHERCE
SUPPLY, EQUIPMENT OR SERVICE ORDER 43-YA-BC-598966
(COIlTUIlJATIOK SUE'll

PAGE
32. SUPPUIlR 33. ISSUING OFFICI! 5. ORDER DATE lB. DATE PRINTED
2 OF 2
1 LAB TECH SYSTEMS BUREAU OF TIlE CENSUS 0111312005 I 0211012005
34. 35. 36. 31. 3B. 39. 40. 41.
UNE MOL QTY QTY FINAL FULL ACCOUNTING CLASSIFICATION OIST% AMOUNT
ITEM RECVD
04 0331000-000 21 10-04-03-000 11-04-0009-00-00-00-00 25-20-04-00 000000 100% 2.500.00

42. 43. 44. 45. 46. SHIP TO ADDRESS 42. 43. 44. 45. 46. SHIP TO ADDRESS
UNE MOL QTY RECEIVING (INCLUDE REl'I!RENCI! ORDER NO. UNE MOL QTY Rl!CEIVING (INCLUDE IU!PI!RENCI! ORDER NO.
ITEM OFFICI! CODI! ON SHIPPING LABEL) ITEM OFFICI! CODE ON SHIPPING LABEL)

41. 4B. 49. 50.

UNE REQUISITION NUMBER REQUlSmON DESCRIPTION REQUISITIONER.INFORMATION
ITEM

39611-0 Renewal ofPO# YAI323~SE-0411 PH DUNTON (W)301-763-2806 Loc: FB 3 Rm: 2705

52. RECEIPT SIGNAnJRE &. TITLE 53. RECEIPT DATE

ACCEPTANCI!; I CERTIFY TIlAT ARTICLES AND/OR SERVICES ANNOTATED 54. ACCEPTANCE SIGNAnJRE A TITLE 55. ACCEPTANCE DATE
ABOVE HAVI! BEEN RECEIVED, INSPECTED AND ACCEPTED AS COMPLYING
wrrn TInS ORDER. AS OF TIlE DATE SHOWN.