Page: 1 of 3

19AF2020P0440

ORDER FOR SUPPLIES OR SERVICES

IMPORTANT: Mark all packages and papers with contract and/or order numbers. PAGE OF PAGES
Page 1
1. DATE OF ORDER 2. CONTRACT NO.(If any) 6. SHIP TO:
17 Mar 2020 19AF2020P0440, KABUL
3. ORDER NO. 4. REQUISITION/REFERENCE NO. a. NAME OF CONSIGNEE
19AF2020P0440 PR9102601 ATTN: GSO/WAREHOUSE

5. ISSUING OFFICE (Address correspondence to) b. STREET ADDRESS

AMERICAN EMBASSY KABUL GREAT MASOUD ROAD
GREAT MASOUD ROAD ATTN: GSO/PROCUREMENT
KABUL, c. CITY d. STATE e. ZIP CODE
KABUL
Contact Name: Masoud Hashemi
Phone: f. SHIP VIA
Email: HASHEMIM@state.gov
7. TO: 8. TYPE OF ORDER

a. NAME OF CONTRACTOR CONTACT PHONE NUMBER a. PURCHASE ORDER b. DELIVERY ORDER -- Except for billing
ENG AHMAD 93(0) 798 782 501 REFERENCE YOUR: _______ instructions on the reverse, this delivery order
is subject to instructions contained on this side
DUNS NUMBER E-MAIL:
Please furnish the following on the terms and conditions only of this form and is issued subject to the
123456787 gtcc.afg@gmail.com specified on both sides of this order and on the attached sheet, terms and conditions of the above-numbered
FAX: if any, including delivery as indicated. contract.

b. COMPANY NAME
Green Tree Construction Supply Co
Legal Name: Green Tree Construction & Supply Co

c. STREET ADDRESS
AFGANISTAN KABUL

d. CITY e. STATE f. ZIP CODE 10. REQUISITIONING OFFICE

AMERICAN EMBASSY KABUL
9.ACCOUNTING AND APPROPRIATION DATA ATTN: FACILITIES
1900-2020--19___X45190001-5604-SCA--9665-19AF2020P0440-2652------
-- $9,610.00USD

Funds Certification Officer Signature:

11. BUSINESS CLASSIFICATION (Check appropriate box(es)) 12. F.O.B. POINT

a. SMALL b. OTHER THAN SMALL c. DISADVANTAGED
Destination
d. WOMEN-OWNED e. HUBZone f. SERVICE-DISABLED VETERAN-OWNED
g. WOMEN-OWNED SMALL BUSINESS (WOSB) ELIGIBLE UNDER h. EDWOSB
THE WOMEN-OWNED SMALL BUSINESS PROGRAM
13. PLACE OF 14. GOVERNMENT B/L NO. 15. DELIVER TO F.O.B. POINT ON OR BEFORE (Date) 16. DISCOUNT TERMS
a. INSPECTION b. ACCEPTANCE 15 Apr 2020

17. SCHEDULE (See reverse for Rejections)

ITEM NO. SUPPLIES OR SERVICES QUANTITY UNIT UNIT PRICE AMOUNT QUANTITY ACCEPTED
(a) (b) ORDERED (d) (e) (f) (g)
(c)

SEE LINE ITEM DETAIL

SEE BILLING 18. SHIPPING POINT 19. GROSS SHIPPING 20. INVOICE NO. 17(h) TOT.
WEIGHT (Cont. pages)
21. MAIL INVOICE TO:
INSTRUCTIONS ON
REVERSE
a. NAME
AMERICAN EMBASSY KABUL
b. STREET ADDRESS (or P.O. Box) 9,610.00USD (AFG) 17(i)
GREAT MASOUD ROAD (KabulFMCDBO@state.gov) (GRAND TOTAL)
ATTN: FMC
c. CITY d. STATE e. ZIP CODE
KABUL
22. UNITED STATES OF AMERICA BY (Signature) 23. NAME Typed
James C Bennett

TITLE: CONTRACTING/ORDERING OFFICER

17 Mar 2020

AUTHORIZED FOR LOCAL REPRODUCTION OPTIONAL FORM 347(REV. 9/2012)

PREVIOUS EDITION NOT USABLE Prescribed by GSA/FAR 48 CFR 53.213(f)
 Page: 2 of 3
19AF2020P0440

ORDER FOR SUPPLIES OR SERVICES PAGE NO.

SCHEDULE - CONTINUATION
IMPORTANT: Mark all packages and papers with contract and/or order numbers.
DATE OF ORDER TITLE CONTRACT NO. ORDER NO.
17 Mar 2020 COVID-FMS-19 Sink project/URGENT-JMM 19AF2020P0440

ITEM NO. SUPPLIES OR SERVICES QUANTITY UNIT UNIT PRICE AMOUNT QUANTITY
(a) (b) ORDERED (d) (e) (f) ACCEPTED
(c) (g)

0001 Counter Top Sink complete set Stainless Steel 22.00 each 200.00USD (AFG) 4,400.00USD (AFG)

0002 Sensor Sink Mixer Valve 22.00 each 70.00USD (AFG) 1,540.00USD (AFG)

0003 PVC P -Trap 50 MM 22.00 each 30.00USD (AFG) 660.00USD (AFG)

0004 Angal Valve 44.00 each 5.00USD (AFG) 220.00USD (AFG)

0005 Copper Tee 90 degree 1/2" 30.00 each 3.00USD (AFG) 90.00USD (AFG)

0006 Copper Elbow 90 degree 1/2" 30.00 each 2.00USD (AFG) 60.00USD (AFG)

0007 Copper Male Adaptor 1/2 x 3/4" 30.00 each 5.00USD (AFG) 150.00USD (AFG)

0008 Copper Female Adaptor 1/2 x 3/4" 30.00 each 5.00USD (AFG) 150.00USD (AFG)

0009 Shutoff Valve 3/4" 20.00 each 15.00USD (AFG) 300.00USD (AFG)

0010 Shutoff Valve 1/2" 30.00 each 12.00USD (AFG) 360.00USD (AFG)

0011 Copper Tee 90 degree 3/4" 30.00 each 4.00USD (AFG) 120.00USD (AFG)

0012 Copper Elbow 90 degree 3/4" 30.00 each 4.00USD (AFG) 120.00USD (AFG)

0013 Copper Male Adaptor 3/4" 40.00 each 5.00USD (AFG) 200.00USD (AFG)

0014 Copper Female Adaptor 3/4" 30.00 foot 5.00USD (AFG) 150.00USD (AFG)

0015 Copper Pipe 3/4" 20.00 meter 6.00USD (AFG) 120.00USD (AFG)

0016 Copper Pipe 1/2" 20.00 meter 5.00USD (AFG) 100.00USD (AFG)

0017 Reapiring Clamp 2" 30.00 each 15.00USD (AFG) 450.00USD (AFG)

0018 Cast Iron Tee 2" 20.00 each 20.00USD (AFG) 400.00USD (AFG)
 Page: 3 of 3
19AF2020P0440

0019 Delivery Charges to the US Embassy 1.00 job 20.00USD (AFG) 20.00USD (AFG)

TOTAL CARRIED FORWARD TO 1ST PAGE (ITEM 17h) 9,610.00USD (AFG)

AUTHORIZED FOR LOCAL REPRODUCTION OPTIONAL FORM 348 (REV. 9/2012)

PREVIOUS EDITION NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.213(f)