Está en la página 1de 2

FORM CD-404-EF (09-91)

u.s. DEPARTMENT OF COMH&RCE


I------.. . . -2. -CONTRACT
I SUPPLY, EQUIPMENT OR SERVICE ORDER
--'--------r-----r----r-----..,....--------!inquiriesto
Usoth.tder 1.0RDERNUMBER
Number for 43.YA-BC.372370
ORDERED AGAINST' 3. PURCHASE 4. DEUVERY S. ORDER DATE 6. SOURCE the
PAGE I OF 2 Specific Provisions Apply ORDER ORDER Procurement 7. SUB lB. DATE PRINTED
NONE • X 1I/06fl002 Office. NONE I 02l10fl005
9. SUPPLIER'S ADDRESS 33549 :0. 1099 TAX: NONE This Reference Order 12. BILUNG ADDRESS

~
TELECLIP INC No. '~REFERENCI!ORDERNO.: OBLIG·2003.72370·0·0
II. EMPLOYER I.D. DUIIllJlpear 00 aU
3601 S CONGRESS BLDG B STE 100 \
iDYoices and BUREAU OF THE CENSUS
13. CONTACT: J.l- packages. Fr,ight
chug, over SI 00
FINANCE DMSION
AUSTIN TX 78704 CASEYWALXER requires I Bill of ROOM 3546, BUILDING 3
Lading.
131. 1EL: 51:1.-851-8800
WASHINGTON DC 20233-4400
13b. FAX: 511-B51-1507

14. IS. 16. 17. lB. 19. 20.


UNE DESCRIPTION DELIVERY QUANllTY UNIT UNIT PRICE AMOUNT
ITEM DATE ISSUE

I CONTRACTOR TO PROVIDE PRINTIBROAOCAST MEDIA I2131fl003 18 4,500.0000 4,500.00


ANALYSIS SERVICES TO INCLUDES GATHERING,
ASSEMBLING, RESEARCI-llNG, ANALYZING AND PRODUCTION
OF REPORTS ABour PRINT AND BROADCAST COVERAGE OF
CENSUS BUREAU DATA RELEASES. INCLUDES OTIffiR
DIRECT COSTS.

PERIOD OF PERFORMANCE: DATE OF AWARD THROUGH


DECEMBER 31, 2003.

CENSUS TASK MANAGER: KIM WHEELER-HESTER 301-763-


3554
ALTERNATE TASK MANAGER: MIKE MORGAN 301-763-3045

U.S. DEI'ARTMENI' OF COMMERCE - n:RMS AND CONDmONS


The following terms and conditions 15 wellu ..y on luaohed sheets, IPPIy when this docu_ is used IS I purcllase order. Uthis document is used 15 I delivery order, it is subject to the terms Ind conditions of
the contract referenced in Block M2 of the order. S2.2S2-2 Cia..... incorporated by Reference (Apr 84). This contract incorporates the following cia..... by reference, with the same Corce Ind effect 15 iClhey were
given in Culllext. Upoo request, the Cootraaing Officer will make Cull \elcIlvailabie.

NOTE: FUIL TEXT ClJ\USES ARE AVAILABLE AT 1fITP:/IWWW.ARNET.GOVIFARJFARQUERYFRAME.HTML


NOTE 2 INVOICE MUST COINCIDE W1m LINE ITEMS ON PUROlASE ORDER
NOTE 3 INSTRUcnONS FOR SUBMlTI1NG INVOICES ARE ATTACHED
NOTE 4 CONTRACTOR SHALL ALLOW TIlE GOVT 30 DAYS FROM DELIVERY TO INSPECT 8t ACCEPT
NOTES CONTRACTOR AGREES TO INVOICI! NO LESS mAN 30 DAYS MTER DEUVERY
NOTE 6 52.246-2 INSPECTON OF SUPPLIES· FIXED PRlCI!

21. ORDERED BY (NAME AND TIlLE)


PAMILLER
PURCHSGAGT $4,500.00
26. CONTRACTINGIORDER1NG OFFICER SIGNATORE 27. DATE SIGNED 12B. PROMPT PAYMENT 129. SHIP VIA
LAVANCE 1 1I/06fl002 I Y I NIA
30. SHIP TO (INCLUDE ON SIfiPPING lJ\BEL) 31. ISSUING OFFICE (DO NOT SHIP OR BILL TO TInS ADDRESS)
OBLIG-2003-72370-0-0
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
Attn: S B MASSIE
SUITLAND, MD 20746 SUITLAND MD 20746

Phone:
FORM CO-404-EF 109-91) J. ORDER NUMBER
U, B, OEl'AR'ftlENT OF COHHERCE
SUPPLY, EQUIPMENT OR SERVICE ORDER 43-YA-BC-372370
(CONTINUATION SUETI

PAGE 132. SUPPLIER 133. ISSUING OFFICE S. ORDER DAlE la. DAlE PRINTED
2 OF 2
TELECLIP INC BUREAU OF THE CENSUS 1110612002 I 02110/2005
34. 3S. 36. 31. 38. 39. 40. 4J.
LINB MDL QTY QTY ANAL FUU. ACCOUNTING CLASSIf1CATION D1ST% AMOUNT
ITEM RECVD

046210000-0002004-03-02-00011-04-0009-00-00-00-00 25-20..()4-00 00000o 100% 4,500.00

42. 43. 44. 4S. 46. SHIP TO ADDRESS 42. 43. 44. 4S. 46. SHIP TO ADDRESS
LINE MDL QTY RECEIVING (INCLUDE REl'I!RENql ORDER NO. LINE MDL QTY RBCIlMNG (INCLUDE REFERENCE ORDER NO.
ITEM OFFICE CODE ON SHIPPING LABEL) ITEM OPflCECODE ON SHIPPING LABEL)

41. 4a. 49. so.


LINE REQUISITION NUMBER REQUIsmON DESCRIPTION REQUlsmONER INFORMATION
IlEM

30664-0 ·Renewal of PO #43-YABC-OI9881 S B MASSIE (W)301·763-3012 Loc: FB 3 Rm: 2720

S2. RECEIPT SIGNATIJRE '" TInE S3. RECEIPT DATE


1.;i[:llliiil.I;;;;ir··:·:::·. i;;.i ili .:.:.:.Jiil·Ii.iiir· TYPE SIDPMENT
ACCEPTANCE: ICERTIFYTHATAR~TI""CLES==ANDti;i;i;l/-OR-SER-Vi-CES--ANN----OT-A-TED=--+S-4.-A-CCEPT--AN:-CE-S-1-GN-A-TIJRE-----I/;-T\T1£-------------+-SS-.A-CCEPT=-AN--CE-D-AlE=----l
ABOVE HAVB BEEN RECEIVED,INSPECTED AND ACCEPTED AS COMPLYING
wrrn nus ORDER, AS OF nIE DAlE SHOWN.

También podría gustarte