FORM CD-404-EF (09-97) ~ I.

ORDER NUMBER
U.8. DEPAR'l'MEN'l OF COMMERCE SUPPLY, EQUIPMENT OR SERVICE ORDER Use thiS Order
Number for 43-YA-BC-14378I
t------.,.---. . . . - -----..,..----.,.----'"T"':"--:=-:-
2. CONlRACT ORDERED AGAINST 3. P1,IR.CHASE 4; DIlUVERY 5. ORDER DATE
-r:~=_=----_1inquiri
the
.. 10

PAG!! I OF 2 Specific Provisiolll Apply 'pRDER' ORDER Procuremenl 7. SUB 8. DATE PRINTED
NONE X 0111212001 Olllce. NONE 0211012005
This Ref_
No.
must appeor on aU
invoices IIld BUREAU OF THE CENSUS
13. CONTACT: packaB", Frciaht FINANCE DMSION
chars- over SI 00
NONE requira a BiD of ROOM 3546, BUILDING 3
I3LTEL:~ 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 0913012001 JB 13,600.0000 13,600.00

SUPPORT OF TIffi CENSUS 2000 PUBUCITY OFFICE'S
ACIlVITlES RELATING TO POST DECENNIAL DATA
DISSEMINATION AS OUTLINED IN TIlE ATTACHED
STATEMENT OF WORK.

PERIOD OF PERFORMANCE: JANUARY 15,2000 THROUGH

SEPTEMBER 30,2001

CENSUS CONTACT: KIMBERLY CREWS 301-457-8565;

JENNIFER MARKS 301-457·3135

U.s. DEPARTMENT OF COMMERCE - TERMS AND CONDmONS

The following terms IIld wnditio.. 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 CIa..... incorponted by Reference (Apr 84). This COIIIJ1Ict incorpontes!he IOUowing cia.... 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:: FUll TEXT CLAUSES ARE AVAILABLE AT 1ITIl':/IWWW.ARNET.GOVIFARlFARQUERYFRAME.HTML

NOTI:2 INVOICE MUS? COINOOE WITH UNE I1EMS ON PURCHASE ORDER
NOTI:3 INSTRUCTIONS FOR SUBMlTI1NG INVOICES ARE ATTACHED
NOTI:4 CONTRACTOR SHAlL AllOW nm GOVT 30 DAYS FROM DEUVERY TO INSPECT &: ACCEPT
NOTI: S CONTRACTOR AGREES TO INVOICE NO LESS mAN 30 DAYS AFffiR DEUVERY
NOTI:6 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 0111212001 Y N/A
30. SHIP TO (INCLUDE ON SHIPPING LABEL)
3I. ISSUING OFFICE (DO NOT SHIP OR BILL TO nus ADDRESS)
OBLlG-2001-43781-0-0
REFERENCE ORDER NO.:
BOC MAIN RECEIVING DOCK BUREAU OF THE CENSUS
ROOM 1203A, FOB 4 ACQUlSmON BRANCH, ROOM G-312-3
4700 SILVER HILL ROAD 4700 SILVER HILL ROAD
Attn: S J CLEVINGER
SUITLAND, MD 20746 SUITLAND MD 20746
Pbone:
 FOIUI cD-404-EF 109-97) I. ORDER NUMBER
\ u. 8. DEPAR2'K£1l'r OF COHHBRCE
SUPPLY; EQUIPMENT OR SERVICE ORDER 43-YA-BC-143781
(COll'rlIlOATIOIl 811:&£2'1

32. SUPPUER 33. ISSUING OFFICE 5. ORDER DATE 18. DATE PRINTED
PAGE 2 OF
1 PATRICIA D WATSON BUREAU OF TIlE CENSU~ 0111212001 I 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 S J CLEVINGER (W)301-763-2990 Lac: FB 3 Rm: 2705
SUPPORT OF TIlE CENSUS

i!!!llli·:~I:III.II:llii!::I!:I:!I:iII151. TYPE SIUPMENT

52. RECEIPT SIGNATURE" TITLE 53. RECEIPT DATE

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.