PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL
Document Type:
Collection:
Document Number (FOIA) /ESDN (CREST):
CIA-RDP64-00360R000400120074-4
Release Decision:
RIPPUB
Original Classification:
K
Document Page Count:
3
Document Creation Date:
November 17, 2016
Document Release Date:
February 14, 2000
Sequence Number:
74
Case Number:
Publication Date:
October 11, 1956
Content Type:
FORM
File:
Attachment | Size |
---|---|
![]() | 136.01 KB |
Body:
(Gen. Rog. No. 51, Supp. No. 11) SEKVICLS UI'HEK THAN YEKSUNAL
(Amended February 20, 1952)
U. S. - COST- iit`1. UR B
(Department, bureau, or establishment)
Voucher prepared at --------------------------------------------------------------- ---------------------------------------
(Give place and date)
THE UNITED STATES, Dr., Payee's Account No_ ----------------
TO -----------------------------------------------------------------------------------------------------------------------------------
(Payee)
-------------------------------------------------------------------------------------------------------------------------------- -------
(Address) (City) (State)
No. and Date of
Date of Delivery
ARTICLES OR SERVICES
(Enter description item number of contract or Federal supply
d
QUANTITY
UNIT PRICE
AMOUNT
Order
or Service
schedule, an
other Information deemed necessary)
Discount Terms
Cost
Per
Dollars
Cts.
Costs
1,663
13
PAYMENT:
Complete ^
Partial ^
Final ^
Use continuation sheet(s) if necessary
Shipped from to Weight Government
B/L No.
Total
1
663
,
I certify that the above bill is correct and just and that payment has not been received.
(Payee must NOT use this space)
Differences ---------------------------------
---------------
-----
(Sign original only)
STATINTL
-----------------------------------------------
---------------
-----
Date ----
-----------------------------------------------
-----
----------
-----
Ired whe bill,)
Amount verified; correct for _________-_
-
t 6
5L 3
Title
Contract No. A101 Date Req. No.
Pursuant to authority vested in me, I certify that this account is correct and proper for payment.
SIGN
ORIGINAL
ONLY
.
(Signature or initials) -- r 27''
-_----------------------------
Title ---------------------------------------------------------- Date -------------------------------------------------------------------------
THE REVERSE OF THIS FORM MUST BE EXECUTED WHEN PURCHASES ARE MADE OR SERVICES SECURED WITHOUT WRITTEN AGREEMENT IN ANY FORM
ACCOUNTING CLASSIFICATION (Appropriation Symbol must be shown; other classification optional)
I CChecaeh, k $ No- -______________________ on _ dated ___-_------------------------, 19 19 _-___, for $_-_________------------------_________ on Treasurer of the United States in
Paid by , favor of payee named above.
Payee ------------------------------
(aign o,igin..l only)
? When a voucher is Al. ed or receipt the qm of a comp~q~ rpgiy~on, q a T
writing the company ort9lfOW s OUa iQB ~$t@irritlYW1 193s0s p aKlHb~' 6Ere( gQROOfl flfl'}2flfl7 =
" John Doe Company, S n mit , ecretary", or "Treasurer", as the case may be.
If the ability to certd authority to approve are combined in one person, one signature only is nec- Title -------------------------------------------------------
essary; otherwise the approving ,officer will sign on the line below "Approved for $___________________ , and
over his official title.
stamclardForm No.
Form r U i Lre ` U gd For Rel (T(~ITO~TDC3 ~TA RbI ~ 20074-4
MEMORANDUM
September 7, 1950
(Gen. Reg. No. 51, Supp. No. 11) Services Other Than Personal
CONTINUATION SHEET
U. S C_C T REINtBURSABI ------------------------------- Sheet No. ---1------ of Bureau Voucher No. ---4.2d---
(Department, bureau, or establishment)
No. and Date
of Order
STATINTL
STATINTL
Date of
Delivery
or Service
ARTICLES OR SERVICES
supply schedule,
(Enter description, item number information of contract or Federal deemed necessary)
on e
Contract A1O1 Applicable to all Systems
Direct Costs Properly Chargeable to
Contract A101 for the period 9/3/56
thru 9/9/56
Tabor Week Ending September 9, 1956
Overhead computed for the Colmmunications
Division at interim rate of
Other Costs - per schedule attached
Tgtal Labor, Overhead and Other Costs
G d A expense computed at interim rate
of
QUAN-
TITY
1 66 L43-/'1i
Q
U. S. GOVERNMENT PR N NG O IC Q0400120074-4
S; adard Form No. 1085a-Revised
rescribed by
1,1 .}09/WC&Ar 2 4db P ( it074-4
~? irf
1 ?`~ ~?l for Relea
Coeepte b r 7 1"I Services Other Than Personal
(0,.. Reg. No. 51, t3 N- No. 11)
MEMORANDUM
COST REINlBURSALM------------------------- Sheet No. ----- ----- of Bureau Voucher No. --- 2o.
(Department, bureau, or establishment)
No
and Date
Date of
ARTICLES OR SERVICES
QUAN-
UNIT PRICE
AMOUNT
*
of Order
Delivery
(Enter description, item number of contract or Federal supply schedule.
TITY
or Service
and other information deemed necessary)
Cost
Per
Dollars
Cts.
Cke Payee P.O. 4
Arno
-t
85 PETTY CASH
3-
30
PETTY CASH
74
8
71 SELL RADIO 529131
70
72 CSICAGO STAND 529133
52
03
v
or a ease
w-
-
5
R