PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP64-00360R000500030012-1
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 3
• Document Creation Date: November 17, 2016
• Document Release Date: July 22, 1999
• Sequence Number: 12
• Publication Date: March 13, 1957
• Content Type: FORM

w$ta> aard. ForpmNo. 1034-Revisdd D. O. Vou. No. ---------- ----------------------
* ConPr oller a Abed li ved For Ret bt0(V?48PE9IK U -1 00030012-1
7.11
September 7,up p. No. 11) SERVICES OTHER THAN PERSONAL Bu. Vou. No. ---------------------------------
(Qen. Reg. No.b1, S February 20, 1462)
(Amended
U. S COST REIlH.TRSABLE
. - ---------------------------------- PAID BY
(Department, bureau, or establishment)
Voucher prepared at --------------------------------------------------------------------------------------------------------
(Give place and date)
THE UNITED STATES, Dr., Payee's Account No- ----------------
To ----------------------------------------------------------------------------------------- -----------------------------------------
(Payee)
44-
SAPC 3 2-
COPY / OF 2__
ARTICLES OR SERVICES
item number of contract or Federal supply
tion
r descri
t
(E
UNIT PRICE AMOUNT
No. and Date of
Order
Date of Delivery
or Service
,
p
n
e
schedule, and other information deemed necessary)
QUANTITY
Cost
Per Dollars Cts.
Discount Terms
F0IAb3a
Costs
F0IAb3b
PAYMENT:
Complete ^
Partial ^
Final ^
Use continuation sheet(s) if necessary
Shipped from to
Weight Government B/L No.
I certify that the above bill is correct and just and that payment has not been received.
Date ---- 3-13-57 _ *Payee _ ------
----------------------d robe.--k-----b--------t--b-------
egvire when s lik.e ceetiAo.t.ste 1. m.d, msde by payee on aEESebed bill or bill,)
-----------?--
Contract No. A Date Req. No
Pursuant to authority vested in me, I certify that this account is correct and proper for payment.
SIGN
ORIGINAL
ONLY
Date
- --------------------
(Authorized Certifying Officer)
Title ---------------------------------------------------------- Date --------------------- ------------------------------------ ---------------
- THE REVERSE OF THIS FORM MUST BE EXECUTED WHEN PURCHASES ARE MADE OR SERVICES SECURED WITHOUT WRITTEN AGREEMENT IN ANY FORM
( Check No- ------------------------ dated -=---------------------------. 19 ------ for $ ----------__________________________ {on Treasurer of the United States in favor of
j` payee named above.
Paid by
Cash, $ on ------------------------------------? 19-----. Payee ----------------- Wm.- ---------only)------------------------------
orieioai
----------------------------------------------
_ -- ------
Amount verified; correct for
When voucherAgy.r l A0005-000-3004-2-1 ------------------------------------------
witing tha e companyof c6rp orae~nam"e,~w slliTs'#h c~c~elEtns tS#aPl-Ce1.8?ekAl#1T'e
"JohnDoe Company, per John Smith, Secretary", or "Treasurer", as the case may be.
tIf the ability to certify and authority to approve are combined in one person, one signature only Is nee- Title _______________________________________________________
essary, otherwise the approving officer will sign on the line below "Approved for $------------------- ", and 1e-22noo,:
..a r-his ntHnial title-
 Approved For Release 2000/04/11 : CIA-RDP64-0036OR000500030012-1
METHOD OF OR ABSENCE OF ADVERTISING
1. Advertising in newspapers Yes ^ No ^.
2. (a) Advertising by circular letters sent to -------------------- dealers.
(b) And by notices posted in public places Yes ^ No ^.
(If notices were not posted in addition to advertising by circular letters sent to dealers, explanation of such omission must be
made below.)
3. Without advertising, under an exigency of the service which existed prior to the order and would not admit of the delay incident to
advertising.
4. Without advertising in accordance with ------------ --- --------------------------------------------------------------------------- ---------
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
(Here state in detail the nature of the exigency or circumstances under which the securing of competition was impracticable under 3 and 4)
NOTE.-The above form "Method of or Absence of Advertising" is to be used when purchases are made or services secured under
proper authority without written agreement in any form. In case of a written agreement (formal contract, proposal, and acceptance, or
less formal agreement) Standard Form No. 103&-Revised should be used for abstracting the method of or absence of advertising and
award of contract. (See General Regulations No. 51, as amended.)
Approved For Release 2000/04/11 : CIA-RDP64-0036OR000500030012-1
Nia* 1"W
 Comptrpollcr ckll~]W1U.V U rvr r~eu~i-exe?LsdU YI wrF~ ir-~rrurv~-v~awrtvr vvu~uu I c- MEMORANDUM
be tembor 7 I950
l
(Clop. Reg. No. bl, Supp. No. 11) Services Other Than Persona
CONTINUATION SHEET
U. S. ------- COST-REDOURSABLE Sheet No. ----- 1 ----- of Bureau Voucher No.
------------------------------------------------------------------------------
(Department, bureau, or establishment)
No. and Date
of Order
ARTICLES OR SERVICES
(Enter description, Item number of contract or Federal supply schedule,
and other information deemed necessary)
Contract A10l - System I
Direct Costs Properly Chargeable to
Contract AlOl for the period 2/25/57
thru 3/3/57
Research &
Develppment
QUAN-
TITY
---6-95 ---