PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP64-00360R000500050037-2
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 3
• Document Creation Date: November 17, 2016
• Document Release Date: July 22, 1999
• Sequence Number: 37
• Publication Date: July 22, 1957
• Content Type: FORM

Standard-TormNo.,1084-Revised D. O. Vou. No_ --------------------------------
Form pre r)bed by
Cyimptrollor n~T olv d For Relea 'cU6/(YQVCP6~4r1 P? 9 050037-2
Beptemb 50 936
SERVICES OTHER THAN PERSONAL Bu. Vou. No- -------
(den. Reg. No. 511, , Su9PP? No. 11) -- -
(Amended February 20, 1952)
(Amended
------ COST -RE-IKBURSABLE
U. S.
(Department, bureau, or establishment)
Voucher prepared at --------------------------------------------------------------------------------------------------------
(Give place and date)
THE UNITED STATES, Dr., Payee's Account No_ ----------------
TO --------------------------------------------F--------------------------------------------------------------------------------------
(Payee)
---------------------------------------------------------------------------------------------------------------------------------------
(Address) (City) (State)
ARTICLES OR SERVICES
tion item number of contract or Federal supply
(Enter descri
UNIT PRICE
AMOUNT
No. and Date of
Order
Date of Delivery
or Service
p
schedule, and other information deemed necessary)
QUANTITY
Cost
Per
Dollars
Cts.
Discount Terms
784,
21
Cost
PAYMENT:
Complete ^
Partial ^
Final ^ Use continuation sheet(s) if necessary
Shipped from to Weight Government B/L No. Total
21
(Payee must NOT use this space)
I certify that the above bill is correct and just and that payment has not been received.
Differences -------------------------------
---------------
' -
FOIAb3b (sign original only)
-----------------------------------------------
______
---------------
--
__
--
-
-----------------------------------------------
------------------------
Date ---- 7__22-t57- Payee
-------------
---------------
----
-----
{~~~~
__ .L- eortifioate not required when a like certificate ie made by payee on Ittsohod bill or bill.)
Amount verified; correct for ___________
Per
Contract No.
Date Req. No.
Pursuant to authority vested in me, I certify that this account is correct and proper for payment.
t Approved for $ -----------------------------------
By -----------------------------------------------------------
Title ----------------------------------------------------------
SIGN
ORIGINAL
ONLY
Date Invoice Rec'd.
'---------------------?------------------------------?----------------------
(Authorized Certifying Officer)
THE REVERSE OF THIS FORM MUST BE EXECUTED WHEN PURCHASES ARE MADE OR SERVICES SECURED WITHOUT WRITTEN AGREEMENT IN ANY FORM
Check NO. on Treasurer of the United States in favor of
-----------------------dated ------------------------------ 19 for $
Paid by payee named above.
Gaah1 $---------------------- a on ------------------------------------- 19 ------ Payee ---------------------- ------------------------------------- -----------
(6iyn original only)
'f~ iZr$ Il Por%OrRL1Htit
? When a voucbAJ V@deffIo Q R
writing the compan of corporate name, as we as a capacl y in w) e fins-must'a fer. Fo
a"uu ie il.t-to ce r ify -?and--_- -t..._---, -to-----app---
tIf the abilityy to certify authority rove are combined in one person, one signature only is nec-
essary; otherwise the approving officer will sign on the line below "Approved for $___________________", and
---- -1rA ial tills
060500050037-2------------------------------------------
Title -------------------------------------------------------
 Approved For Release 2000/04/11: CIA-RDP64-0036OR000500050037-2
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 S 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. 1036-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-RDP64-0036OR000500050037-2
 'wow
Standard Form N "lo3Sa-A 'd
Form pre01 ve or Re geOWbff~'h If&U gLig0fi 050037-2
compp ptelor Gc e 1, . s. MEMORANDUM
6eptmbar 7 1950
(Gen. Reg'. No. 61, bupp. No. 11) Services Other Than Personal
CONTINUATION SHEET
U. S- _____----__ COST RED4BURSABL----------------------------------------------------- Sheet No.1---------- of Bureau Voucher No. ---536 (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.
Contract A101 - System I
Direct Costs Properly Chargeable to
Contract A101 for the period 7/8/57
thru 7/14/57
Research &
Development
duct'
on
Tot
al
Labor Wee
ending
ly 14, 1957 16.72
13
.1
151
-91
Overhead
omputed
or Communications
Division.
t inter
rates as follows:
Resear
h & Deve
,
lopment - 145% 24.24
Produc
tion - 19
%
26
.62
28
Other Cos
s - per
schedule attached
230
-50
Total Lab
r, Overh
ad and Other Costs
67
.27
G& A e
nse c
ted. at interim
v
rate of 1
7% of $67
.27
113
. 94
I,
Total Cos
ts
$ 78H
.21
Approved For Release 2000/04/11: CIA-RDP64-0036OR000500050037-2