PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP64-00360R000500050127-2
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 4
• Document Creation Date: November 17, 2016
• Document Release Date: July 22, 1999
• Sequence Number: 127
• Publication Date: June 25, 1957
• Content Type: FORM

Standard Form No. 1034---Revised
Form Prescribed bt
Core Jr 9 foved For MR (Gen. Reg. . o. 51, Supp. 1)
(Amended February 20,1952)
COST REIMBURSABLE
dw
A YN R000500057-2
U. S- ------------------------------------------- ---------------------------------------------------------------------------------
(Department, bureau, or establishment)
Voucher prepared at --------------------------------------------------------------------------------------------------------
(Cive place and date)
THE UNITED STATES, Dr., Payee's Account No. ----------------
TO -----------------------------------------------------------------------------------------------------------------------------------
(Payee)
----------------------------------------------------------------------------------------------------------------------------------------
(Address) (City) (State)
No. and Date of
Order
Date of Delivery
or Service
ARTICLES OR SERVICES
(Enter description item number of contract or Federal supply
schedule, and other information deemed necessary)
Discount Terms
PAYMENT:
Complete ^
Partial ^
Final ^
Shipped from to Weight Government B_.!L No. Total
(Payee must NOT use this space)
I certify that the above bill is correct and just and that payment has not been received.
FOIAb3b
6-25-57
Date *Payee ------------------------------------------ ----
- ---- ------------------
.s
Per ------ ----- Title ---------------------------------------------
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 $ -----------------------------------
SIGN
Differences ---------------------------------
-----------------------------------------------
------------------------------------------------
47,841
95
4758 i.
---------------
---------------
---------------
Amount verified; corre or _____ Its / I /Q
(Signature or initials) -- - ----------------------------------
--------------------------------
(Authorized Certifying Officer)
ORIGINAL Title ----------------------------------------------------- - -------------------
By ------------------------------------------------------------ ONLY
Title ----------------------------------------------------------
THE REVERSE OF THIS FORM MUST BE EXECUTED WHEN PURCHASES ARE MADE OR SERVICES SECURED WITHOUT WRITTEN AGREEMENT IN ANT FORM
ACCOUNTING CLASSIFICATION (Appropriation Symbol must be shown; other classification optional)
I Check No. ___ dated _____________________________ 19 for $_______ on Treasurer of the United States in favor ei
payee named above.
Paid by
------------
.60-1 Dory) --------------- --------------
Cash, $------------------------, on ------------------------------------? 19-----. Payee ------------------------------- (Si..
' When voucher is J~pR p5 1 11~d~th A ~ioi~Mbfl lY x",o~ol p 64 0 3GE}R000 Ofl?5fl`I '~7'L
writing the company or
' John Doe Company, p or aunt r John Smithth, Secretary", or "Treasurer", as the case may be.
If the ability to certify and authority to approve are combined in one person, one signature only i's, nee- Title -------------------------------------------------------
weary; otherwise the approving officer will sign on the line below "Approved for $______________, and 16-22900-,
a. h "mn,al title.
 Approved For Release 2000/04/11 : CIA-RDP64-00360R000500050127-2
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 in to
advertising.
----------------- - --------------------------------------------------------- - -------------------------------------------------------------------- --------------------------------
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
(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. 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-RDP64-00360R000500050127-2
 Standard Form No. 10tifia--Revised
.Plprm escribed by
mpt_alle Ge r r
Co .roved J .-X1jTlri f gP 4 --PGf 6~4 360R000~6'Ap~uM
Septemberr Fo h an Reg. No. 51, Supp. No. 11) ervic ~js er hen Mrs to
CONTINUATION SHEET
U. S . COST RE ----tTRSABLE Sheet No. ---- of Bureau Voucher No. ----- 82
------ u ------
(Department, bureau, or establishment)
Date of
ARTICLES OR SERVICES
AN- '
UNIT PRICE
AMOUNT
No. and Date
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 IV
Direct Costs Properly Chargeable to
Contract A101 for the period 6/10/57
tbru 6/16/57
Research &
Developmt
Pro
ductio
n
To
tal
Labor Wee
Ending
June 16, 1957 12,735.52
1,033
.E
Ad j . -
dUeet no
2 152.5
,ice.65
,03
13.,923
-50
overhead
omputed
or Communications
Division
t inter
rates as follows:
-
Rese
h & Deve
lopment - 135% 17,398.88
Produc
ion - 190
5 %
2,01
.20
19,411
.08
Other Cost
s - per
schedule attached 9,560.18
adju
stments-sheet no 2 9.13)?
8,6_-<
..o
Total Lab
, Overhe
ad and Other Costs
41,966
.63'
G & A e
nse cm
omy
ted at interim
N
rate of l
of $41,
966.63
5,87
.32
Total Cos
s
I$ 814
.
Approved For Releaseu21OO/(44444 e:F.GIA-RDP64-00360R000500050127-2
 Form prescribed.by caved Fol Me ~ ~rl/'1- 460R000
T ~. '7ijQDUM
,tF (Gen. Reg. No. 51, Supp. No. 11) ervices v r Ilan ersona
CONTINUATION SHEET
COST REIlR3[TRSABLE ----------------------------- Shed No- ---- ------ of Bureau Voucher No. ------------
No. and Dare
No.
of Order
of
Delivery
or Service
ARTICLES OR SERVICES
(Enter descriptitem number of contract or Federal supply schedule,
and other information deemed necessary)
UNIT PRICE
Cost Per
AMOUNT
Dollars Cts
Labor
JV 057911 90.50
V
JV 027004.2 62.04
150
-51
Other Costs
JV 057918 .0
JV 057918 (e03)
JV 057060 .60
JV 057051 (950.00)
JV 057040 20.00
(92
Approved For Release 2OE 4/1T1~. :FCIA41OP64-0036OR000500050127-2