PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP64-00360R000700030029-1
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 2
• Document Creation Date: November 17, 2016
• Document Release Date: June 29, 1999
• Sequence Number: 29
• Content Type: FORM

Standard Form No. 1084--Revised
Form prescribed by 'iDT
Co l ~qr ReIeasq
(Gen. V Rol 51, Hupp. No. 1 7
(Amended February 20, 1952)
U. U.S. -------------------------------------------------------------------------------------------------------------------------------
(Depa.rtment, bureau, or establishment)
Voucher prepared at --------------------------------------------------------------------------------------------------------
(Give place and date)
THE UNITED STATES, Dr., Payee's Account No_ ----------------
------------------------------------------------
To ------------------------------------------------------ BAIRLi-ATOMIC INC.
(Payee)
--------------------------------------------------------------Cambridge--381--Massachusetts
---- ----------------------------
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)
5125-19
5125-20
PAYMENT:
Complete ^
Partial ^
Final ^
Use continuation sheet(s) if necessary
Date -------------------- *Payee -- -- --- ---------- -----
(Th)e oortifie.te not retched when n like oertl5oate le med. by payee on attached bill or bill,)
Per -------------------------------------------- Title ---------------------------------25X.1-A
Contract No. BA-732
Pursuant to authority vested in me, I certify that this account is correct and proper for
t Approved for $ -----------------------------------
Tit
By 0
a TH EVERSE OF THIS F 11
25X1A
Check No. ________________________ dated _____________________________, 19_____, for $-------------------------------------- on Treasurer of the United States in
Paid by { favor of payee named above.
Cash, $----------------------- on ------------------------------------- 19-----. Payee -------------------------------------------------------------------------
(Sige o,ininnl only)
SIGN
ORIGINAL
ONLY
You. No. -------------------------------
07 0030029-1
NAM Bu. Vou. No. ---------------------------------
Page 1 of 1
(Payee must NJT use this space)
-----------------------------------------------
Amount verified; correct for ___________
390
,266
iT
75
4,657
---------------
---------------
---------------
V
' When a voucher is signed or recoipted in the name of a corn any or corporation, the name of the orson
writing the~p~p ~~, t ~y mu t 1
John DoerCbbd~>rgbll4r~nlif>,, e t ma AAwROP 6IIR000?OOII3D029..1
t If the ability to certify and authority to approve are combined in one person, one signature only is nec-
essary; otherwise the approving officer will sign on the line below "Approved for $ ", and Title _______________________________________________________
over his official title. ___________________ 16-22900-5
 Approved For Release 2000/04/11: CIA-RDP64-00360R000700030029-1
METHOD OF OR ABSENCE OF ADVERTISING
1. Advertising in newspapers Yes ^ No D.
2. (a) Advertising by circular letters sent to ---------- --------- dealers.
(b) And by notices posted in public places Yes ^ No M.
(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 ---------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
(Hero 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 200%04/11: CIA-RDP64-00360R000700030029-1
%Ww