REQUEST TO PROCUREMENT DIVISION FOR SERVICES

• Document Type: CREST
• Collection: NGA Records (Formerly NIMA)
• Document Number (FOIA) /ESDN (CREST): CIA-RDP78B05171A000100010079-2
• Release Decision: RIPPUB
• Original Classification: C
• Document Page Count: 1
• Document Creation Date: December 28, 2016
• Document Release Date: September 8, 2003
• Sequence Number: 79
• Publication Date: June 9, 1969
• Content Type: FORM

JRESEARCH/DEV
G R A N T
,OFFICE/DIV/BR jREQUEST NO.
N1'IC T5SG1SSD __55-6005-69 (A-i
PROJECITLE I PROJECT OR CONTACT OFFICER
REP AIR
MAINTENANCE.
Air System j
Black Box R R
CONTRACTOR (if known) PROPOSAL NO. ANO DATE
TYPE OF SERVICE REQUESTED
25X1
TRANSFER OF FUNDS TO
OTHER GOV T. AGENCY
(specify if applicable)
Consulting
Services
SEERILITY I CONTRACT CLASSIFICATION
Sc z
SSi iED U CONFIDENTIAL a _~ --u
ApprovedQligi[DP78'I7dda66f00010079-2
(other than property or building maintenance and repairs)
9~une 1~26
THE EG: MATEU ~l -
FAN ~~ ~~ ~2_ ..7 Iyl~1 4
RECEIVING DEPOT T & I TECHNICAL MONITOR
ITEMS TO BE PICKED UP OR p SERVICES PERFORMED AT;
FI CERTIFY T
AMOUNT OF F $
(AVAILABLE. CHARGE TO
Confidential j i
kSHORT SUBSTANTIVE TITLE AND/OR DESCRIPTION OF SERVICE TO BE PERFORMED
Additional. funding of. is authorized for the subcontracting of
one Air System (Black Box) in accordance with
proposal dated 27 May 1969.
This subcontract is to be a fixed price performance type contract. Flow
Diagram, Pint # 97450 C is attached.
A 6% subcontracting fee to F & A is included in the funding cost.
(See reverse for specific injGrmati0.1
required on R&D requests.)
25X1
DESIGNATION
'`7"yam
FORM 2420 REPLACEND roy"
3.67 2420 HAG 416
WHICH MAY BE
USED.
25X1
25P(1
Declass Review by NIMA/DOD
03/1M :c 1 B $O5171VM0 95b07f
(yDeciTv)