PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP81B00879R000500110002-7
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 2
• Document Creation Date: December 9, 2016
• Document Release Date: September 12, 2000
• Sequence Number: 2
• Publication Date: July 18, 1958
• Content Type: FORM

-- pt ler GeiSAE6 o`~ed For Rele
Comptroller Cie
September acP~!W~ E 1 =`RDPB"1
(qeu. Reg. No. bl, Bupli. No. 11) SER ES OTHER THAN PE
U. S
(Department, bureau, or establishment)
Voucher prepared at --------------------------------------------------------------------------------------------------------
(Give place and date)
THE UNITED STATES, Dr., Payee's Account No. ----------------
To -------------------------=----------------------- H eoa-Mfg. --Ca per i --------------------------------------------
(Payee)
-------------------------------- _Z4p_ ena~--California------------------------
(Address) (City) (State)
ARTICLES OR SERVICES
UNIT
PRICE
AMOUNT
li
f D
D
(Enter description item number of contract or Federal supply
No. and Date of
very
ate o
e
S
i
p~y{{~atiyL
and other information d
schedule
QUANTITY
Order
or
erv
ce
?
~
,
Cost
Per
Dollars
Cts.
Discount Terms
13319
2
6l
1532
WO
76
PAYMENT:
Complete F1
Partial F1
Final F-1
Use continuation sheet(s) if necessary
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.
Differences ---------------------------------
---------------
-----
(Sign original only)
-----------------------------------------------
---------------
-----
?
Date -------------------- *Payee -- --
(This aertiflonte not rewired when a nke eortlfioete I. mode by payee on etteehed bia or hills)
-----------------------------------------------
-----------------------------------------------
_________
__
Amount verified; correct for
---------------
- ---
-----
o 3
-----
-----
3
Contract No.
Pursuant to authority vested in me. I certify that this account is correct and proper for
t Approved for $ -----------------------------------
SIGN
ORIGINAL
ONLY
FOIAb3b
D O. Vou. No- -------------------------------
95001 2-7
Bu. ou. No. ---------------------------------
el?f1
PAID BY
Check No_ ________________________ dated ------------------------------ 19_____, for $-------------------------------------- on Treasurer of the United States in
Paid by { favor of payee named above.
Cash, $----------------------- on ------------------------------------- 19-----. Payee -----------------------------(s--------------------------------------------
ian orl,Innionly)
(Signature or initials) ______________________
in t n me of a c o o ati0
* When a voucher is i ned or rec219
in
`
0b o f h
s
1
l
set g,
writing the company ane
Secretary", or `Treasurer", as t e case may
per John Smith
"John Doe Company
o.
,
,
t If the ability to certify and authority to a prove are combined in one person, one signature only is nec-
essary; otherwise the approving officer will sign on the lino below "Approved for $___________________ , and
R0005DD't1DDD7-T____________________________________
Title _____________________________ -
16-22900-5
aver his official title.
 Approved For Release 2001/08/01 : CIA-RDP81B00879R000500110002-7
METHOD OF OR ABSENCE OF ADVERTISING
1. Advertising in newspapers Yes F1 No ^.
2. (a) Advertising by circular letters sent to -------------------- dealers.
(b) And by notices posted in public places Yes ^ No O.
(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 ---------------------------------------------------------------------------------------------------------------------------
5. Without advertising, it being impracticable to secure competition because of --------------------------------------_----------------------------------
-------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------ -------------------- --------------------------------------------
---------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
(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 2001/08/01 : CIA-RDP81B00879R000500110002-7