PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP81B00879R000900040104-8
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 3
• Document Creation Date: December 19, 2016
• Document Release Date: May 4, 2006
• Sequence Number: 104
• Publication Date: December 13, 1958
• Content Type: STATEMENT

Standard Form No. cosyy-?eevisea pg p
Cortptoller Ge eral, J. S. Approved el /~Y :
195
September 77 0 No 11) S VICES OTHER THA
1
npp
(Gen. 1.w No. 5
(Amenlllyd February 20, 1952)
~~NN D. O. Vou. No-
~g JVV85'A000900040104r8
Bu. Vou. No. --------- I -----------------------
U. S. _ Us S o Government -------------------------------------
---
(Department, bureau, or establishment)
Voucher prepared at _______-oehester,~ New ............ une_ 13-1.128--------------------
(Give place and date)
THE UNITED STATES, Dr., Payee's Account No. - Z - 1 8 9 3 - - -
)
343 State Street Rochester --Li.,, New-- York ----
-------- - ----- ---
----------------------------------------------------------------------
- - (Addres (City) (State)
No. and Date of
Order
PAYMENT:
Complete ^
Partial ^
Final ^
Date of Delivery
or Service
Mar? 2L,,,
1958
through
Apr. 20s
1958
Dollars I Cts,
315 00
613'26
38'33
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.
-
p
a
o
ii?
Eas
---------- -------------------- ------ .--
sa ee -
nnree nn attaoaed bILL or bal.)
Date y a mn-., . ru. .n.dannte ie mnde by -
LUA I/ --
Title ---------- (Signature or initials) -_ _ -------------------------------
Per
Req. No. Date Invoice Rec'd.
Date 7.,Ze67
Contract No. ~..f j' .r1
Pursuant to authority vested in me, I certify that this account is correct and proper for payment.
SIGN
ORIGINAL
ONLY
----------------------
(Authorized Certifying Officer)
Title -------------- -- ------ Date --------------------------------------------------------------------------
.`1HE REVERSE OF THIS FORM MUST BE EXECUTED WHEN PURCHASES ARE MADE OR SERVICES SECURED WITHOUT WRITTEN AGREEMENT IN ANY FORM
ACCOUNTING CLASSICICATION (Appropriation Symbol must be shown; or classification optional)
on Treasurer of the United States in favor of
Check No, __---------------- dated ----------------------- 1$ 9_____, for ^--------------------------- _____ {payee named above.
Paid by -----------------------------
---------? 19-----. Payee ----------------------------- is)a~aria~~nl env)
Cash, $ ? on -------------------- -------
ARTICLES OR SERVICES
(Enter chedule, anc?I other Information deemed necessary)
Discount Terms
Direct Charges
Provisional 1958 Overhead
Provisional 1958 G & A Expense
an r
i
k
d
K
i
.When a voucher is signed or rec~ Pted In the nT of af4m any or cor oration, the name of the person -~ Per ________________________________________________________________
writing D the company or corporate n4tLW Cj." oe Sri OW-PR P 1 B00879R000900040104-8
w
eoretary", or re as he a
"John oc Company, per John it asurer
t If the ability to certify and authority thority to approve are combined bined in one person, one signature only is nee- Title ------------------------------------------------------
f essary; otherwise the approving officer will sin on the line below "Approved for $___ ______________", and-ns-s23oa-s
over his official title.
 Approved For Release 2006/05/25 : CIA-RDP81 B00879R000900040104-8
METHOD OF OR ABSENCE OF ADVERTISING
1. Advertising in newspapers Yes 0 No M.
2. (a) Advertising by circular letters sent to -------------------- dealers.
(b) And by notices posted in public places Yes 0 No 0.
(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 -----------..--------------------------------------------------------------
(lore state in detail the nature of cne exigency or
NOTu.-I'ne above '-form iwubnvu vx yr t~uac=, uc ?.+ .~ .~?~=vim=-s
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 2006/05/25 : CIA-RDP81 B00879R000900040104-8
 Approved For Release 2006/05/25 : CIA-RDP81 B00879R000900040104-8
Approved For Release 2006/05/25 : CIA-RDP81 B00879R000900040104-8