ORDER-AWARD

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP86-00244R000100010014-0
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 1
• Document Creation Date: December 9, 2016
• Document Release Date: May 13, 1999
• Sequence Number: 14
• Publication Date: November 12, 1969
• Content Type: FORM

THIS NUMBER MUST APPEAR ON
PAGE NO.
NO. OF PAGES
A
p roved For RReIease 2001/08/09 : CI
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DR 649--P I AND A80001000
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OR-NIER - AWARD
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PREPARED BY
REFERENCE (QUOTATION/ CONTRACT/ INVITATION/ REQUEST NO.)
DATE OF ORDER/ CONTRACT
DATE OF D. V.
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PURCHASE ORDER-IN ACCORDANCE WITH YOUR QUOTATION AS INDICATED ABOVE PLEASE FURNISH THE FOLLOWING ON THE TERMS SPECIFIED ON BOTH SIDES OF THIS
ORDER AND ON THE ATTACHED SHEETS, IF ANY, INCLUDING DELIVERY AS INDICATED.
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DELIVERY ORDER-SUBJECT TO INSTRUCTIONS CONTAINED ON THIS SIDE ONLY OF THIS FORM AND ISSUED ON ANOTHER GOVERNMENT AGENCY OR IN ACCORDANCE
AND SUBJECT TO THE TERMS AND CONDITIONS OF THE CONTRACT INDICATED ABOVE.
AWARD-Your bid or proposal on the above numbered invitation for bids or request for proposals is hereby accepted as to the items enumerated below with the additions or changes made
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by you, which additions or changes are set forth in full below. This award of acceptance consumates the contract, which consists of the following documents, including any continuation
sheets thereto (A) the government's invitation for bids and your bid or the government's request for proposal and your proposal (B) the schedule (C) the general provisions and (0) the
government's award or acceptance. No further contractual document is necessary.
TO: (Contractor and Address)
MAIL INVOICE TO:
off"* of 311100ft*
25X1A
Viral Iatet1 s Agiefty
a: t , D* C.
SHIP TO: (Consignee and Address)
ISSUING OFFICE (Address inquiries to)
06 i y.% ,.# CIA
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IMPORTANT: (Please comply with Identification & marking instructions para. 12. reverse).
DISCOUNT TERMS
DELIVER ON OR BEFORE
1 DELIVERY F. 0. B. -rr
CITY & STATE - SHIP VIA
PREPAID
OTHER
BILL COST
AS SPECI?
REF. # 10
FIED IN
DESTINATION
REVERSE
SCHEDULE
SCHEDULE
ITEM
NO.
SUPPLIES OR SERVICES
UNIT
QUANTITY
(No. of
Units)
UNIT
PRICE
AMOUNT
QUANTITY
ACCEPTED
rhe pulrp of this Ameadmeat is to a
to baste Agnmwaft., spe tel pro ect, as
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Special Topographic Map, 14400 1> s:t,
am! fie foot ce ow Interval 1,00A. SPR
job
2
155.00
$2,155.00
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alid Total S $11,?
*t IMT,* 2,} . 00
155
*e e of Agreement r iac bsuged.
DD
DEFENSE ORDER
TOTAL AMOUNT
3
1+5.00
CERTIFIED UNDER DMS REGULATION NO. I.
1,
RECEIVING - INSPECTION
DATE RECEIVED
PIECES
SHIPMENT NUMBER:
REMARKS
PARTIAL FINAL
WEIGHT
CUBE
CARRIER
25X1
QUANTITY IN "QUANTITY ACCEPTED" COLUMN HAS BEEN
RECEIVED BY ME AND CONFORMS TO THE CONTRACT.
SIGNATURE OF AUTHORIZED GOVERNMENT REP.
TO BE INSPECTED BY
PROCURED AS S. C.
-
-
Other As
No. Dealers
1
N. Bids
Recd
I Awarded To Lowest Bidder As
To Price Expenditure.
I
T and I
i
Specified
In Schedule
NNT
ZERO
ONE
ADV.
.
S
1
YES NO Meat heat
CHARGE ALLOTMENT NO.
COST CENTER SYMBOL
N
PURSUANT TO SEC. 3(a) PL 81-110, 1949
see Below
See below
E
AND APPLICABLE AGENCY REGULATION
REQUISITION NO.
BUDGET REQ. OFFICE COPY TO
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PUBLIC
IMPRACTICAL TO
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EXIGENCY
SECURE COMPETITION
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NAME - ROOM - BUILDING
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SHOULD NOT BE
OTHER (Specify)
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PUBLICLY DISCLOSED
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____
For STOCK: ALLOCATION NO.
For SHIPMENT: STATION NO.
V
AIR
SEA
POUCH
OTHER (Specify)
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A
NOT SUBJECT TO F.P.A.
(Pay on basis of
INVOICE BY AN APPROVING OFFICIAL
RECEIVING REPORT BY AN
APPROVING OFFICIAL
OTHER (AS SPECIFIED IN
SCHEDULE OR BELOW)
1
certification on) 7-
(O/ F forward to office shown above.)
W/ O DEBIT VOUCHER NO.
MEMORANDUM 1s t for ~ al project aphic Map) only- Charge #11ot.a 4 Cost
~ 1010k R*VM*t no-
78-51-70. 0/? send invoice for t (ts- #O only to (L/M,
25X1A
Viral
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