PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP64-00360R000400010024-1
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 4
• Document Creation Date: November 17, 2016
• Document Release Date: June 29, 1999
• Sequence Number: 24
• Content Type: FORM

w""indua^l Form No. 1034-Revised f~ ,i~ TTn~** 77rr * n
VT prescribed by DURUC. I..^ it .f1GR 'r? a
(Gen. teg. No. 51, Supp. No. 11) fto
(Amended February 20, 1952)
D. O. Vou. No. x__ . - 110 -----
6WOR00( 4QOON1002 1
U. S. Gosh Reimbursable- --------------------------------------------------
(Department, bureau, or establishment)
Voucher prepared at --------------------------------------------------------------------------------------------------------
d d
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(Give p
THE UNITED STATES, Dr., Payee's Account No. ___39.___...
----------------------------------------------------------------------------------------------------------
(payee)
----------------------------City) -------------------------------- ----------------------
(Address) ( (State)
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 doomed necessary)
Discount Terms
PAYMENT:
Complete
Partial
Final
Shipped from
I certify that the above bill is correct and just and that payment has not been received.
STATINTL
STATINTL
B/L No. I Total
(Payee must NOT use this space)
Date __~ =51r *Payee ------ ----- ----
ereau4ed whene or hills)
Contract No. A101 Date Req. No.
Pursuant to authority vested in me, I certify that this account is correct and proper for payment.
Amount verified; correct for -----------
425..701
5,701 51
---------------
---------------
---------------
(Signature or initials) -----------------------------------------
Date Invoice Rec'd.
I. -----------
ORIGINAL - Title -------- Cer=tityiug-i0f f icar------------------------------
ONLY
Title -Contracting.-officer.------------------ STATINTL - Date ___ ,,el ----------------------------------------
THE REVERSE OF THIS FORM MUST BE EXECUTED WHEN PURCHASES ARE MADE OR SERVICES SECURED WITHOUT WRITTEN AGREEMENT IN ANY FORM
ACCOUNTING CLASSIFICATION (Appropriation Symbol must be shown; other classification optional)
STATINTL
PPx'ov ng
Check No. _ --___ dated ------------------------------ 19------ for $_____-_______--___--------------------J on Treasurer of the United States in
1 favor of payee named above.
Paid by
Cash, $--- ----- - ---------? on ----------------------------------- 19-----. Payee ----------------------------- -(Sign-o-ri----ginal ---rfnel --on-- lrl ------------------------------
- When a voucher is signed or receipted in the name of a company or corporation, l .be name of the person Per -- - --------------------------------------------------
writing the 1 '9 pw i }~hj~ ina' illy "John Doe3 ;~ ~ 1C571+~a ~e 1 Td>iJL1~19~F1I rv ~ 036 000400010024-1
If and authority to a prove arc combined in one Berson, one sl n C r y I n - tt e _ _________ _________ ________ _________ ____________
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essary; otherwise the approving officer will sign on the line below "Approved for $---- _-------------- an 16--22900-5
over his official title.
 : TA-FrcP6g-00360RQ0040001Y024-1-
tana aA~ib C RRelease 00
V041
For Comptroller General, I7.6. tblic YY ouc er or aseE id
September 7, lobo
(Gen. Reg. No. 81, Supp. No. 11) services Other Than Personal
CONTINUATION SHEET
U. S. ----------------------------------------------------------- Sheet No. ----1------ of Bureau Voucher No. _-2
ST
ATINTL
d D
t
N
Date of
ARTICLES OR SERVICES
UAN-
UNIT PRICE
AMOUNT
a
e
o. an
of Order
Delivery
(Enter description, item number of contract or Federal supply schedule,
TITY
or Service
and other Information deemed necessary)
Cost
Per
Dollars
Cts.
SYSTEM CONFIDENTIAL PAYROLL
Direct Labor Costs properly chargeable to
Contract A101 for the period 4-4-55 thru
6-5-55.
Week Ending
4-10-55
4-17-55
4-24-55
5-1-55 STATINTL
5-8-55
5-15-55
5-22-55
5-29-55
6-5-55
Less Labor Adjustment JV055204
STATIN
L
Overhead com uted at interim rate
of
25,542
51
OTHER COSTS
P.0.6416 - Henry Radio - Invoice 6967
Check # 7477
159
00
25,701
51
Approved For Release 2000/04/11 : CIA-RDP64-0036OR000400010024-1
 VOICE
NUMBER
6967
MAIL ADDRESS: BOX 64398 ? LOS ANGELES 64, CALIFORNIA ? 11240 W. OLYMPIC BLVD.
INV.
DATE April 14, 1955
o? Ramo-Wooldridge Corp.
L 8820 Bell-e,nea Avenue
T
0
Los Angele's L 5, Calif.
S
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0
CUSTOMER'S ORDER NO. (
DATE ~SHIPPED
~'? I
Ai?_. ~.
IPPED VI e
1.V TE7 ms; ^
et 3o C.U.D.
( Rria E. T BILLED er Der
LLI
MES
QUANTITY
ORDERED
BACK
ORDER
D, SCR I P T I O N
QUANTITY
SHIPPED
UNIT PRICE
AMOUNT
LA-
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159.00
.XAX 4
9 Sales
Tax
6136
T
otal
$ 165.36
ON TRIAL
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accompanied by this bill
 ? ACCOUNTING COPY
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