FORM CD-404-EF (09-91)

U.S. DEPAR'fMENT OF COHHERCE

I ~:::der
SUPPLY, EQUIPMENT OR SERVICE ORDER
....... 1.0RDERNUMBER
43-YA-BC-313472
/-------,-----L------..,..----.....---..... -----r---------1inquiiest.
2. CONTRACT ORDERED AGAINST 3. PURCHASE 4. DEUVERY 5. ORDER DATE . SOURCE the
PAGE I OF 2 Specific Provisi.ns Apply ORDER ORDBR Procuremeot 7. SUB IS. DATE PRINTED
NONE X 0110312003 Offic:e. NONE I 02/1012005
9. SUPPUER'S ADDRESS 31320 10. 1099 TAX: MISe This Refesence~ \1. Bn.uNG ADDRESS
ERIC WENOCUR No. -...-- REFi!RENCEORDERNO.: OBLlG-2003-13412-O-O
II. EMPLOYERI.D.-' DIUI\ appear 011 aU
LAB TECH SYSTEMS invoica and BUREAU OF TIlE CENSUS
3822 DUNSINANE DR 13. CONTACT: paws Freight FINANCE DIVISION
SILVER SPRING MD 20906 chars·o SIOO
NONE requRs B BiU.f ROOM 3546, BUILDING 3
LadioS·
I3L TEL: 301-43I-S170
WASHINGTON DC 20233-4400
I3b. FAX: NONE

I~ 1~ 16. 17. IS. 19. 10.

UNE DESCRIPTION DEUVERY QUANTITY UNIT UNIT PRICE AMOUNT
ITEM DATE ISSUI!

1 CONTRACTOR TO PERFORM MAINTENANCE SERVICES TO 0913012003 JB 1,500.0000 1,500.00

INCLUDE REPAIR, SERVICE AND DESIGN OF BROADCAST
HARDWARE INrnE PUBUC INFORMATION OFFICE DIGITAL
EDITING FACILITIES AND SUPPLY OF MAl:ERIALS
(HARDWARE, SOflWARE AND EQUIPMENT), FOR USE IN
CREATION OF BROADCAST AND IN-HOUSE VIDEO, RADIO
AND PHOTOGRAPHY PROGRAMS. INCLUDES OrnER DIRECT
COSTS.

PERIOD OF PERFORMANCE: DATE OF AWARD THROUGH

SEPTEMBER 30, 2003.

CENSUS TASK MANAGER: MIKE MORGAN 301-163-3045

ALTERNATE TASK MANAGER: TOM WEBSTER 301-163-3053

u.s. DEPARTMENT OF COMMERCE· TERMS AND CONDmONS

Th. fullowinS 'esms and conditions as well as any un nl\llcbed sheela, apply wilen this document is used as a purcbase .rder.lfthis document is used as B deliYery order. it is subject 10 the terms and conditions of
the conmet <rierenced in Bloclc *1 of the order. 52.152-2 Cia..... incolJlOratcd by Rcfesence (Apr S4). This contract incorporates the following "Ia.... by ref......,., with the same foroe and effect as if they were
Biven in full text. Upon request, the Conmetins Officer will make full text available.

NOTE: FULL TEXT CLAUSES ARE AVAILABLE AT 1ITTP:IIWWW.ARNET.OOYIFARlfARQUERYFRAME.HTML

NOTE 1 INVOICE MUST COINCIDE WIlli UNE ITIiMS ON PURCHASE ORDER
NOTE 3 INSTRUcnONS FOR SUBMITTING INVOICES ARE ATTACHED
NOTE 4 CONTRACTOR SHALL AlLOW TIm OOVT 30 DAYS FROM DEUVERY TO INSPECT &: ACCEPT
NOTE 5 CONTRACTOR AGREES TO INVOICE NO LESS mAN 30 DAYS AFTER DELIVERY
NOTE 6 51.246-1INSPECTON OF SUPPLIES - FIXED PRICE

21. ORDERED BY (NAME AND lITLE)

PAMll..LER
PURCHSGAGT
16. CONTRACTlNGIORDERlNG OFFICER SIGNATURE
II ;:-~':'3':'= ":';
27. DATE SIGNED
'< == ~"'i::.I.
lIS. PROMPT PAYMENT 129. SHIP VIA
$_1_,5_0_0_.0_0-1

LA VANCE 1 01/0312003 I Y I N/A

30 SJnP TO (INCLUDE ON SJnPPING LABEl.) 31. ISSUING OFFICE (DO NOT SHIP OR Bill. TO TInS ADDRESS)
OBLIG-2003-13412-0-0
REFERENCE ORDER NO.:
BOC MAIN RECEIVING DOCK BUREAU OF THE CENSUS
ROOM 1203A, FOB 4 ACQUISmON BRANCH, ROOM G-312-3
4100 SILVER HlLL ROAD 4100 Sn..VER HILL ROAD
Attn: S B MASSIE
SUTI1..AND, MD 20146 SUTI1..AND MD 20146

Phone:
FORM CD-404-EF (09-971 I. ORDER NUMBER
u. S.DEPARTKElIT OF COHMERC£
SUPPLY, EQUIPMENT OR SERVICE ORDER 43-YA-BC-373472
lCOllTlNlJATION SHEET)

32. SUPPUER 33. ISSUING OFFlCE '.ORDERDATE Is. DATE PRINTED

PAGE 2 OF 2
\
ERIC WENOCUR BUREAU OF THE CENSUS 01/0312003 I 0211012005
34. 35. 36. 37. 3S. 39. , 40. 41.
UNB MOL QTY QTY FINAL FULL ACCOUNTING CLASSIFICATION DIST% AMOUNT
ITEM RECVD

046210000-000 20 04-03-02-000 11-04-0009-00-00-00-00 25-20-04-00 000000 100% 7.500.00

42. 43. 44. 45. 46. SHIP TO ADDRESS 42. 43. 44. 4'. 46. SIUP TO ADDRESS
UNE MOL QTY RECENING (INCLUDE Rl!FERl!NCE ORDER NO. UNE MOL QTY RIlCI!IVING (INCLUDE REFERBNCE ORDER NO.
ITEM OFFlCECODE ON SHIPPING LABEL) ITEM OFFlCECODE ON SHIPPING LABEL)

47. 4S. 49. '0.

UNE REQUISITION NUMBER REQUISITION DESCRIPTION REQUISITIONER INFORMATION
ITEM

31085-0 Renewal of PO #43-YABC-02022I S B MASSIE (W)301-763-3012 Loe: FB 3 Rrn: 2720

52. RECEIPT SIGNATURE & TITLE '3. RECEIPT DATE

ACCEPTANCE: I CERTIFY TIlAT ARTICLES AND/OR SERVICES ANNOTATED 54. ACCEPTANCE SIGNATURE It TITI.E 55. ACCEPTANCE DATE
ABOVE HAVE BEEN RECEIVED, INSPECTED AND ACCEPTED AS COMPLYlNG
WlTII THIS ORDER, AS OF 1lIE DATE SHOWN.