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RECD JUL 17 2015 <br />ORDER FOR SUPPLIES OR SERVICES <br />PAGE <br />1. <br />1 aF6 <br />i <br />RCH DRQER/AGREEMENT N0. Z. DELIVERY ORDEPWALL NO <br />3, DATE OF ORDERICALL 4, REOUtSRIOWPURCH REQUEST NO• <br />P45oo-14- -D00 <br />SP4500 74-t3-0003 0115 py"YUMMOn1 <br />S, PRIORITY <br />2014 JUN t i See Schedule <br />6. ISSUED BY <br />CODE SP4500 <br />DLA DiSPOSTION SERVICE . Pas 7. ADMINISTERED BY (ffofher #W 6) 'ODE <br />{SP45CD <br />DLA RT wAsSPAZ NrroN TRACT OLA DISPOSTKIH SERVICE -ED$ -----� <br />74 NORTH WASHINGTON <br />S'D�' RY FOB <br />BATTLDLA IMSP SVCSS HQ CONTRAC' <br />M! 4Z037.3 <br />49037-3%274 NORTH WAsMWG1oN <br />USA <br />X-1 DESTINATION <br />BATTLE CRIMK W 49W7 ,VW <br />Logmh. DaNN SrAuemarn PWMPH4u6 TO 2941.161-5236 USA <br />Em.Y: aA <br />DavuM.schwma�+Q}dla. mN <br />OTHER <br />C PAZ: N. <br />9. CONTRACTOR <br />is- gra it <br />CODE <br />CODE 4KBW8 <br />_... FACIi"fY 583200 10, DELIVER TO FOS POINT BY (pate) <br />fYYYYMM <br />DOUBLE BARREL ENVIRONMENTAL <br />11, X 1F BUSINESS IS <br />2014 <br />2014 JUL Ot <br />NAME SERVICES, INC. DBA <br />SMALL <br />AND 121 MAIN ST 12, DISCOUNT TERMS <br />SMALL DISAD• <br />ADDRESS RIVERSIDE CA 92501-1023 NN 30 days <br />VANTAGED <br />USA <br />WOWN-OWNED <br />13. MAIL INVOICES TO THE ADDRESS IN BLOCK <br />11. SHIP To See B!OCk 15 <br />CODE <br />IC PAYMENT WILL BE MADE By CODE SL4701 <br />DEF FIN AND ACCOUNTING SVC <br />MARLS ALL <br />BSM <br />SEE SCHEDULE, DO NOT SHIP TO ADDRESSES ON THIS <br />PACKAa AND <br />PAGE P O BOX 389031 <br />ERS <br />PAPERS WtT3N <br />COLUMBUS OH 43236-9031 <br />IDENTIFICATION <br />t6 DELIVERY! x USA <br />NUMBERS It <br />BLOCKS 1 AND L <br />CALL T� oraertcatl LS Issued on another G-mmem <br />TYPE agency or in, accordance with and &ubjeel to Irons and conditions of above numbered <br />I <br />ence o <br />Reference your <br />OF PURCHASE <br />contract <br />the np an terms specified herh <br />ORDER ACCEPTANCE, THE CONTRAC74R HERESY ACOEP75 THE OFFER REPRESENTED BY TfSE NtMi8ERE0 PURCEIA E ORlu"hDER AS <br />BEEN DR ES NOW MODIFIED, SUBJEE."T' TO ALL OF THE TERMS A <br />ITMAY PREVIOUSI <br />AND CONDITIONS SET FORTH• AND AGREES TO PERFORM SAME <br />AYE <br />NAME OF CONTRACTOR SIGNATURE <br />TYPED NAME AND TITLE <br />If ftbox is med¢ed, supPSer must sfon AoaD(anoe and return the fdlovrng number of <br />DATE SIGNED <br />copies: <br />17. ACCOUNTING AND APPROPRIATION DATAILOCAL USE <br />(YYYYAtAttdDD) <br />AA' 97X4930 5CBX 0012520 S33189 $4536.22 <br />18, ITEM NO, 1 19. SCHEDULE OF SUPPLIESMERVICES <br />See Schedule <br />ttq-MI),-god by the Gowrnmept Is 24. UNITED STATES OF AM <br />aanNr ea gttantlty t+aYered, htdFsate byX Jayne Wilson <br />N o4Naravd, anter actual quanWy adcapted below <br />quantity oath and eno,'Icm' il <br />BY: j2yn9-*1S0n@dla.rn <br />DJW0003 <br />27s. QUANTITY IN COLUMN 20 HAS BEEN <br />INSPECTED n RECENTI) ACCEPTED, AND CONFORMS TO <br />-- I THE CONTRACT EXCEPT AS NOT <br />b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE <br />V. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE <br />ORDERED/ACCEPTEp• 21UNR- UNR 73, AMOUNT <br />PRICE <br />3202.000 `_ <br />f�LtA c"� 2S. TOTAL $4.538.22 <br />26. <br />CONTRACTINWORDERIIG OFFICER DIFFERENCES • <br />c. DATEI d- PRINTED NAMEANO ?ITLE OF AUTHOWZEp <br />(VYYYMAW,DD) j GOVERNMENT REPRESENTATIVE <br />23. SNIP. N0, 129. Q.O. VOUCHER k0. 3@. tNTT1ALS <br />f. TELEPHONE NUMBER I g. E•RtAILMORESS <br />PARTIAL 32. PAID BY 33. AMOUNT VERIFIED CORRECT FOR <br />FINAL <br />31. PATMENT ----.� <br />36. 1 CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT, 34, CHECK NUMBER <br />a. DATE b SIGNATURE AND TRI F OF CERTIFYING OFFICER OOMPLETE <br />{YYYYAWMDD) PAR€IAL 3i, BILL OF LADING No. <br />FINAL <br />37. RECEIVED 99. RECEIVED 8Y (Print,, 39. DATE RECEfVED 40. TOTAL CON- 41. SIR ACCOUNT NUMBER 42. SIR VOUCHER MO. <br />AT l YYYYMMAtOB) <br />TAItIIERS <br />CC FORK! 1155. DEC 2001 PREVIOUS EDITION IS OBSOLETE, <br />Adore Professional 8.0 <br />