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TRACTOR P`ul ;7 k
<br /> =,plr� su i' 1985
<br /> F
<br /> ..� ..._.. 5 E' r IFIED ' P
<br /> I. l,WTRACTYPURCH ORDER NT- 12. DELIVERY ORDER NO. 3. DATc OF r)ft[+ER, 4. REIIUISITIr!N/PURCH R6,!U'E.S a•. fl "rs D��Erx t 1
<br /> SAAC2190POO6610/02/89 � ,•_ I
<br /> a5 2;rW9 ,.;8,iia ;11cn. U,15 REG ;
<br /> 6. ISSUED BY CODEW6 ,32S 7. ADMINISTERED BY
<br /> SHARPE ARMY DEPOT
<br /> DIRECTORATE OF CONTRACTING SHARPE ARMY DEPOT ![�; 5T
<br /> LATHROP, CA. 95331-51!39 DIRECTftfi.A?E OF CL'PdTfiACTlttG 0?HE;
<br /> AD14INISTRATION DIV, BLDGS-4 a4:, ychzOL i:3
<br /> GERI FIORE (209)-982-2423 LATHROP, EA 95331-5108 j i; othFr?
<br /> �j �9. CONTRACTOR CODE 014011249 FrCILITY 5- P IF w ,'
<br /> a 21 3' ] SMALLNA4E AND
<br /> . .ALL DI �-
<br /> ADDRESS SAN JOAQUIN COUNTY PUBLIC c : i,a r i� -' 111. UEI
<br /> HEALTH 5VCSIENV. HEALTH DIV. `` ;_ `! r , ,,;f ,,:F ,
<br /> WOME+ (,r_L
<br /> P.O. BOX 2li009
<br /> I STOCKTON, CA 95281-
<br /> i 1EE -P ch, 15
<br /> { _ F
<br /> 144. SHIP TO CODErF'G �15 PAYMENT ;WILL 8E rV&E- S'� Li:Ir _yJ r,.,� icy x• "c
<br /> EPO, BLDG. S-4 F&A OFFICER, SAAI+ �_____.._ �,i[ -14pp'n "Tr
<br /> SHARPE ARMY DEPOT SACRAMENTO, CA 95813-5013 � CO!TRACT
<br /> LATHROP, CA. 95331-5108 SU TR... CE ,•,;'T r �,;-:_
<br /> DAAC2190P0866/ BAIT i.a1,OI4c IN uUHDdUPLslai, rL+th Num Et
<br /> 'I+cLIVER`i Th/s deliver order is is-u=+{, r n -""" r
<br /> y t_ on ani h r �G_r n:.. n. agE,'ic o: 1.
<br /> to terms and conditions of above numbered contract.
<br /> PURCHASE X Reference your BILLING STATEMENT ATCHD fLrnisr ie fa!!„r+i~:.'_n Teras Epa_ified hEr in.
<br /> ACCEPTANCE. THE CONTRACTOR HEREBY ACCEPTS THE OFFER REPRESENTED BY THE NUMBERED PURCHASE ORDER t;S �!" ' P'�+;= i'+ BEEN'
<br /> _..l
<br /> IT ' + n.. �USLY b,HJE B'r.r.
<br /> OR IS NOW MODIFIED, SUBJECT TO ALL OF THE TERMS AND CONDITIONS SET FORTH, AND AGREES TO PERFORM THE SAME,
<br /> NAME OF CONTRACTOR SIGNATURE TYPED N4P= r'dJ TI-,LE
<br /> if this box is marked, su.piier must sign Acceptance and r=eturn bile following number ci cOpias, t
<br /> 17. ACCOUNTING AND APPROPRIATION DATA/LOCAL USE —_ - �---� - --_._.._•
<br /> 21X4992.06PR 6P-25721 SO4170 PCN:5DC605 CC:3A400
<br /> !8.• ITEM NO. 19. SCHEDULE OF SUPPLIES/SERVICE �g.inyl (
<br /> - ORDEF EL/ .l:1.
<br /> tt++
<br /> 4 i
<br /> i ACCEPTED*
<br /> 1 r
<br /> SPECIAL ATTENTIUON: Read Bloch 15 care- I }
<br /> fully; it is important to indicate your
<br /> y
<br /> purchase order number on your invoice
<br /> for prompt payment.
<br /> 6001 UNDERGROUND STORAGE TANK FEES FORt i
<br /> SERVICES RENDERED INCALENDAR YEAR OF 1 E iE ( ;r_.,.,,; V
<br /> 1988. , `
<br /> cif quantity accepted by the Government 24.
<br /> INITEIT" �S OF Ai'iEn"" "1 T � ��is same as quantity ordered, indicate
<br /> by ;;. If different, enter, actualquantity accepted below quantity , ra,5IFFE ENCESordered and encircle. BY: R. ARNOLD CONTRACTIsGft�z--.,ry26. QUANTITY IN COLUMN 20 HAS BEENSHIP.17. ?ii). iii, D.O. �i i1�.11Gtij,§N IT AL S
<br /> i.
<br /> [ ]INSPECTED [ ]RECEIVED I ]ACCEPTED AND CONFORMS TO THE
<br /> CONTRACT EXCEPT AS NOTEDl ' PARTIAL
<br /> ,i I MAL 3~ PAxf��[4 f"�1�!�� j 1 HNEnlF1c:1 L'l�kii
<br /> DATE SIENATUR:E OF AUTHORIZED GOVERNMENT REP. 31. PA'(MENT `• _
<br /> 36.1 certify this account i5 correct and proper for p,fm_ t ] L!>,
<br /> PLETE or,
<br /> I ] PARTIAL
<br /> ] FIii;L "r. LL ;T _i;GIP:3 rib,
<br /> DATE SIGNATURE AND TITLE OF CERTIFYI146 OFFICER
<br /> .
<br /> 37. RECD AT 38. RECEIVED BY 39.DATE R-cC'D 4th. TOTAL CONT. 41. SIR A��1�J,jT-• -��$5� � `' F 01 i"HER NO.
<br /> DD For•ta 1155, JUL 87 Previous editions are obsolete. CCdihnCTv< M,:T �u::yIT`F.OuRCCOPIES OF
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