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• FORM CD-404-EF (09-91)

U. S. iltPARTHENT OF COMMERCE
I SUPPLY, EQillPMENT OR SERVICE ORDER
~ I. ORDER NUMBER
Use Ibis Order
Number for 43-YA-BC-382807
ilIquirieslO
2. CONTRACT ORDERED AGAINST l. PURCHASE 4. DEUVERY S. ORDER DATE . SOURCE the
PAGE I Of 2 Specif", Provisio.. Apply ORDER ORDER • Procurement 1. SUB IS. DATE PRINlED
NONE X 0913012003 Office. NONE I 02/1012005
9. SUPPUER'S ADDRESS 70152 10.1099 TAX: MJSC This ReferencoOrder 12. BILUNG ADDRESS
FLEISHMAN Hlll.ARD INC
1615 L STNW STE 1000 ~ ~~~~~~~~~
E
II. EMPLOYERlD.':
hLj-
~.
No. '~ REfERENCE ORDER NO.: OBUG-2oo3-82807-o-o
_appear 00 aU
iIlvoic...1ld
pacbses. Freight
BUREAU OF THE CENSUS
FINANCE DNISION
Il. CONTACT:
WASHINGTON DC 20036-5610 charg. over $100
BETfELEVIN roque a Bill of ROOM 3546, BUll..DING 3
lAding.
IlL TEL: 102.-121-97ll
WASlDNGTON DC 20233-4400
Ilb. FAX: NONE

14. IS. 16. 11. 18. 19. 20.

UNE DESCRIPTION DEUVERY QUANIlTY UNIT UNIT PRICE AMOUNT
ITEM DATE ISSUE

I MEDIA TRAIN1NG FOR 1HE BUREAU OF TIIE CENSUS PUBUC 0913012005 JB 24,000.0000 24,000.00
INFORMATION OFFICE FOR THE PERIOD SEPTEMBER 26, 2003
THROUGH SEPTEMBER 30, 2005 IN ACCORDANCE WITH 1HE
ATIACHED STATEMENT OF WORK. AND THE CQ}ffRA<;TOR'S
PROPOSAL DATED AUGUST 22,2003.

THIS DELIVERY ORDER IS FOR A MINIMUM OF TltREE (3) AND

A MAXIMUM OF THIRTY (30) TRAlNING SESSIONS
THROUGHOUT THE UFE OF THIS ORDER. PRICING SHALL BE
IN ACCORDANCE wrrn THE ATIACHED PRICING SCHEDULE.

TASK MANAGER: LAVERNE V. COLLINS 301-763-8469

u.s. DUAllTMUIT 01' COMMmCE - TEllMS AND CONDmONS

The following terms and conditio.. as weD as any on anacbed sbeets, apply when Ibis dooument is used as a purcllase onIer. If Ibis document is used as. delivery order. it is sul!ject 10 !be ...... and conditions of
.... con..... refl:ren<:ed in Block 112 of .... order. 52.252·2 Clauses inalrporated by l\eCereaoe (Ap< 14). This co_a incorporates thc fi>UowiDs cia.... by rer....-.:e, with thc same force and elfea as if Ihey were
giYen in full telrt- Upon request, .... CoDlJKting Officer will male. fUll text available.

NOTE: FULL TEXT CLAUSES ARE AVAllABU! AT lfIiP:/IWWW.ARNET.GOVIFARIFARQUERYFRAME.1ITMl

NOTE 2 INVOICE MUST COINCIDE wrnl UNE ITEMS ON PURCHASE ORDER
NOTEl INSTRUGnONS FOR SUBMITTING INVOICES ARE ATTAOIED
NOTE 4 CONTRACTOR SItALL ALLOW TIlE GOVT lO DAYS FROM DEUVERY TO INSPECT & ACCEPT
NOTES CONTRACTOR AGREES TO INVOICE NO LESS THAN 30 DAYS AFIER DEUVERY
NOTE 6 12.246-2INSPECTON Of SUPPlIES - F1XED PRICE

21. ORDERED BY (NAME AND TITLE)

L R SAFEWRIGHT
PURCHSGAGT $24,000.00
26. CONTRACflNGIORDERING OFFICER SIGNATIJRE 21. DATE SIGNED 128. PROMPT PAYMENT 129. SHIP VIA
LAVANCE
\
09/3012003 I Y NIA
30. SHIP TO (INCLUDE ON SHIPPING LABEl) 31. ISSUING OFFICE (DO NOT SIfiP OR Bill TO nus ADDRESS)
REFERENCE OIWER NO.OBLIG-2003-82807-0-0
BOC MAIN RECEIVING DOCK BUREAU OF THE CENSUS
ROOM 1203A, FOB 4 ACQUlSmON BRANCH, ROOM G-312-3
4700 SILVER HILL ROAD 4700 SILVER HILL ROAD
Attn: S J CLEVINGER
SUITLAND, MD 20746 SUITLAND MD 20746
Phone:
 F'ba" CD-404-EF (09-91) SUPPLY, EQUIPMENT OR SERVICE ORDER ). ORDER NUMBER
, '. U. s. 'bEPAR'lME1lT OF COHMERCE
ICOllTlllUATION SHEET)
43-YA-BC-382807
32. SUPPUER 33. I;iSUlNG OffiCE 5. ORDER DAn; Is. DAn; PRINTED
PAGE 2 OF 2
1 FLEISHMAN HILLARD INC BUREAU OF TIlE CENSUS 09/30/2003 I 02110/2005
34. 35. 36. 31. 38. 39. 40. 41.
UNE MOL QTY QTY FINAL FULL ACCOUNTING CLASSIFICATION DlST% AMOUNT
)n;M RECVD

04 6210000-000 20 04-03-02-000 11-04-0009-00-00-00-0o 25-20-04-00 000000 100010 24.000.00

42 43. 44. 45. 46. SHIP TO ADDRESS 42 43. 44. 45. 46. SHIP TO ADDRESS
UNE MOL QTY RECEIVING (INCLUDE REfERENCE ORDER NO. UNE MOL QTY RECEIVING (INCLUDE REFERENCIl ORDER NO.
ITEM OFFICE CODE ON SIUPPlNG LABEL) ITEM OFFICE CODE ON SIDPPING LABEL)

41. 4S. 49. 50

UNE REQUISITION NUMBER REQUISITION DESCRIPllON REQUISITIONER INFORMATION
ITEM

33088-0 ConlIactor will provide approximately 10 media and crisis lIaining S] CLEVINGER (W)301-763-2990 Lac: FB 3 Rm: 2705

52. RECEIPT SIGNAlURE & TITLE 53. RECEIPT DAn;

ACCEPTANCE: I CERTIFY rnAT ARTICLES AND/OR SERVICES ANNOTAn;D 54. ACCEPTANCE SIGNAlURE & TITLE 55. ACCEPTANCE DAn;
ABOVE HAVE BEEN RECEIVED. INSPECTED AND ACCEPn;D AS COMPLYING
WITII nus ORDER, AS OF TIlE DAn; SHOWN.