, FOIU! CD-404-EF 109-97) ....... I.

ORDER NUMBER
U. 8. DEPAR'rHENT OF COHHERCE SUPPLY, EQUIPMENT OR SERVICE ORDER U•• 1hili Order
Number for 43-YA-BC-373469
t------,..:-:'==-:=-::-- ----r----,----T""
2. CONTRACT ORDERED AGAINST 3. PURCHASE
~ __.......
"T:"'"==:__---__1inquiries 10
4. DEllVIlRY 5. ORDI!R DATE . SOURCl! the
PAGE I OF 2' Specific Provisions Apply ORDER ORDI!R remenl 7. SUB B. DATE PRlNl'ED
NONE X 0110312003 Office. NONE 0211012005
9. SUPPUER'S ADDRESS 35843 10. 1099 TAX: MISC This ReCera>ce 12. BIUlNG ADDRESS
OBLlG-2003-73469-o-o
~~~~~~~~~~JNO.
REFl!Rl!NCB ORDIl1l NO.:
II. EMPLOYI!R LD. ... must appear 00 aU
mwicaend BUREAU OF lHE CENSUS
13. CONTACT: 4 l.f pacbges. F~
c:IIargeovuSIOO
FINANCE DIVISION
DO.JlIOT USE BAS NEW ADDRESS requires a BiU of ROOM 3546, BUll.DING 3
13"~ Lading.
WASHINGTON DC 20233-4400
I3b.FAX:~lI

14. 15. 16. 17. 18. 19. 20.

UNE DESCRIPTION DEllVIlRY QUANTITY UNIT UNIT PRICE AMOUNT
ITEM DATE ISSUE

CONTRACTOR TO PROVIDE BROADCAST MEDIA 1213112003 JB 5,513.0000 5,513.00

PRODUCTION TO INCLUDE lHE FOLLOWING: SCRIPT
WRITING, PRODUCING, DIRECTING, RESEARCHING, AND
PRODUCIlON ASSISTANCE FOR CREATING BROADCAST AND
IN-HOUSE VIDEO, RADIO AND TRANSLAl'IDNS PROGRAMS.
INCLUDES OlHER DIRECT COSTS.

PERIOD OF PERFORMANCE: DATE OF AWARD THROUGH

DECEMBER 31, 2003

CENSUS TASK MANAGER: MIKE MORGAN 301-763-3045

ALTERNATE TASK MANAGER: TOB WEBSTER 301-763-3053

U.S. DEPARTMENT OFCOMMEllCE· TERMS AND CONDmONS

The following tams end conditio.... well .. any on attached sheets, apply when this document is used as a purchase ordcr.lfthis documeol is uscd .. a deliYery order, it is .ubjecllo the lenns and tooditio.. of
the tonlJact relcrenccd in Block fI2 of the order. 52.252-2 CIa.... incorporated by Reference (Apr 84~ This tOntract incorporates the following clauses by reference, with the ...... force and dI'tct .. if they were
8iven ill fullleX\. Upon request, lhe ConU1leting OffICer will make CuB text available.

NOTE: FULL TEXT CLAUSES ARE AVA1lAI!L.E AT H1TP:/IWWW.ARNET.GOVIFARIFARQUERYFRAME.HTML

NOTE 2 INVOICE MUST COINCIDE WI1lI UNE ITEMS ON PURCHASE ORDER
NOTE 3 INSTRUcnONS FOR SUBMlTJ1NG INVOICES ARE ATTACHED
NOTE 4 CONTRACTOR SHALL AlLOW TIlE GOVT 30 DAYS FROM DELlV£Ry TO INSPECT &: ACCEPT
NOTES CONTRACTOR AGREES TO INVOICE NO LESS TItAN 30 DAYS AFTI!R DEUVERY
NOTE 6 52.246-2 INSPECTQN OF SUPPUES - FIXED PRICE

21. ORDERED BY (NAME AND TITLE)

PAMILLER
PURCHSGAGT $5,513.00
26. CONTRAC11NGIORDERING OrnCER SIGNATURE 27. DATE SIGNED 28. PROMPT PAYMENT 29. SHIP VIA
LA VANCE 0110312003 Y N/A
30. SHIP TO (INCLUDE ON SHIPPING LABEL) 31. ISSUING OrnCE (DO NOT SHIP OR Bill TO TInS ADDRESS)
OBLIG-2003-73469-0-0
REFERENCE ORDER NO.:
BOC MAIN RECEMNG DOCK BUREAU OF lHE CENSUS
ROOM 1203A., FOB 4 ACQUISmON BRANCH, ROOM G-312-3
4700 SILVER HILL ROAD 4700 SILVER HILL ROAD
AIIn: S B MASSIE
SUITLAND, MD 20746 SUIT1.AND MD 20746

Phone:
, FORM C.J-404-EF (09-97) J. ORDER NUMBER
U. B. DEPAR'l'HEN'I' OF lXHlERCE
SUPPLY, EQUIPMENT OR SERVICE ORDER 43·YA-BC-373469
lCOllTllIOA'I'IOII SIlBE'I'1

32. SUPPLIER 33. ISSUING OFFICE 5. ORDER DATE lB. DATE PRINTED
PAGE 2 OF 2
1 LAURA SCHEBLER BUREAU OF TIlE CENSUS 0110312003 I 0211012005
34. 35. 36. 37. 3B. 39. 40. 41.
UNE MOL QTY QTY FINAL FULL ACCOUNTING CLASSIFICATION DIST% AMOUNT
ITEM RECVD

04 0200000-000 21 10-02-07-00011-04·0009·00-00-00-00 25·20-04-00 000000 100% 5.513.00

42. 43. 44. 45. 46. SIDP TO ADDRESS 42. 43. 44. 45. 46. SIDP TO ADDRESS
UNE MOL QTY RECEIVING (INCLUDE REFERENCE ORDER NO. UNE MOL QTY RECEIVING (INO..UDE REFERENCE ORDER NO.
ITEM OFFICE CODE ON SlDPPING LABEL) ITEM OFFICE CODE ON SIDPPlNG LABEL)

47. 4B. 49. so.

UNE REQUISITION NUMBER REQUISITION DESCRIPTION REQUlSmONER INFORMATION
ITEM

31088-0 Renewal ofPO# 43-YABC-259588 S B MASSIE (W)301·763-3012 Loc: FB 3 Rm: 2720

!111111111"111111~1111111'.1
52. RECEIPT SIGNATIJRE &: TITLE 53. RECEJPTDATE

S1. TYPE SJJJPMENT

ACCEPTANCE: I CERTIFY TIlAT ARTICLES AND/OR SERVICES ANNOTATED 54. ACCEPTANCE SIGNATIJRE '" TITLE 55. ACCEPTANCE DATE
ABOVE HAVE BEEN RECEIVED, INSPECTED AND ACCEPTED AS COMPLYING
W1T11 T1DS ORDER, AS OF TIlE DATE SHOWN.