\ ,

FORM CD-404-EF 109-91) I SUPPLY, EQUIPMENT OR SERVICE ORDER U"~d'" 1.0RDERNUMBER

O.S. DEPIIRnlElIT OF COHHERCE Numberror 43-YA-BC-486333
I------.,..---...L-------.------r-----r------.--------~inquiries 10
2. CONTRACT ORDERED AGAINST ]. PURCHASE 4. DEUVERY S. ORDER DATE 16· SOURCE !he
PAGE I OF 2 Specific Provisions Apply ORDER ORDER Procurement 7. SUB 18. DATE PRINTED
NONE X 0111412004 Olllc:e. NONE I 0211012005
9. SUPPLIER'S ADDRESS
ERIC WENOCUR
LAB TECH SYSTEMS
31320 110. 1099 TAX:
II I. EMPWYER I.D.,- MISC This Refer...... ~der 12. BI1LING ADDRESS
No. ~ REFERENCE ORDER NO.:
must oppear on aU
invoices and BUREAU OF TIlE CENSUS
OBLlG-2oo4-86333-o-o

3822 DUNSINANE DR
SILVER SPRING MD 20906
13. CONTACT: bJ..f packages. F",ighI
charge over SlllO
FINANCE DMSION
I'JUC WENOCUR requires a Bill of ROOM 3546, BUILDING 3
Lading.
l3a. TEL: 301-438-8170
WASHINGTON DC 20233-4400
Ilb. FAX: NONE

14. IS. 16. 17. lB. 19. 20.

UN\! DESCRIPTION DEUVERY QUANTITY UNIT UNIT PRICE AMOUNT
fI1!M DATE ISSUE

I CONTRACTOR TO PROVIDE MAINTENANCE SERVICES TO 12/3112004 18 7,500.0000 7,500.00

INCLUDE REPAIR, SERVICE AND DESIGN OF BROADCAST
HARDWARE IN TIlE PUBLIC INFORMATION omCE DIGITAL
EDITING FACILITIES AND SUPPLY OF MATERIALS
(HARDWARE. SOfTWARE AND EQUIPMENT) FOR USE IN
CREATION OF BROADCAST AND IN-HOUSE VIDEO, RADIO
AND PHOTOGRAPHY PROGRAMS.

INCLUDES OTIIER DIRECT COSTS.

PERIOD OF PERFORMANCE: JANUARY 1.2004 THROUGH

DECEMBER 31, 2004

CENSUS TASK MANAGER - MIKE MORGAN 301-763-3045

ALTERNATE TASK MANAGER - TOM WEBSTER - 301-763-3053

U.S. DUAJl.TMENT OF COMMERCE - TERMS AND CONDmoNS

The foBowing lerms and "'mditions as weD as any on alUlched.heeIs, apply when Ihis documMl is used as a purchase order.lfcbis documenl is used as a delivery order, it is subject 10 the terms and conditions of
the conuact mercnccd in BIocIt .2 of the order. 52.252-2 Clauses incorporaled by Reference (Apr 84). This contract incorporales !he foBowing clauses by reference, with the ..... force and effect as if they were
given in run I.... Upon req...... the Codr.aetiDg Officer will make run text available.

NOTE: FULL TEXT CLAUSES ARE AVAILABLE AT IITIPJIWWW.ARNET.GOVIFARJFARQUERYFRAME.HThIL

NOTE 2 fNVOICE MUST COINCIDE WlTII LINE ITEMS ON PURCHASE ORDER
NOTE] INSTRUCTIONS FOR SUBMITTING INVOICES ARE ATTACHED
NOTE 4 CONTRACTOR SHAlL ALLOW TIlE GOVT]O DAYS FROM DEUVERY TO INSPECT &: ACCEPT
NOTES CONTRACTOR AGREES TO INVOICE NO LESS THAN ]0 DAYS AFTER DEUVERY
NOTE 6 52.246-2INSPECTON OF SUPPUES - FIXED PRICE

21. ORDERED BY (NAME AND TITLE) 22. FOR eNQUIRIES CALL 2]. FOB POINT 24. DISCOUNT TERMS
PAMILLER 301-763-3547 DESTIN O%inOnetO
PURCHSGAGT $7,500.00
26. CONTRACTlNGIORDERING OmCER SIGNATURE 21. DATE SIGNED \28. PROMPT PAYMENT 129. SHIP VIA
LA VANCE
1 0111412004 I Y N/A
]0. SHIP TO (INCLUDE ON SHIPPeNG LABEL) ]1. ISSUING omCE (DO NOT SHIP OR Bll.L TO TInS ADDRESS)
OBLlG-2004-86333-0-o
REfERENCE ORDER NO.:
BOC MAIN RECEIVING DOCK BUREAU OF THE CENSUS
ROOM 120JA, FOB 4 ACQUISITION BRANCH, ROOM G-312-3
4700 SILVER HILL ROAD 4700 SILVER HILL ROAD
Attn: S B MASSIE
SUITLAND, MD 20746 SUITLAND MD 20746

Phone:
FORM CD-404-EF (09-91\ I. ORDER NUMBER
U. B. DEPARTHBKT OF COHHERCE
SUPPLY, EQUIPMENT OR SERVICE ORDER 43-YA-BC-486333
. (CONTI_TIOK SHEET)

PAGE 2 132. SUPPUER 33. ISSUING OFFICE 5. ORDER DATE 18. DATE PRINTED
OF 2
ERIC WENOCUR BUREAU OF THE CENSUS 01/1412004 I 0211012005
34. 35. 36. 37. 38. 39. 40. 41.
LINE MDL QTY QTY FINAL FULL ACCOUNTING CLASSIFICATION mST'" AMOUNT
ITEM RECVD

1 1 1 04 0331000-000 21 10-04-03-000 11-04-0009-00-00-00-0025-20-04-00000000 100% 7.500.00

42. 43. 44. 45. 46. SHIP TO ADDRESS 42. 43. 44. 45. 46. SHIP TO ADDRESS
LINE MDL QTY Rl!CEIVlNG (IN<llJDE RE.FHRENCE ORDER NO. LINE MDL QTY RECEIVING (INCLUDE REFERENCI! ORDER NO.
ITEM OFFICE CODE ON SHIPPING LABEL) ITEM OFFICI! CODE ON SHIPPING LABEL)

47. 48. 49. 50.

LINE REQUISITION NUMBER REQUISITION DESCRIPTION REQUlSmONER INFORMATION
ITEM

35650-0 Renewal ofPO# YAI323-03-SE-0I3I S B MASSIE (W)301-763-3012 Loc: FB 3 Rm: 2720

1·111:_..
11 ::·"":I:I"'li=I 5_I._TYP_E_S_HlP_MENT
L
ACCEPTANCE: I CERTIFY TIfAT ARTICLES AND/OR SERVICES ANNOTATED
+-5_2._RE_CElYf
_ _S_IG_N_A_TIlRE
_ _&_TI_1l.E

54. ACCEPTANCE SIGNATIlRE .t: TI1l.E

+5_3_.RE_CElYf
__ DA_TE

55. ACCEPTANCE DATE

--t

ABOVE HAVE BEEN RECEIVED, INSPECTED AND ACCEPTED AS COMPLYING

WITII nus ORDER, AS OF TIlE DATE SHOWN.