FORM CD-404-EF (09-91) ~ I.

ORDERNUMBER
U.8. DEl'AR7ME1ft OF COMHEIICI!: SUPPLY, EQUIPMENT OR SERVICE ORDER Use this Order

1------~---....J.------""T"----T"""--
2. CONnACT ORDI!RI!D AGAINST 3. PURCHASE 4. DBLIVI!RY S. ORDER DATE
Specific Provisiolll Apply ORDER ORDER
...
T """-.....;..--.......-------~iIlquirieslo

Number for 43-YA-BC-491443

8. DATE PRINTED
PAGE I OF 2 1. SUB
NONE X 06/0412004 NONE 0211012005
9. SUPP~'S ADDRESS 3SSSI 10. 1099 TAX: MISC TIDs Rdorence 12. BD.UNG ADDRESS
No. REFERI!NCI! ORDER NO.: OBLlG-2004-91443-O-O
II.I!MPLOYI!R I.D. N. IlIUSI appear on aD
invoices and BUREAU OF 1lffi CENSUS
13. CONTAn: pacIaoses. F r . FINANCE DMSION
charg. over $100
JOHN PRJ:EBUIlH requir.. a Bill of ROOM 3546, BUll.DING 3
Lading.
13a.TEL:"
13b. FAX: NONE bU WASHINGTON DC 20233-4400

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

UNE DESCRIPTION DEUVERY QUANIlTY UNIT UNIT PRICE AMOUNT
ITEM DATE ISSUE

Digital Editing & Graphic Design - Includes the creation of video, radio, IU3112oo4 JB 5,000.0000 5,000.00
and photography source elements for use in broadcast and web-based
products. Includes other direct costs.

Period ofPerforrnance: Date of Award through December 31, 2004.

Task Manager - Mike Morgan/301-763-3045

Alternate Task Manager Tom W~bster/301-763-3053

U.s. DEPAIlTMENT OF COMMERCE - TERMS AND CONDmONS

The foJlowinlllenDs and WnditioDS IS weD IS any on alla.hed .heets, apply when this docurncnl is used IS a purchas. order. If this d~ is used as a delivery order, it is subject '0 the terms and COnditioDS of
the contrael referenced in Block N2 of the order. 52.252-2 CIa.... incorporated by Reference (Apr 84). This conlract incorporales the followinS cia.... by r.Ference, with the same force and elI"ect IS ifthey were
siven in full_ Upon request. the CoDlractins Oflicer will make fuB text available.
NOTE: FULL TEXT CbAUSES ARE AVAILABLE AT HTTP://WWW.ARNET.GOVIFARlfARQUERYFRAME.HTML
NOTE 2 INVOICE MUST COINCIDE WITH UNE ITEMS ON PURCHASE ORDER
NOTE 3 INSTRUCTIONS FOR SUBMITIlNG INVOICES ARE ATTACHED
NOTE 4 CONTRACTOR SHAlL AlLOW THE GOVT 30 DAYS FROM DEUVERY TO INSPECT a: ACCEPT
NOTES CONTRACTOR AGREES TO INVOICE NO LESS THAN 30 DAYS AFTER DEUVERY
NOTE 6 52.246-2 INSPECTON OF SUPPLIES - AXED PRICE

21. ORDERED BY (NAME AND TITLE)

PAMILLER
PURCHSGAGT $5,000.00
26. CONTRACTINGIORDERING OffiCER SIGNATURE 21. DATE SIGNED 28. PROMPT PAYMENT 29. SHIP VIA
LA VANCE 06/04/2004 Y N/A
30. SIUP TO (INCLUDE ON SHIPPING LABEL) 31. ISSUING OFFICE (DO NOT SHIP OR BILL TO TIllS ADDRESS)
REFERENCE ORDER NO.: OBLlG-2004-91443-0-0
BOC MAIN RECEIVING DOCK BUREAU OF 1lffi CENSUS
ROOM 120lA, FOB 4 ACQUISmON BRANCH, ROOM G-312-3
4700 SILVER Hll.L ROAD 4700 SILVER Hll.L ROAD
AIIn: S B MASSIE
SUITLAND, MD 20746 SUITLAND MD 20746

Pbone:
FORM CD-404-EF (09-97) I. ORDER NUMBER
U. 8. DEPAR'ftIEHT OF CCNlEIlCE
SUPPLY, EQUIPMENT OR SERVICE ORDER
(COHTIIItJATIOH 811E11:TI 43-YA-Bc-491443

PAG!! :z 132. SUPPUI!R 33: ISSUING OFFICE 5. ORDER DATI! 18. DATI! PRINTI!D
OF 2
I JOHN FREEBURN BUREAU OF THE CENSUS 0610412004 I 0211012005
34. 35. 36. 37. 38. 39. 40. 41.
LINI! MOL QTY QTY FINAL RILL ACCOUNTING a.ASSlPICATION DIST% AMOUNT
rrnM RECVD

04 0200000-000 21 10-02-07-000 11-04-0009-00-00-00-00 25-20-04-00 000000 100% 5.000.00

42. 43. 44. 45. 46. SIUP TO ADDRI!SS 42. 43. 44. 45. 46. SIUP TO ADDRI!SS
UN!! MOL QTY Rl!CBlVlNG (INC-UDI! REI'I!RJ!NQ! ORDER NO. UN!! MOL QTY RI!CEJVING (INC-lID!! Rl!FI!RENCB ORDER NO.
ITI!M OmCECODB ON SIUPPING LABEL) ITI!M OFFICE COD!! ON SHIPPING LABEL)

47. 48. 49. SO.

LINI! REQUlSmON NUMBER REQUISITION DESCRIPTION REQUISITIONER INFORMATION
ITEM

36543-0 'Renewal of PO #43·YABC-372368 S B MASSIE (W)301-763-3012 Lac: FB 3 Rrn: 2720

'llIIIIJ!II::!1~1~!~:!"'''''''''' . . .
52. RECEIPT SIGNATURE oil: TITLE 53. RECEIPT DATE
::::111111 5I. TYP!! StUPMENT
~iol...-_------f---------------+---------i
ACCEPTANCE: I CERllFYTIlAT ARTIa.ES AND/OR SERVICES ANNOTATED 54. ACCEPTANCE SIGNATURE" TITLE 55. ACCEPTANCE DATE
ABOY!! HAY!! BEEN RECEIVED, INSPECTI!D AND ACCEPTED AS COMPLYING
WITH TIllS ORDER, AS OF THE DATE SHOWN.