FORM CD-404-EF (09-97)

U.S. DEPIIRTHEHT OF COHMERCE

I SUPPLY, EQUIPMENT OR SERVICE ORDER
....
~:,e':~der
I. ORDERNUMIlER
43-YA-BC-599052
t-------r--::-:-:-~~- ---""T----r_-__
2. CONTRACT ORDERED AGAINST
__,~:=
3. PUROIASE 4. DELIVERY 5. ORDER DATE 6. SOURCE
r:_:=~----__1inquiri<s\O
the
PAGE I OF 2 SpecifIC Provisions Apply ORDER ORDER Procuremenl ,. SUB IS. DATE PRINTED
NONE X 01/1412005 Ollice. NONE I 02/1012005
9. SUPPUER'S ADDRESS 33549 10. 1099 TAX: NONE This Reference 12. BIWNG ADDRESS Order
TELECLIP INC • ~ No. '~ REFERENCE ORDI!R NO.: OBLlG-2005-99052-0-0
I I. EMPLOYER I.D. must appear on aU
360 I S CONGRESS BLDG B STE 100 iuvoi<esand BUREAU OF TIlE CENSUS
13. CONTACT: bJ.f
packases. FreisM
I charge oyer $100
FINANCE DMSION
.
AUSTIN TX 78704 THELMA L KRATZ requires a Bal of ROOM 3546, BUILDING 3
Lading.
13L TEL: Sl2-851-81OO
WASHINGTON DC 20233-4400
I3b. fAX: Sl2-851-8581

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

UNE DESCRIPTION DELIVERY QUANllTY UNIT UNIT PRICE AMOUNT
ITEM DATE ISSUE

I CONTRACTOR TO PROVIDE PRINTIBROADCAST MEDIA 12/3112005 m 5,000.0000 5,000.00

ANALYSIS SERVICES TO INCLUDE GATHERING, ASSEMBLING,
RESEARCHING, ANALYZING AND PRODUCTION OF REPORTS
ABOl.IT PRINT AND BROADCAST COVERAGE OF CENSUS
BUREAU DATA RELEASES. INCLUDES OTHER DIRECT COSTS.

PERIOD OF PERFORMANCE: JANUARY 1,2005 THROUGH

DECEMBER 31, 2005

TASK MANAGER: MIKE MORGAN 301-763-3045

ALT. TASK MANAGER: TOM WEBSTER 301-763-3053

U.s. DEPARTMENT OF COMMERCE - TERMS AND CONDmONS

The following terms and conditions as weD as any on attached sheets, ipplywlJen this document is used as a purcbase order.lflhisdocument is used as a dolivel}' order, ~ is subje<t 10 the I""'" and condilions or
lite 00_ referenced in BIocIt 112 of !be order. 52.252-2 Cla.... incorponted by Refere<lCO (Apr 84). This contnl<t incorporales !be foUowing clauses by refer...... with the same force and effiocl as if they were
I""
given in filU 1exI. Upon request, the Contracting 0Ificer will makefilH available.

NOTE: FULLTEXTQ.AUSESAREAVAIl.ABLEATHT11':JIWWW.ARNET.GOVIFARlfARQUERYFRAME.HTML
NOTE 2 INVOICE MUST COINCIDE WIllI LINE ITEMS ON PURCHASE ORDER
NOTE 3 INSTRucnONS FOR SUBMITTING INVOICES ARE ATTACHED
NOTE 4 CONTRACTOR SHAU. AlLOW TIlE GOVT 30 DAYS fROM DEUVERY TO INSPECT &: ACCEPT
NOTE 5 CONTRACTOR AGREES TO INVOICE NO LESS THAN 30 DAYS AFTER DEUVERY
NOTE 6 52.246-2INSPECTON OF SUPPUES - FIXED PRICE

21. ORDERED BY (NAME AND TITLE) 22. FOR INQUIRIES CALL 23. FOB POINT 24. DISCOUNT TERMS #llr@mr
PAMILLER 301-763-3547 DESTIN 0%inOnet30 ;ro.YAL
PURCHSGAGT !lllli;~:;:;I;;;: $5,000.00
26. CONTRACTING/ORDERING OmCER SIGNATURE 21. DATE SIGNED 128. PROMPT PAYMENT 1 29. SHIP VIA

LAVANCE 1 01/1412005 I Y NIA

30. SHIP TO (INCLUDE ON SHIPPING LABEL) 31. ISSUING omCE (DO NOT SHIP OR BIll. TO nus ADDRESS)
REFERENCE ORDER NO.: OBLIG-2005-99052-0-o
BOC MAIN RECEIVING DOCK BUREAU OF THE CENSUS
ROOM 1203A, FOB 4 ACQUISITION BRANCH, ROOM G-312-3
4700 SILVER HILL ROAD 4700 SILVER HILL ROAD
Attn: M S MORGAN
SUITLAND, MD 20746 SUITLAND MD 20746

Phone:
 I. ORDER NUMBER
FORM CD-404-EF (09-97)
U.S. DEPARTMENT OF COHKERCE
SUPPLY, EQUIPMENT OR SERVICE ORDER 43-YA-BC-599052
(CONTINUATION SHEET)

PAGE
131. SUPPUER 33. ISSUING OfFICE 5. ORDER DATE 18. DATE PRINTED
1 OF 2
TELECLIP INC BUREAU OF TIlE CENSUS 0111412005 I 0211012005
34. 3S. 36. 37. 38. 39. 40. 41.
UNE MOL QTY QTY FINAL FUll. ACCOUNTING a.ASSIFlCATION DI~T% AMOUNT
ITEM RECVD

04 0200000-000 21 10-02-07-000 11-04-0009-00-00-00-0025·20-04·00 000000 100% 5.000.00

42. 43. 44. 45. 46. SIUP TO ADDRESS 42. 43. 44. 45. 46. SIUP TO ADDRESS
UNB MOL QTY RECmVING (INCLUDI! REPERENCE ORDER NO. UNI! MOL QTY 1U!CI!IVING (INa..uDE REFERENCE ORDER NO.
ITEM OFPICEOODI! ON SHIPPING LABEL) ITEM OFFICE COOl! ON SHIPPING LABEL)

47. 48. 49. so.

UNE REQUISITION NUMBER REQUlSmON DESCRIPTION REQUISITIONER INFORMATION
ITEM

39666-0 Renewal of PO 1143-YABC-372370 PH DUNTON (W)301-763-2806 we: FB 3 Rm: 2705

III:III!:I~I~:.;;·. :::~l[iir~ll~f::···:'llillltljl 51.

52. RECEIPT SIGNATURE & 1TI1.E 53. RECElYT DATE
TYPE SHWMENT

=:1....--------+.------------------1---------1
ACCEPTANCE: I CERTIFY TIlAT ARTICLES AND/OR SERVICES ANNOTATED 54. ACCEPTANCE SIGNATIJRE & 1TI1.E 55. ACCEPTANCE DATE
ABOVE HAVE BEEN RECEIVED, INSPECTED AND ACCEPTED AS COMPLYING
WITII nus ORDER, AS OF TIlE DATE SHOWN.