FORK CD-404-EF (09-97)

U. S. DBPAR'nlEHT OF COMMERCE
I SUPPLY, EQUIPMENT OR SERVICE ORDER usethJrrder
Number for
1.0RDERNUMBER
43-YA-BC-486355
t------,.---....L-------r----T"""--:--'T""__
2 CONTRACT ORDERED AGAINST
=:-:--:=:-r:--:::=:::;:-------linquiries to
3. PURCHASE 4. DEiJvERy 5. ORDER DATE 6. SOURCE the
PAGE I OF 2 Specific ProvWo'" Apply ORDER ORDER Pro<:uremenl 7. SUB 18. DATE PRINTED
NONE X 0111512004 Office. NONE I 02/1012005
9. SUPPUER'S ADDRESS 61792 :10. 1099 TAX: MJSC ThisRefer=Order 12BlLUNGADDRESS
No. ~ REFERllNCE ORDER NO.: OBLIG-2004-86355-o-0

1!IL
VENTANA PRODUCTIONS INC II. EMPLOYER lD. must appcor 00 III
1825 K ST NW NO 501 1 '. invoices.... BUREAU OF THE CENSUS
13. CONTACT: pocbges. Freipt FINANCE DMSION
WASHINGTON DC 20006 charBe over $100
VlCKlSKATZES requires a BiD of ROOM 3546, BUILDING 3
ladiDg.
I3L TEL: :182 7115-5112
WASHINGTON DC 20233-4400
I3b. PAX: NONE

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

lJNE DESCRIPTION DEUVERY QUANIITY UNIT UNIT PRICE AMOUNT
ITEM DATE ISSUE

1 CONTRACTOR TO PROVIDE FIElD PRODUCTION SERVICES TO 1213112004 m 7,500.0000 7,500.00

INCLUDES THE DIRECTING, PRODUCING AND INDIVIDUAL
SERVICES REQUIRED FOR PRODUCTION OF BROADCAST AND
IN-HOUSE VIDEO, RADIO AND PHOTOGRAPHY SERVICES.

INCLUDES OTHER 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. DEPARTMENT OF COMMERCE - TERMS AND CONDmONS

The foDowing lerms .... cooditio..... well .. any 00 lIItached sheets, apply whea this document is used ... purd1ase order. If!bis document is used ... delivery order, it is ,u\Jjed 10 the terms and conditions of
the CODIrllCl referenced in BIod< 112 of the order. 52252-2 CIa_ incorporated by Reference (Apr 84). This contract incofporata the rouowing clause> by refereace. with the _ force and effect as if they were
given in run Iext. Upon requ..~ the Contracting Ollicer will make run lext available.

NOTE: FUlL TEXT ClAUSES ARE AVAIl.ABLE AT HTIP:lIWWW.ARNET.GOVIFARIFARQUERYFRAME.HTML

NOTE 2 INVOICE MUST COINCIDE WlTII UNE ITEMS ON PURCHASE ORDER
NOTE 3 INSl1I.UcnONS FOR SUBMlTnNG INVOICES ARE ATTACHED
NOTE 4 CONl1l.ACTOR SHAlL AlLOW TIlE GOVT 30 DAYS FROM DELIVERY TO INSPECT '" ACCEPT
NOTE 5 CONl1l.ACTOR AGREES TO INVOICE NO LESS TIIAN 30 DAYS AFTER DEUVERY
NOTE 6 52.246-2 INSPECTON OF SUPPUES - FIXED PRICE

21. ORDERED BY (NAME AND TITLE)

PAMILLER
PURCHSGAGT $7,500.00
26. CON'IRACTING/ORDERING OffiCER SIGNATURE 27. DATE SIGNED 128. PROMPT PAYMENT 1 29. SHIPYIA

LA VANCE
1
0111512004 I Y N/A
30. SHIP TO (INCLUDE ON SHIPPING LABEL)
31. ISSUING OffiCE (DO NOT SHIP OR Btl TO nus ADDRESS)
OBLlG-2oo4-86355-o-0
REFERENCE ORDER NO.:
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: S B MASSIE
SUITLAND, MD 20746 SUITLAND MD 20746

Phone:
FORK CD-404-EF (09-91\ I. ORDER NUMBER
U.S. DEPARTMENT OF COHHERCE
SUPPLY, EQUIPMENT OR SERVICE ORDER 43·YA-BC-486355
(CONTINUATION SHEET)

PAGE OF
32. SUPPUER ·133. ISSUING OFFICE 5. ORDER DATE 18. DATE PRINT6D
2
\ VENTANA PRODUCTIONS INC I BUREAU OF TIlE CENSUS 01115(2004 I 02/10(2005
34. 35. 36. 31. 38. 39. 40. 41.
UNE MOL QTY QTY FINAL FUll. ACCOUN11NG CLASSIFICATION DIST% AMOUNT
ITEM RECVD
040200000-00021 10-02-07-000 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
UNE MOL QTY RECEIVING (INCLUDE 1Ull'I!RENCE ORDER NO. UNE MOL QTY RECEIVING (INCLUDE REFERENCE ORDER NO.
ITEM OFFiCECODB ON SHIPPlNG LABEL) ITEM OFFICE CODE ON SHIPPING LABEL)

41. 48. 49. 50.

UNE REQUlsmON NUMBER REQUlsmON DESCRIPTION REQUlSmONER INFORMATION
ITEM

35677-0 Renewal ofPO# YAI323-03-SE-0I30 S B MASSIE (W)30\-763-3012 Lee: FB 3 Rm: 2720

52. RECEIPT SIGNATURE '" l1TI.E n. RECEIYT DATE

ACCEPTANCE: I CERllfY llIAT ARTIa.ES ANDfOR SERVICES ANNOTATED 54. ACCEPTANCE SIGNATURE '" TITLE 55. ACCEPTANCE DATE
ABOVE HAVE BEEN RECEIVED, INSPECTED AND ACCEPTED AS COMPLYlNG
W11l11l11S ORDER, AS OF 1116 DATE SHOWN.