FORM CD-404-EF (09-97) ~ I.

ORDER NUMBER
U. S. DEPARTMENT OF CC41MERCE' SUPPLY, EQUIPMENT OR SERVICE ORDER Use \his Order
Number for 43-YA-BC-598348
t-------,------'------. . . . .- ----.-----.------,.--------1inquiries
2. CONTRACT ORDERED AGAINST 3. PURCHASE 4. DEUVERY 5. ORDER DATE. SOURCE the
10

PAGE I OF 2 SpecifIC Provisions Apply ORDER ORDER Procurement 7. SUB 8. DATE PRINTED
NONE X 12120/2004 OffICe. NONE 0211012005
9. SUPPUER'S ADDRESS 40465 This Reference Order 12. BIWNG ADDRESS
No. REFERENCE ORDER NO.: OBUG-2005-98348-o-o
must appear on all
iovoioes and BUREAU OF TIlE CENSUS
packages. Freight FINANCE DMSION
cllarge aver $100
requires a Bili of ROOM 3546, BUILDING 3
Lading.
WASHINGTON DC 20233-4400

14. 15. 16. 17. II. 19. 20.

UNE DESCRIPTION DEUVERY QUANnTY UNIT UNIT PRICE AMOUNT
ITEM DATE ISSUE

RENEWAL OF BROADCAST MEDIA PRODUCTION SERVICES 12131/2005 m 21,000.0000 21,000.00

INCLUDING SCRIPT WRITING, PRODUCING, DIRECTING,
LANGUAGE TRANS LATION, RESEARCIDNG, AND
PRODUCTION ASSISTANCE FOR CREATING BROADCAST AND
IN-HOUSE VIDEO AND RADIO PROGRAMS. INCLUDES OTHER
DIRECT COSTS.

PERIOD OF PEFORMANCE: JANUARY I, 2005 TIfROUGH

DECEMBER 31, 2005

CENSUS TASK MANAGER:

TOM EDWARDS
301-763-2184

ALlERNAIE TASK MANAGER:

PAT DUNTON
301-763-2806

PREVIOUS PO #YA132304SE0376

u.s. DEPARTMENT OF COMMERCE - TEaMS AND CONDITIONS

The following.enns and conditions as weD as any on a.tached sheets, apply wben Ibis docwnenl is used as a purchase order. If this doeumeot is used'as a delivery order. it is subject 10 !he Ienm and conditio.. of
!he conlrad rcfererlCed ill Block '2 of the order. 52.252-2 CIa..... iDoorporalcd by ReferCDCe (Apr 84). Tbis co_ iocorpora.es the following clauses by reference. with the same IOree and effca as if they were
giv.. iIIha .ext. Upon ,<qUeSt, !he Conlraclini 0fIicet wiD moIee fuR _ available.

NOTE: FULL TEXT a..AUSES ARE AVAD..ABLE ATH1TP:/IWWW.ARNET.GOVn.ARlFARQUERYFRAME.HTML

NOTE 2 INVOICE MUST COfNaDE WITH UNE ITEMS ON PURCHASE ORDER
NOTE 3 INSTRUCTIONS FOR SUBMITI1NG INVOICES ARE ATTAOIED
NOTE 4 CONTRACTOR SIIAU ALLOW 1HE GOVT 30 DAYS FROM DEUVERY TO fNSPECT &. ACCEPT
NOTES CONTRACTOR AGREES TO INVOICE NO LESS THAN 30 DAYS AFTER DElIVERY
NOTE 6 52.246-2 fNSPECTON OF SUPPUES - FIXED PRICE

21. ORDERED BY (NAME AND TIlLE)

LA VANCE
SUPVY PURCHSG AGT $21,000.00
26. CONTRACTINGIORDERING OFFICER SIGNATIJRE 27. DATE SIGNED 28. PROMPT PAYMENT 29. SIDP VIA
LA VANCE 1212012004 Y N/A
30. SIDP TO (INCLUDE ON SIDPPING LABEL) 31. ISSUfNG OFFICE (DO NOT SIDP OR BIlL TO TIllS ADDRESS)
OBLIG-2005-98348-o-o
REFERENCE ORDER NO.:
BOC MAIN RECEIVING DOCK BUREAU OF THE CENSUS
ROOM 1203A, FOB 4 ACQUISmON BRANCH, ROOM G-312-3
4700 SILVER HILL ROAD 4700 SILVER HILL ROAD
AltD: P H DUNTON
SUITLAND, MD 20746 SUITLAND MD 20746
Phone:
 FOlUl CD-404-EF 109-91) I. ORDER NUMBER
U.S. DEPARTMENT OF COHMEilCE
SUPPLY, EQUIPMENT OR SERVICE ORDER 43-YA-BC-598348
tCOtlTIIltlATIOIl SHEET)

PAGE 2 2
n SUPPLIER 33. ISSUING OffiCE 5. ORDER DATE lB. DATE PRINTED
OF
MARIA C SICCARDI 1 BUREAU OF TIlE CENSUS 1212012004 I 02/1012005
3~. 35. 36. 31. 38. 39. 40. ~1.
UNE MOL QTY QTY FINAL FULL ACCOUNTING CLASSmCATION DIST% AMOUNT
ITEM RECVD

I I 1 04 0200000-000 21 10-02-{)7-000 11-04-0009-00-00-00-00 25-20-{)4-()() 00000o 100% 21.000.00

42. 43. 4'!. 45. 46. SlDP 1'0 ADDRESS 42. 43. 4'!. 45. 46. SIDP TO ADDRESS
UNE MOL QTY RECEIVING (INCLUDE ~ORDER NO. UHf MOL QTY RECEIVING (INCLUDE REFERENCE ORDER NO.
ITEM OmCECODE ON SIDPPlNG LABEL) ITEM OmCECODE ON SIDPPING LABEL)

41. 48. 49. SO.

UNE REQUISITION NUMJlER REQUISITION DESCRIPllON REQUlSI110NER INFORMATION
ITEM

39665-0 Renewal of PO flYA1323-Q4·SE-0376 PH DUNTON (W)301-763-2806 Loc: FB 3 Rm: 2705

'i:~:::t 51. TYPE SHIPMENT 52. RECEIPT SIGNATURE & TIl1Jl 53. RECEIPT DATE

ACCEPTANCE: I CERTIFY THAT ARTICLES AND/OR SERVICES ANNOTATED 54. ACCEPTANCE SIGNATIJRE & TITI.E 55. ACCEPTANCE DATE
ABOVE HAVE BEEN RECEIVED, INSPECTED AND ACCEPTED AS COMPI.YlNG
WlTII TInS ORDER. AS OF mE DATE SHOWN.