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FORI.

CO-404-EF 109-971
u.s. DEPAATHENT OF COHHERCE
I SUPPLY, EQUIPMENT OR SERVICE ORDER
use~der
Number for
1.0RDERNUMBER
43-YA-BC-373365
I------...----'-------.......
2. COIflRACT ORDERED AGAINST
-----r----r------r---------linquirieslo
1. PURCHASE 4. DEUVERY 5. ORDER DATE 16· SOURCE !he
PAGE I OF 2 Specific ProYi5iol1s Apply ORDER ORDER PnlQIrement 7. SUB 18. DATE PRINTED
I
9. SUPPUER'S ADDRESS

CREW CONNECTION INC


POBOX2101
NONE
3355 J :°.
X

1099 TAX:

1I EMPLOYER l.
I.
.om: 1212412002

This
No.
ReIi:t~
~
musloppear 00 aD
iovoica and
\2- BIU-JN(j ADDRESS
REFERENCEORDEIlNO.:

BUREAU OF THE CENSUS


Office. NONE

OB1IG-2oo3-73365-o-o
0211012005

13. CONTACT: b ~..!"""


_ FRishI
..,ovuSIOO FINANCE DNISlON
EVERGREEN CO 80437 MICHELLI: PEATROWSKY requires I Bil of ROOM 3546, BUILDING 3
13.. TEL: 30-'7..0303 l.adiD3-
WASHINGTON DC 20233-4400
13b. FAX: 3Ol-67Um

J~ 11 16. 17. 18. 19. 20.


UNE DESCRIPTION DEUVERY QUANTITY UNIT UNlTPRle;. AMOUNT
fIEM DATE ISSUE

I CONTRACTOR TO PROVIDE FIELD PRODUCTION SERVlCES 1213112003 m 3,500.0000 3.500.00


INCLUDING mE DIRECTING. PRODUCING AND INDIVIDUAL
SERVlCES REQUIRED FOR PRODUCTION OF BROADCAST AND
IN-HOUSE VIDEO. RADIO AND PHOTOORAPHY SERVlCES.

PERIOD OF PERFORMANCE: DATE OF AWARD THROUGH


DECEMBER 31, 2003

CENSUS TASK MANAGER:


MIKE MORGAN
301-763-3045

ALTERNATE TASK MANAGER:


TOM WEBSTER
301-763-3053

PREVlOUS PO #43 YABC 140973

u.s. DEPAltTMENT OF COMMERCE - TERMS AND CONDrnoNS


The followiug lenDs and <oDditiom .. wellS lIlY 011 attad>ed sheds. appJy ....... this _ is used ... pun;bose ....der. Iflbis ~ is _ I S . ddiYay order. ~ is JUl!ject 10 !he _ ..... conditions of

given .. fuD1_
!he COIIb'act refereu<cd .. Biodt III of tile order. 52.252-2 Clauses iacorponled by Reference (AIM" 14). This CODIla<I iacorpomes lite followias do..... by reference, lriJI!he ...... force aDd dfect IS j{ they ~
req-.
Upoo \be Colllnc:lina Offioa- will II1II<. fiIJI_ .....bIe.

NOTE: FULL TEXT CLAUSES ARE AVAILABLE AT JITTP-J/WWW.ARNET.GOVIFARIFARQUERYFRAME.HTMl.


NOTE 2 INVOICE MUST COINCIPE wrm UNE I1EMS ON PURCHASE ORDER
NOTE 3 INSTRUcnONS FOR SUBMITf1NO INVOICES ARE ATTAaIED
NOTE 4 CONTRACTOR SIIAIL AUOW 1HE GOVT 30DAYSFROMDEUVERY TO INSPECT~ACCEPT

NOTES CONTRACTOR AGREES TO INVOICll NO LESS 11IAN 30 DAYS AFTER DEUVERY


NOTE 6 S2.246-ZINSfECTON OF SIJPPUES - FIXED PRICE

21. ORDERED BY (NAME AND TTI1.E)


LAVANCE
SUPVY PURCHSG AGT
22. FOR INQUIRIES CALL 23. FOB POINT
301-763-1840 DESTIN 24'~~~D:J': "...': $3,500.00
...
....Z-6.-CONTRA---CTIN--G/O-RD-ERlN--O-O-m-CEIl-S-,GN-/i.-TI/RE....;..------....L.------
rl27
.L-.D-A-TE-SI-ONED---':'---TI:28-.-PR--OMPT~:-P-:-AYMENT 29.SJUPVJA

L A VANCE 12124/2002 I Y NtA


30. SHIP TO (INCLUDE ON SHIPPING LABEL) 31. ISSUING orne;. (DO NOT SHIP OR BILL TO nus ADDRESS)
REFERENCE ORDER NO.;OBLIG-2ooJ-73365-o-0
BOC MAIN RECEIVlNG D<XK BUREAU OF THE CENSUS
ROOM 1203A, FOB 4 ACQUISmON BRANCH, ROOM G-312-3
4700 SILVER JllLL ROAD 4700 SILVER JllLL ROAD
Attn: S B MASSIE
SUITLAND, MD 20746 SUITLAND MD 20746

Phone:
·
-~=-=::-:-::-=--r----:==----:-::::-=:-=::=-=-:=-:-:--::------::------r--==:-:::-==---------.I
FO!\ll·!;1}-40HF 109-91) SUPPLY t EQUIPMENT OR SERVICE ORDER I. ORDER NUMBER
u.s. DEPARnIENT OF COHHERCE • (CONTIRUATION SHEET) 43-YA-BC-373365

32. SUPPUER 5. ORDER DATE


PAGE 2 Of 2 133. ISSUING OmCE 18. DATI:: PRJNnD
CREW CONNECTION INC BUREAU OF THE CENSUS 1212412002 0211012005
34. lS. 36. 17. 38. 39. 40. 41.
UNE MDL QTY QTY FINAL FID.l. ACCOUNTING CLASSIFICATION DIST% AMOUNT
ITEM RECVD

1 1 1 046210000-0oo 20 04-03-02-000 11-04-0009-00-00-00-00 25-20-04-00 000000 100r. 3500.00

42. 43. 44. 45. 46. SIDP TO ADDRESS 42. 43. 44. 45. 46. SHIP TO ADDRESS
LINE MDL QTY RECEJVJNG (INCLUDE lU!lERENCE ORDER NO. LINE MOL QTY RECEMNG (lNCLUD£ REFERENCE ORDER NO.
ITEM OmCBCODE ON SHIPPING LABEL) ITEM OmCECODE ON SHIPPING LABEL)

41. 48. 49. so.


LINE REQtnSmON NVMBER REQUISITION DESCRIP110N REQUlSmONER INFORMATION
ITEM

31078-0 Renewal afPO #43- YABC-140973 S B MASSIE (W)301-763-3012 Lac: FB 3 Rm: 2720

52. RECEIPT SIGNATURE I!L TITI..I! S3.RECEJPTDATE

ACCEPTANCE: I CBR11FYlllAT ARTICUS AND/ORSERVlCESANNOTATED 54. ACCEPTANCE SIGNATIJRE I!L TI11.E 55. ACCEPTANCE DATE
ABOVE HAVE BEEN RECEIVED, INSPECTED AND ACCEP1ED AS COMP\.Y1NG
wrrn TInS ORDER, AS OF TIlE DATE SHOWN.

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