ORDER FOR SUPPLIES OR SERVICE

• Document Type: CREST
• Collection: NGA Records (Formerly NIMA)
• Document Number (FOIA) /ESDN (CREST): CIA-RDP78B04770A000400030009-7
• Release Decision: RIPPUB
• Original Classification: C
• Document Page Count: 3
• Document Creation Date: December 28, 2016
• Document Release Date: January 4, 2005
• Sequence Number: 9
• Publication Date: April 11, 1966
• Content Type: FORM

CONTRACT NO
SHEET
NO.OF
.
ORDER FOR SUPPLIES OR SERVICE
rvo.1
SHEETS
~,.
DEPARTMENT DATE OF ORDER
REQUISITION NO./PURCHASE AUTHORITY 0
. 0. VOUCHER NO.
NAVY It* ? 66
19-66-80112 (wepe )
ISSUED BY
MAIL INVOICES TO
PAID BY
BUREAU OF NAVAL WEAPONS
Bureau of Naval Weapons
WASHINGTON 25,D. C. 20360
Declass Review b
SHIP TO (Consignee and Address)
PAYMENT WILL BE MADE BY
3i
?,~y~ late%4 date
at ~
'W %4 `Via e
gry~o
.. Bureau
TO (Contractor and Address)
PAYMENTI
^ COMPLETE ^ PARTIAL ^ FINAL
F-
(For use of Paying Office)
~j`
16
i
?ecvl
j7
?"
-
o
6
l
DATE(S) OF DELIVERY
Attention
w119
,(~
L JI e ~,)6405
DELIVERY F. O. B.
DISCOUNT TERMS
I
^ DESTINATION
(,] ~t ~ 18 66
[" 18 U
OTHERS
(Fold on This Line)
(See Schedule)
I
In accordance with your of please furnish the following on the terms specified on both sides of this
CHASE
r
order and on the attached shoots, if any, including delivery as indicated. This purchase is negotiated under authority of l0 U.S.C. 2304(a) ( ).
7his delivery order is sub)ect fo instructions contained on this side only of this form and is issued on another government agency or in accordance
VERY
with and subject to the terms and conditions of the above numbered contract.
UNITED STATES OF AMERICA
MARK ALL PACKAGES AND PAPERS WITH
CONTRACT AND/OR ORDER NUMBERS
eY CONTRACTING/ORDERING OFFICER
ACCOUN
TING AND A
PPROPRIATION
DATA
ITEM
APPROPRIATION SYMBOL
OBJECT
EXPENDITURE
CHARGEABLE
BUREAU CONTROL
BUREAU
SUBAUYHOR
IZATION AMOUNT
NO.
,
AND SUBHEAD
CLASS
ACCOUNT
ACTIVITY
ACTIVITY NO.
CONTROL NO.
ACTIVITY
NUMBER
17X1319.9657
310
96000
?~G
ITEM
NO
SUPPLIES OR SERVICES
QUANTITY
(No. of Units)
UNIT
UNIT
PRICE
AMOUNT
QUANTITY
ACCEPTED
.
Two (2) Briefihl ' P-,? nt tit r"ge:" s
2
(fluid te9 3 to 60 times 4 ?atio )
Us
COP Mt
FFLmc~~......
((r~~~~,~[ yr~
r - QV V 11~
Tj~ `'
MSF0ow..'
RECEIVED AT
SHIPMENT NO.
^ FINAL ^ PARTIAL
TOTAL AMOUNT 0i - i ~i e '
(See
reverse
for
DATE RECEIVED
GROSS WEIGHT
NO. PIECES
RECEIVED
B L No.
DIFFERENCES
re$ec-
J
tiOns)
RECEIVED BY
LOCATION
CARRIERS ROUTING
INITIALS
AMOUNT VERIFIED CORRECT FOR
I CERTIFY that the supplies or services listed in the "Quantity
B/R ACCOUNT NO. I CERTIFY that this account is correct and proper for payment.
Accepted" column were inspected and accepted, that they conform to
the contract requirements; that the supplies or services listed on re-
verse side were rejected for reasons stated, and that the foregoing
ig'yf.OZl
S/R VOUCHE
t
ns
report is correct.
ftz=at
a
DATE AUTHORIZED GOVT. REPRESENTATIVE
a SIGNATURE AND TITLE OP CERTIFYING OFFICER
CHECK NO.
DATED
CASH $g
Bff4 dS riginal only when paid in cash)
FOR ( myunt),
ON TREASURER OF THE
ON (Date)
BY
TITLE
Ap
"Te 2
05/02/10 : CI
-RDP78B04770A000400
30009-7
FORM PREVIOUS EDITIONS ARE OBSOLETE EXCEPT H 4 6 4 6 6 Form approved by Comptroller
DD i FEB 58 1155 1 APR 57 EDITION WHICH MAY BE USED UNTIL I DEC 58 General, U. S., June 15, 1956
25
25
 CONF: DENTIAL
PROCUREMENT FINANCIAL DATA AIRS,ease 2005/02/10 : CIA-RDP7 1-504 TO-- 1100% -4
$UWEPS APPROPRIATION ACCOUNTS CARD DOC
TYPE TYPE
X NAVWEPS FORM 7000/30 (REV. 4-65) (Mo1 ay/yr) CC 1 CC 2-4*
PROGRAM
DIRECTIVE
046002
APPROPRI-
ATION
17x1319
SUI3
HEAD
OBJ
CLASS
BUREAU
CONTROL
NUMBER
01694
SUB AUTHORIZATION
ALLOT. ACCOUNTING
ACTIVITY
TRAN
TYPE
PROPERTY
ACCOUNTING
ACTIVITY
11 April 160
OP OR
COMP
45.48
NRFC DOCUMENT NO. REV.
NO.
CC 5-6 CC 7-16 CC 17-19 r
Q 19-66. 42(Weps)
42 (Weps
0 *DOCUMENT TYPE CODES: 140 -MRILLITARYEIINTERDEPAR PrLoMe4 1 ReIease(2oO5/02/1OJ-CF > MB04Yf b/"+06W4665030009-7
OR ORDER FOR MATERIAL OR SERVICES (IPR)
 Approved For R&se 2005/02/10 : CIA-RDP78B04770i 400030009-7
IPR / 9-t C4D ~ WEPS
PAGE OF 2
This order is issued under authority of Section 601 of the Economy Act
(47 Stat. 417, approved 30 June 19320 as amended). Standard Form 1080
billing for work performed or material delivered on a reimbursable basis
should be forwarded to the Bureau of Naval Weapons (Attn: Code MSD-22)
for certifications, Advance of funds will be made to Consolidated Working
Funds in accordance with current.regulations. Payment will be made by the
Navy Finance Center, Washington, D.C.
It is requested that acceptance of this order be made by signing and
returning the "Acceptance Copy" to the Chief.. Bureau of Naval Weapons
(Attn: Code MSD-22), Washington, D. C. If any of the work under this
order will not be performed on a reimbursable basis, the acceptance
copy should indicate the method of performance along with the related amounts.
PleaseLNote: Pursuant to Dept. of Navy reorganization, effective 1 May 1966,
the Naval Air Systems Coimnand has become the successor to Bur. of
Naval Weapons with respect to this IPR 19-66..8042 WEPS. Accordingly,
each reference in the j1pr to the Bur. of Naval Weapons shall be
deemed to'refer to Naval Air Systems Cow & any -reference to Chief,
Bur of Naval Weapons to Comnander, Naval Air Systems Command.
Approved For Release 2005/02/10 : CIA-RDP78BO477OA000400030009-7