DISBURSEMENT BY TREASURY CHECK

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP65-00523R000100180019-3
• Release Decision: RIPPUB
• Original Classification: S
• Document Page Count: 11
• Document Creation Date: December 22, 2016
• Document Release Date: June 8, 2010
• Sequence Number: 19
• Publication Date: September 9, 1957
• Content Type: MEMO

Sanitized Copy Approved for Release 2010/06/08: CIA-RDP65-00523R000100180019-3
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Sanitized Copy Approved for Release 2010/06/08: CIA-RDP65-00523R000100180019-3
 Sanitized Copy Approved for Release 2010/06/08: CIA-RDP65-00523R000100180019-3
Standard r'orm No. 1034-Revised
~? Com roller General, U. S.
September 7, 1950
(Gen. Reg. No..51, Stipp. No. 11)
PUBLIC VOUCHER FOR PURCHASEID
SERVICES OTHER THAN PERSOM
U. S. ------------------------------------- _
(Department, bureau, or establishment)
---------------------
Voucher prepared at ------------ ___________
(Give place and date)
THE UNITED STATES, Dr., Payee's Account No. ____________
To___Edgerton,__Germeshausen & Grier, Ine
----------------
-----------------------
(Payee)
--- ------- 1622__South._"A"_-Street ------------------------ - Las Vegas:_-Nevada
(Address)
(Cit (State)
No. and Date of
Order
Date of Delivery
or Service
ARTICLES OR SERVICES
(Enter description item number of contract or Federal supply
schedule, anJ other information deemed necessary)
Discount Terms INVOICE NUMBERS
PAYMENT:
Complete ^
Partial ^
Final ^
page 1
PAID BY
UNIT PRICE
Cost I Per
$17,727
23,291
4,070
Shipped from to Weight Government B/L No. Total
I certify that the above bill is correct and just and that' payment therefor has not been received. (Payee must NOT use this apace)
Date -------------------- *Payee ----------- --------
oertific.t, not .Qui,.d when ? lik. oertifie.t. I. med. by Poe., on .tl..h.d bill o, hill.)
------------------------------------------
Account verified: correct for
Cts.
13
39
.52
STAT Pursuant to authority vested in me, I certify that this account is correct and proper for payment
t Approved for $ -------- --------------------------
STAT ~
appropriation, limitation, or
project symbol
Appropriation title
Limit'n. or Proj't.
Amount
Appropriation
.I Inerint
-------------------------------------
-------------------------------------------------------------------------------------------
-------------------------
------- ----------------
Allotment symbol
Amount
Obllations
11qutdated
COST ACCOUNT
______________
OBJECTIVE CLASSIFICATION
Symbol
Amount
Symbol
Amount
------------------
-----
( Check No- ________________________ dated ------------------------------ 19_____, for $--------------
_________________________ { onfTavorreofasupraer of the. United Stater, in
yee named above.
Paid by Cash, $------------------------- on ------------------------------------- 19 Payee ---------------------- -
~ ____________________
,64nori.ln.lonl
r
When a voucher is signed or receipted in the name of a company or corporation, the name of the person Per- thecomlanyorcorporate name, aswell asthecapacity inwhich hesigns, must appear. For example: __ ----------------------------
writing Doe Compang
er John 8mlth Socr
L
"
' T
"
I p
e
ary
or
reasurer
,,,aye.
as the case m b
t It the ability to certify and authority to approve are combined In one person, one signature only is 11eC- Title _ _ ___.
Cseary; otherwise the approving officer will sign on the line below "Approved for ______._
is Meial titan
over h n
-------__._" arid
-------------------------------?
SIGN
ORIGINAL
ONLY
t -----
$456-088
---------------
---------------
---------------
7,
---------------------
?ce
Int MUSE OF THIS FORM MUST BE EXECUTED WHEN PURCHASES ARE MADE OR SERVICES SECURED WITHOUT WRITTEN AGREEMENT IN ANT FORM
ACCOUNTING CLASSIFICATION (For completion by Administrative Office)
Sanitized Copy Approved for Release 2010/06/08: CIA-RDP65-00523R000100180019-3 -"a-a
 Sanitized Copy Approved for Release 2010/06/08: CIA-RDP65-00523R000100180019-3
Fbrm prescribed by
? Comptroller General, U. S. PUBLIC VOUCHER FOR September (Gen. Reg. N.. , Sapp No. 11) SERVICES OTHER THAN PERSO
U. U.S.
--------------------------
(Department, bureau, or establishment)
Voucher prepared at ----------------------------------------------- ----
(Give place and date)
THE UNITED STATES, Dr., Payee's Account No_ ----------------
To ____ er on,--t elra.ehauaen_Ei Grier, Inv
- -- - - - ------------------------- ---------
(Payee)
------------ 622-.South---"-A-"---S3,reef--------------- Loa Yeg"p_ jieveda
(Address) (City) (State)
No. and Date of
Order
Date of Delivery
or Service
ARTICLES OR SERVICES
(Enter description item number of contract or Federal supply
schedule, anJ other Information ~tdeeme oosary)
Discount Terms INVOICE N
PAYMENT:
Complete ^
Partial ^
Final ^
Use continuation sheet(s) if necessary
Shipped from to Weight Government B/L No. - I Total
I certify that the above bill is correct and just and that payment therefor has not been received. (Payee must NOT use this space)
Date -------------------- *Payee ----------- --------------------------- --- ---- -------------------
eertitic.,. not rein r.d when. like oertidc?G i. ,n.d. by e.y.. on ntt.nh.d bill or bill.)
---------- - ---------------------------
Account verified; correct for -__---._-__
Limit'n. or Proj't. Appropriation
Amount t tauunt
Date Req. No.
STAT Pursuant to authority vested in me, I certify that this account is correct and proper for payment.
t Approved for $ -----------------------------------
SIGN
ORIGINAL
ONLY
Date
Page1of1
----- (Cc*itraeting Offitter)
Title ------ Date -------------------------------------------------------------------------
THE REVERSE OF THIS FORM MUST BE EXECUTED WHEN PURCHASES ARE MADE OR SERVICES SECURED WITHOUT WRITTEN AGREEMENT IN ANY FORM
Appropriation, limitation, or
project symbol
Obligations
liquidated
------------------------------------
------------------- -
---------------------
---------------------------
------------------------------------
---------------------
---------------------
---------------------------
------------------------------------
----------------------
---------------------
---------------------------
-------------------------
------------------------
-------------------------
$17,727
23,29
4,077
13
39
00
5 obi - _52
---------------
---------------
---------------
--------------------------
-------------------------
-------------------------
Check No- ------------------------ dated ------------------------------ 19------ for $-------------------------- -
----------- on Treasurer of the United States in
Paid by ), favor of payee named above.
Cash. $------------------------- on ------------------------------------- 19 Payee ----------------------- ------ ----- - -
lSign nrigin.t onty- ------- ---------
? When a voucher is signed or receipted in the name of a company or corporation, the name of the person
writing the company or corporate name, as well as the capacity in which he signs, must appear. For example.
"John Doe Company, per John Smith, Secretary", or "Treasurer" as the can ma be
Per
---------------------------
t If the ability to cert. fy and authority to approve are combined in one person, one signature only Is nec- Title ------
~,asary;oterr ;otherwise the approving officer will sign an the line below "Anoroved for t------ -- " n?a
Sanitized Copy Approved for Release 2010/06/08: CIA-RDP65-00523R000100180019-3 --uceo-a
 Sanitized Copy Approved for Release 2010/06/08: CIA-RDP65-00523R000100180019-3 ________________
utauaardarrm pre scribed bY-,.~.,~
CompSroller General, U. S. PUBLIC VO JC? tt1t FOR PURCHAS D
September 7, 1upp. 950 SERVICES OTHER THAN PERSO AL
(Gen. Reg. No. 51, S No. 11)
(Amended February 20, 1952)
U. S- ------ i n..trac_ti ng- --of bureau, or establishment)
Voucher prepared at --------------------------------------------------------------------------------------------------------
THE UNITED STATES, Dr.,
(Give place and date)
Payee's Account No_ ----------------
To ---------aers?n~_ ~ermeshausen__&_Srx7.ex~ Zx~---------------------------------------------------
(Payee)
------------------------------------ ----------------------------city) -------------------------------------------------------
(Adaress)
TE-
Pursuant to authority vests in me, I certify that this account is correct and proper for payment.
t Approved for $ -----------------------------------
BY ------------------------------------------------------------
Title ----------------------------------------------------------
SIGN
ORIGINAL
ONLY
I ------------------(Authorized Certifying 0-----------------------------
Title --------------------------------------------------------------------------
ARTICLES OR SERVICES
item number of contract or Federal supply
descri
tion
(Enter
UNIT
PRICE
AMOUNT
No. and Date of
Order
Date of Delivery
or Service
t
p
shedule, and other information deemed necessary)
c
r
s
t T
Di
QUANTITY
Cost
Per
Dollars
Cu.
m
scoun
e
Month ending 30 June 1957
Direct Labor
Materials & Services
Burden
Overhead
7,648-
8,095
5,624
1,923
5 7
.50
.10
.14
PAYMENT:
Complete ^
Partial ^
Final ^
Use continuation sheet(s) if necessary
Shipped from to Weight Government
I certify that the above bill is correct and just and that payment has not been received.
B/L No. Total
(Payee must NOT use this space)
Differences ---------------------------------
' 23 291.39
--------------- -----
(Sign original only)
-----------------------------------------------
--------------- -----
erz>eshaiasen & Oxiex s l~
hen .lik rdfimte in made by payee on attached bia or bills)
-----------------------------------------
-------------------------------------------
Amount verified; co
--------------- -----
3y
le -
(Signature or initials
--------------------
Req. No.
Date
Check No. --------------------- favor dated ------------------------------ 19_____, for $______________________________________ on Treasurer of the United States in
Paid by { I. favor of payee named above.
----------------------------------------
t Cash, $--- , on ------------------------------------- 19-----. Payee ----------------------------------i
(Bi-n prdn.i only)
? When a voucher is signed or receipted in the name of a company or corporation, the name of the person Per _________________________________________________________________
writing the company or corporate name, as well as the capacity in which he signs, must appear. For example:
"John Doe Company, per John Smith, Secretary", or "Treasurer", as the case may be. are } If the ability to hcertify and authority ill xi~ron the line b in w in o person [arcane signature only is nee and Title -------------------------------------------------------
essary oth?^?'??
his a Sanitized Copy Approved for Release v2010/06/08 CIA-RDP65-00523R000100180019-3
over
 Sanitized Copy Approved for Release 2010/06/08: CIA-RDP65-00523R000100180019-3
- $tanaard. Form No. loss-Revised
Dorm prescribed by 9 W Public Voucher for PurchaM and
troller General
II
C
.
omp . .
September 7, 190
Coen. Reg. No. 51, Supp. No. 11) Services Other Than Personal
CONTINUATION SHEET 1 3
U. S. ------- _GQntracting--offiG-eC--------------------------------------------------- Sheet No. ----1----- of Bureau Voucher No. -----
(Department, bureau, or establishment)
f
D
t
ARTICLES OR SERVICES
QUAN-
UNIT PRICE
AMOUNT
No. and Date
of Order
a
e o
Delivery
or Service
(Enter description, item number of contract or Federal supply schedule,
and other information deemed necessary)
TITY
Cost
Per
Dollars
Cts.
Direct Labor
Week ending 6/2/57 559.95
It It /57 b6oo.35
if