SF 1034.pdf

Standard Form PDF 514 KB Posted

Attached to
Evaluation of Rapid HIV Self-Testing among MSM in High Prevalence Cities
Solicitation number
2011-N-13417
Issued by

About this file

From the source

Attachment J4 SF Form 1034

View the file

Other versions and copies of SF 1034

46 government files on GovTribe name SF 1034. Different revisions are separate documents; copies of this exact file point search engines to its first posting.

File Revision Posted Attached to
AttachmentQ_SF1034 Public Voucher.pdf Revision not stated Washington DC Area Local Moving and Storage Services
2.11.1 Other (SOW Attachment 4 - SF1034-Public Voucher).pdf Revision not stated Amendment 0005 Direct Lease (DR4827NC)
1.1.4 PWS Attachment 4 - SF1034-Public Voucher.pdf Revision not stated Florida Direct Lease Request for Quote No. 70FBR425Q00000037
Attachment 4 - SF1034.pdf Revision not stated Transcription / Court Reporting Services
Attachment J-12 - Appendix B - SF 1034 - Final.pdf Revision not stated Request for Proposal (RFP) Project Management Oversight (PMO) Requirement
Attachment J-12 - Appendix B - SF 1034 Example.pdf Revision not stated Pre-Solicitation Draft Request for Proposal Project Management Oversight (PMO) IDIQ Contract
Attachment Q- SF1034 Public Voucher.pdf Revision not stated Washington DC Area Local Moving and Storage Services
ATTACHMENT_J.7_-__Voucher_for_purchases_and_Services_Other_than_Personal_SF_1034.pdf Revision not stated Freight Forwarding and Logistics Services
J.05_-_SF-1034.pdf Revision not stated Pakistan Capacity Development Services (PCDS)
3E_Standard_Form_1034_SAMPLE.pdf Revision not stated Court Security Officer Services - 8(a) Set-Aside
RFP_2016-N-17753__Public_Voucher__SF1034-87c.pdf Revision not stated Diabetes Prevention Computer Simulation Models
3(E)_-_Standard_Form_1034_(SAMPLE).pdf Revision not stated Court Security Officers Services
ATTACHMENT 3a SF-1034 CDRL 1 example.pdf Revision not stated Revised Flight Planning and International Ground Handling REQUEST FOR OFFER
ATTACHMENT 3a SF-1034 CDRL 1 example.pdf Revision not stated Revised Flight Planning and International Ground Handling REQUEST FOR OFFER
ATTACHMENT 3a SF-1034 CDRL 1 example.pdf Revision not stated Revised Flight Planning and International Ground Handling REQUEST FOR OFFER
ATTACHMENT 3a SF-1034 CDRL 1 example.pdf Revision not stated Revised Flight Planning and International Ground Handling REQUEST FOR OFFER
ATTACHMENT 3a SF-1034 CDRL 1 example.pdf Revision not stated Revised Flight Planning and International Ground Handling REQUEST FOR OFFER
ATTACHMENT 3a SF-1034 CDRL 1 example.pdf Revision not stated Revised Flight Planning and International Ground Handling REQUEST FOR OFFER
ATTACHMENT 3a SF-1034 CDRL 1 example.pdf Revision not stated Revised Flight Planning and International Ground Handling REQUEST FOR OFFER
SF-1034_Public_Voucher_for_Purchases_Services_other_than_Personnel_Attachment_J-3.pdf Revision not stated Tuberculosis Laboratory Testing for the U. S. -affiliated Pacific Islands
Show all 20

Who attaches SF 1034

Agency Files
Department of Health and Human Services Centers for Disease Control and Prevention Office of Acquisition Services 20
Department of Transportation Federal Aviation Administration Aeronautical Center 7
Department of Defense Education Activity 4
Department of Justice US Marshals Service 2
Department of Justice US Marshals Service Judicial Security Division 2
Department of State Office of Acquisition Management 2
Department of Transportation Federal Transit Administration 2
Federal Emergency Management Agency 2

Other files

File Type Posted
RFP 2011-N-13417 QUESTIONS ANSWERS ROUND 6.docx DOCX document
RFP 2011-N-13417 Questions and Answers Round 5.docx DOCX document
RFP 2011-N-13417 QUESTIONS ANSWERS ROUND 4.docx DOCX document
RFP 2011-N-13417 update to Criterion 2 Page 87.docx DOCX document
RFP 2011-N-13417 Questions Answers Round 3 July-7-2011.docx DOCX document
RFP 2011-N-13417 Q As Round 2 6-30-2011.docx DOCX document
RFP 2011-N-13417 Q As Round 1.docx DOCX document
RFP 2011-N-13417 Cover Letter.docx DOCX document
Attachment J1 ACH Form.pdf PDF
RFP 2011-N-13417 Attachment J2 Contractor Performance Report.docx DOCX document
RFP 2011-N-13417 J3 Billing Instructions for Negotiated Cost.docx DOCX document
sf1035.pdf PDF
RFP 2011-N-13417 Subcontracting Plan.docx DOCX document
RFP_2011-N-13417_Solicitation_Document.pdf PDF
Show all 14

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file
Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

PRIVACY ACT STATEMENT

The information requested on this form is required under the provisions of 31 U.S.C. 82b and 82c, for the purpose of disbursing Federal money.

The information requested is to identify the particular creditor and the amounts to be paid. Failure to furnish this information will hinder discharge of the payment obligation.

PUBLIC VOUCHER FOR PURCHASES AND

SERVICES OTHER THAN PERSONAL

VOUCHER NO.

U.S. DEPARTMENT, BUREAU, OR ESTABLISHMENT AND LOCATION DATE VOUCHER PREPARED

CONTRACT NUMBER AND DATE

REQUISITION NUMBER AND DATE

SCHEDULE NO.

PAID BY

DATE INVOICE RECEIVED

DISCOUNT TERMS

PAYEE'S ACCOUNT NUMBER

GOVERNMENT B/L NUMBERSHIPPED FROM TO WEIGHT

ARTICLES OR SERVICES

(Enter description, item number of contract or Federal supply schedule, and other information deemed necessary)

QUANTITY

UNIT PRICE

COST PER

AMOUNT

(Use continuation sheet(s) if necessary) (Payee must NOT use the space below) TOTAL

DIFFERENCES

PAYMENT: APPROVED FOR EXCHANGE RATE

BY2

TITLE

Amount verified; correct for payment (Signature or initials)

=$ =$1.00

Pursuant to authority vested in me, I certify that this voucher is correct and proper for payment.

(Date)

ACCOUNTING CLASSIFICATION

CHECK NUMBER

CASH

ON ACCOUNT OF U.S.TREASURY

DATE

CHECK NUMBER

PAYEE 3

ON (Name of bank)

1 When stated in foreign currency, insert name of currency.

2 If the ability to certify and authority to approve are combined in one person, one signature only is necessary; otherwise the approving officer will sign in the space provided, over his official title.

3 When a voucher is 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 case may be.

FOR

TITLE

NSN 7540-00-900-2234

Standard Form 1034 Revised October 1987 Department of the Treasury

1 TFM 4-2000

PAYEE'S

NAME

AND

ADDRESS

NUMBER

AND DATE

OF ORDER

DATE OF

DELIVERY

OR SERVICE (1)

PROVISIONAL

COMPLETE

PARTIAL

FINAL

PROGRESS

ADVANCE

(Title)(Authorized Certifying Officer)

Previous edition usable

P A I D

B Y

PRIVACY ACT STATEMENT

The information requested on this form is required under the provisions of 31 U.S.C. 82b and 82c, for the purpose of disbursing Federal money.

The information requested is to identify the particular creditor and the amounts to be paid. Failure to furnish this information will hinder discharge of the payment obligation.

PUBLIC VOUCHER FOR PURCHASES AND

SERVICES OTHER THAN PERSONAL

VOUCHER NO.

U.S. DEPARTMENT, BUREAU, OR ESTABLISHMENT AND LOCATION

DATE VOUCHER PREPARED

CONTRACT NUMBER AND DATE

REQUISITION NUMBER AND DATE

SCHEDULE NO.

PAID BY

DATE INVOICE RECEIVED

DISCOUNT TERMS

PAYEE'S ACCOUNT NUMBER

GOVERNMENT B/L NUMBER

SHIPPED FROM

TO

WEIGHT

ARTICLES OR SERVICES

(Enter description, item number of contract or Federal supply schedule, and other information deemed necessary)

QUANTITY

UNIT PRICE

COST

PER

AMOUNT

(Use continuation sheet(s) if necessary) (Payee must NOT use the space below)

TOTAL

DIFFERENCES

PAYMENT:

APPROVED FOR

EXCHANGE RATE

BY2

TITLE

Amount verified; correct for payment (Signature or initials) =$1.00 Pursuant to authority vested in me, I certify that this voucher is correct and proper for payment.

(Date)

ACCOUNTING CLASSIFICATION

CHECK NUMBER

CASH

ON ACCOUNT OF U.S.TREASURY

DATE

CHECK NUMBER

PAYEE 3

ON (Name of bank) 1 When stated in foreign currency, insert name of currency.

2 If the ability to certify and authority to approve are combined in one person, one signature only is necessary; otherwise the approving officer will sign in the space provided, over his official title.

3 When a voucher is 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 case may be.

FOR

TITLE

NSN 7540-00-900-2234

Standard Form 1034 Revised October 1987 Department of the Treasury

1 TFM 4-2000

PAYEE'S

NAME

AND

ADDRESS

NUMBER

AND DATE

OF ORDER

DATE OF

DELIVERY

OR SERVICE

(1)

PROVISIONAL

COMPLETE

PARTIAL

FINAL

PROGRESS

ADVANCE

(Title) (Authorized Certifying Officer) Previous edition usable P A I D

B Y

VOUCHER NUMBER:
U.S. DEPARTMENT, BUREAU, OR ESTABLISHMENT AND LOCATION:
DATE VOUCHER PREPARED. Enter 2 digit month, 2 digit day and 4 digit year.:
CONTRACT DATE. Enter 2 digit month, 2 digit day and 4 digit year.:
CONTRACT NUMBER:
REQUISITION NUMBER:
REQUISITION DATE. Enter 2 digit month, 2 digit day and 4 digit year.:
PAID BY:
DATE INVOICE RECEIVED. Enter 2 digit month, 2 digit day and 4 digit year.:
PAYEE'S NAME AND ADDRESS:
DISCOUNT TERMS:
PAYEE'S ACCOUNT NUMBER:
GOVERNMENT B/L NUMBER:
SHIPPED FROM:
SHIPPED TO:
WEIGHT:
NUMBER OF ORDER:
DATE OF ORDER. Enter 2 digit month, 2 digit day and 4 digit year.:
DATE OF DELIVERY OR SERVICE. Enter 2 digit month, 2 digit day and 4 digit year.:
QUANTITY:
UNIT PRICE. COST.:
UNIT PRICE. PER:
AMOUNT:
ARTICLES OR SERVICES (Enter description, item number of contract or Federal supply schedule, and other information deemed necessary):
NUMBER OF ORDER:
AMOUNT:
UNIT PRICE. PER:
UNIT PRICE. COST.:
QUANTITY:
ARTICLES OR SERVICES (Enter description, item number of contract or Federal supply schedule, and other information deemed necessary):
DATE OF DELIVERY OR SERVICE. Enter 2 digit month, 2 digit day and 4 digit year.:
DATE OF ORDER. Enter 2 digit month, 2 digit day and 4 digit year.:
NUMBER OF ORDER:
AMOUNT:
UNIT PRICE. PER:
UNIT PRICE. COST.:
QUANTITY:
ARTICLES OR SERVICES (Enter description, item number of contract or Federal supply schedule, and other information deemed necessary):
DATE OF DELIVERY OR SERVICE. Enter 2 digit month, 2 digit day and 4 digit year.:
DATE OF ORDER. Enter 2 digit month, 2 digit day and 4 digit year.:
NUMBER OF ORDER:
AMOUNT:
UNIT PRICE. PER:
UNIT PRICE. COST.:
QUANTITY:
ARTICLES OR SERVICES (Enter description, item number of contract or Federal supply schedule, and other information deemed necessary):
DATE OF DELIVERY OR SERVICE. Enter 2 digit month, 2 digit day and 4 digit year.:
DATE OF ORDER. Enter 2 digit month, 2 digit day and 4 digit year.:
NUMBER OF ORDER:
DATE OF ORDER. Enter 2 digit month, 2 digit day and 4 digit year.:
DATE OF DELIVERY OR SERVICE. Enter 2 digit month, 2 digit day and 4 digit year.:
QUANTITY:
UNIT PRICE. COST.:
UNIT PRICE. PER:
AMOUNT:
ARTICLES OR SERVICES (Enter description, item number of contract or Federal supply schedule, and other information deemed necessary):
NUMBER OF ORDER:
DATE OF ORDER. Enter 2 digit month, 2 digit day and 4 digit year.:
DATE OF DELIVERY OR SERVICE. Enter 2 digit month, 2 digit day and 4 digit year.:
QUANTITY:
UNIT PRICE. COST.:
UNIT PRICE. PER:
AMOUNT:
ARTICLES OR SERVICES (Enter description, item number of contract or Federal supply schedule, and other information deemed necessary):
NUMBER OF ORDER:
DATE OF ORDER. Enter 2 digit month, 2 digit day and 4 digit year.:
DATE OF DELIVERY OR SERVICE. Enter 2 digit month, 2 digit day and 4 digit year.:
QUANTITY:
UNIT PRICE. COST.:
UNIT PRICE. PER:
AMOUNT:
ARTICLES OR SERVICES (Enter description, item number of contract or Federal supply schedule, and other information deemed necessary):
NUMBER OF ORDER:
DATE OF ORDER. Enter 2 digit month, 2 digit day and 4 digit year.:
DATE OF DELIVERY OR SERVICE. Enter 2 digit month, 2 digit day and 4 digit year.:
QUANTITY:
UNIT PRICE. COST.:
UNIT PRICE. PER:
AMOUNT:
ARTICLES OR SERVICES (Enter description, item number of contract or Federal supply schedule, and other information deemed necessary):
NUMBER OF ORDER:
DATE OF ORDER. Enter 2 digit month, 2 digit day and 4 digit year.:
DATE OF DELIVERY OR SERVICE. Enter 2 digit month, 2 digit day and 4 digit year.:
QUANTITY:
UNIT PRICE. COST.:
UNIT PRICE. PER:
AMOUNT:
ARTICLES OR SERVICES (Enter description, item number of contract or Federal supply schedule, and other information deemed necessary):
NUMBER OF ORDER:
DATE OF ORDER. Enter 2 digit month, 2 digit day and 4 digit year.:
DATE OF DELIVERY OR SERVICE. Enter 2 digit month, 2 digit day and 4 digit year.:
QUANTITY:
UNIT PRICE. COST.:
UNIT PRICE. PER:
AMOUNT:
ARTICLES OR SERVICES (Enter description, item number of contract or Federal supply schedule, and other information deemed necessary):
NUMBER OF ORDER:
DATE OF ORDER. Enter 2 digit month, 2 digit day and 4 digit year.:
DATE OF DELIVERY OR SERVICE. Enter 2 digit month, 2 digit day and 4 digit year.:
QUANTITY:
UNIT PRICE. COST.:
UNIT PRICE. PER:
AMOUNT:
ARTICLES OR SERVICES (Enter description, item number of contract or Federal supply schedule, and other information deemed necessary):
NUMBER OF ORDER:
DATE OF ORDER. Enter 2 digit month, 2 digit day and 4 digit year.:
DATE OF DELIVERY OR SERVICE. Enter 2 digit month, 2 digit day and 4 digit year.:
QUANTITY:
UNIT PRICE. COST.:
UNIT PRICE. PER:
AMOUNT:
ARTICLES OR SERVICES (Enter description, item number of contract or Federal supply schedule, and other information deemed necessary):
PAYMENT: PROVISIONAL: 0
PAYMENT: COMPLETE: 0
PAYMENT: PARTIAL: 0
PAYMENT: FINAL: 0
PAYMENT: PROGRESS: 0
PAYMENT: ADVANCE: 0
APPROVED AMOUNT:
APPROVED FOR:
BY:
TITLE:
TOTAL:
Amount verified; correct for payment:
DIFFERENCES:
DIFFERENCES:
DIFFERENCES:
DIFFERENCES :
Signature or initials. This is a protected field:
Signature:
DATE. Enter 2 digit month, 2 digit day and 4 digit year.:
Authorized Certifying Officer:
ACCOUNTING CLASSIFICATION:
CHECK NUMBER:
CHECK NUMBER:
ON TREASURER OF THE UNITED STATES:
CASH:
DATE. Enter 2 digit month, 2 digit day and 4 digit year.:
PAYEE:
FOR:
TITLE:
SCHEDULE NUMBER:
ON (Name of bank):
EXCHANGE RATE:
DIFFERENCES:
DIFFERENCES:
DIFFERENCES :
DIFFERENCES :

File details come from the government source that posted it. Updated .