AG-3142-P-10-0327.pdf

ORDER FOR SUPPLIES OR SERVICES

3. ORDER NO. 4. REQUISITION/REFERENCE NO.

PAGE OF PAGES

5. ISSUING OFFICE (Address correspondence to) b. STREET ADDRESS

IMPORTANT: Mark all packages and papers with contract and/or order numbers. 1

1. DATE OF ORDER 2. CONTRACT NO. (If any) 6. SHIP TO:

a. NAME OF CONSIGNEE

c. CITY d. STATE e. ZIP CODE

7. TO:

a. NAME OF CONTRACTOR

f. SHIP VIA

8. TYPE OF ORDER

b. COMPANY NAME

c. STREET ADDRESS

d. CITY e. STATE f. ZIP CODE

9. ACCOUNTING AND APPROPRIATION DATA

a. PURCHASE b. DELIVERY

REFERENCE YOUR:

Please furnish the following on the terms and conditions specified on both sides of this order and on the attached sheet, if any, including delivery as indicated.

Except for billing instructions on the reverse, this delivery order is subject to instructions contained on this side only of this form and is issued subject to the terms and conditions of the above-numbered contract.

10. REQUISITIONING OFFICE

11. BUSINESS CLASSIFICATION (Check appropriate box(es))

a. SMALL b. OTHER THAN SMALL c. DISADVANTAGED

d. WOMEN-OWNED

13. PLACE OF

a. INSPECTION b. ACCEPTANCE

14. GOVERNMENT B/L NO. 15. DELIVER TO F.O.B. POINT

ON OR BEFORE (Date)

16. DISCOUNT TERMS

17. SCHEDULE (See reverse for Rejections)

09/29/2010

AG-3142-P-10-0327 452753

USDA, OPPM-POD/ SERVICE AND SUPPLY

ANDROMEDA ROMANO-LAX

ANDROMEDA ROMANO-LAX

PO BOX 233394

1102364848#

ANCHORAGE AK 99523-3394

See Schedule

12. F.O.B. POINT

Destination

60 Days After Award

Office of Communications

Broadcast Media & Technology Ctr 1400 Independence Avenue, SW

Washington DC 20250-1360

TAYLOR, PATRICE T.

ITEM NO.

(a)

SUPPLIES OR SERVICES

(b)

QUANTITY

ORDERED

(c)

UNIT

(d)

UNIT

PRICE

(e)

AMOUNT

(f)

QUANTITY

ACCEPTED

(g)

X

X

Destination Destination

ROOM 1614-SOUTH

NET/30

g. SERVICE-

DISABLED

VETERAN-

OWNED

e. HUBZone f. EMERGING SMALL

BUSINESS

Tax ID Number: 33-0727517 DUNS Number: 963459040 Contractor is to provide research and writing services determined by USDA Technical POC in regards to Chugach National Forest film project.

Continued ...

19. GROSS SHIPPING WEIGHT18. SHIPPING POINT 20. INVOICE NO.

21. MAIL INVOICE TO:

a. NAME

b. STREET ADDRESS

(or P.O. Box)

c. CITY d. STATE e. ZIP CODE

SEE BILLING

INSTRUCTIONS

ON REVERSE

17(h)

TOTAL

(Cont.

pages)

17(i)

GRAND

TOTAL

GENERAL INVOICES

P.O. BOX 60000

NEW ORLEANS LA 70160

$9,700.00

22. UNITED STATES OF AMERICA

BY (Signature)

23. NAME (Typed)

TITLE: CONTRACTING/ORDERING OFFICER

JODEY A. BARNES-EDWARDS

$9,700.00

OPTIONAL FORM 347 (Rev. 3/2005)

Prescribed by GSA/FAR 48 CFR 53.213(e)

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION NOT USABLE

DATE OF ORDER

2 3

ORDER FOR SUPPLIES OR SERVICES

SCHEDULE - CONTINUATION

CONTRACT NO.

AMOUNTUNIT

PRICE

UNITQUANTITY

ORDERED

SUPPLIES/SERVICESITEM NO.

IMPORTANT: Mark all packages and papers with contract and/or order numbers.

ORDER NO.

QUANTITY

ACCEPTED

09/29/2010 AG-3142-P-10-0327

PAGE OF PAGES

(A) (B) (C) (D) (E) (F) (G)

Purchase Order is based on estimated 180 hours needed to complete goals of USDA Technical POC.

USDA Technical POC will determine requirements of film project and determine if contractor's submissions are acceptable to meet Purchase Order#AG-3142-P-10-0327 requirements.

Technical POC will determine Purchase Order milestones. Milestones are not considered reached until all services prior to milestone are accepted by Technical POC.

Period of Performance is 10/01/2010-02/20/2012.

No funds have been obligated for work performed outside of Period of Performance.

Contractor is to be paid after submitting invoices for milestones determined by Technical POC, Contractor is required to submit USDA Technical POC's milestone schedule to Contract Specialist. Contract Specialist will submit invoices for payment against Purchase Order milestones.

Admin Office:

USDA, OPPM-POD/ SERVICE AND SUPPLY

300 7th St., S.W.

Suite 377 Attention: S&S Contracts Team Washington DC 20024 Accounting Info:

CM00.10.ZZ.ZZZZZZ.ZZZZZZZ.ZZ.ZZZZZZZ.ZZ.10EB

2000013.2540.ZZ.ZZZZZZZZ.ZZZZ Agency Code (4): CM00 Program Code (25): 10EB2000013 BOC: 2540 Sub BOC (2): ZZ Cost Org (7):

ZZZZZZZ Job Code (8): ZZZZZZZZ Sub Cost Org (2): ZZ Budget Yr Start (2): 10 Budget Yr End (2): ZZ Fund (6): ZZZZZZ Budget Org (7): ZZZZZZZ Sub Budget Org (2): ZZ Report Category (4): ZZZZ Period of Performance: 10/01/2010 to 02/20/2012 Continued ...

Prescribed by GSA

FAR (48 CFR) 53.213(c)

OPTIONAL FORM 348 (Rev. 6/95)NSN 7540-01-152-8082

TOTAL CARRIED FORWARD TO 1ST PAGE (ITEM 17(H))

503-48-101

DATE OF ORDER

3 3

ORDER FOR SUPPLIES OR SERVICES

SCHEDULE - CONTINUATION

CONTRACT NO.

AMOUNTUNIT

PRICE

UNITQUANTITY

ORDERED

SUPPLIES/SERVICESITEM NO.

IMPORTANT: Mark all packages and papers with contract and/or order numbers.

ORDER NO.

QUANTITY

ACCEPTED

09/29/2010 AG-3142-P-10-0327

PAGE OF PAGES

(A) (B) (C) (D) (E) (F) (G)

001 Services as writer and researcher for 9,700.00 Chugach National Forest film project.

Product/Service Code: D309 Product/Service Description: INFO

EXIT; BROADCASTING/DATA DISTRIBUT

When submitting invoices for payment, contractor shall submit invoices simultaneously to both Technical POC and Contract Specialist.

Contract Specialist:

Ali L. Khan

USDA-POD

300 7th Street, SW Reporters Building, Room 374 Washington DC 20024 ali.khan@dm.usda.gov 202-720-2850

Technical POC:

Garth Clark USDA-Broadcast Media & Tech Ctr 1400 Independence Avenue, SW South Building, Room 1614 Washington DC 20250 202-720-5376 garth.clark@oc.usda.gov

The total amount of award: $9,700.00. The obligation for this award is shown in box 17(i).

Prescribed by GSA

FAR (48 CFR) 53.213(c)

OPTIONAL FORM 348 (Rev. 6/95)NSN 7540-01-152-8082

TOTAL CARRIED FORWARD TO 1ST PAGE (ITEM 17(H))

503-48-101