Attachment J.4 Public Voucher for Purchases and Services Other Than Personal - Continuation Sheet.pdf

PDF 288 KB Posted Jun 30, 2020

Attached to: Tuberculosis Laboratory Testing Services for U. S. Pacific Islands Federal contract opportunity
Solicitation number: 75D301-20-R-67962
Issued by: Department of Health and Human Services Centers for Disease Control and Prevention Office of Acquisition Services

About this file

Written by GovTribe AI · Dec 28, 2023

This document is a template for a public voucher for purchases and services other than personal. It includes blank fields for voucher number, schedule number, sheet number, date of order, date of delivery or service, articles or services, number of order, amount, unit price, quantity, and currency. However, it does not provide any specific details on products, services, response dates, pricing terms, or federal agencies involved for a procurement.

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Other files for this federal contract opportunity

Other files attached to Tuberculosis Laboratory Testing Services for U. S. Pacific Islands, newest first.
File	Type	Posted
Attachment J.1 ACH Vendor Miscellaneous Payment Enrollment Form.pdf	PDF	Jun 30, 2020
Attachment J.2 Past Performance Questionnaire.docx	DOCX document	Jun 30, 2020
TB Lab Testing Services Solicitation 75D301-20-R-67962 FINAL.pdf	PDF	Jun 30, 2020
Attachment J.3 Public Voucher for Purchases and Services Other Than Personal.pdf	PDF	Jun 30, 2020

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PUBLIC VOUCHER FOR PURCHASES AND

SERVICES OTHER THAN PERSONAL

Standard Form 1035 (EG) September 1973

4 Treasury FRM 2000 1035-110

QUAN-

TITY

CONTINUATION SHEET

VOUCHER NO.

SCHEDULE NO.

SHEET NO.

U.S. DEPARTMENT, BUREAU, OR ESTABLISHMENT

NUMBER

AND DATE

OF ORDER

DATE OF

DELIVERY

OR SERVICE

ARTICLES OR SERVICES

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

UNIT PRICE AMOUNT

COST PER

Designed using Perform Pro, WHS/DIOR, Aug 96

Accessible FormNet VisualFill - WendlerJ

PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL

Standard Form 1035 (EG) September 1973 4 Treasury FRM 2000 1035-110

QUAN-

TITY

CONTINUATION SHEET

VOUCHER NO.

SCHEDULE NO.

SHEET NO.

U.S. DEPARTMENT, BUREAU, OR ESTABLISHMENT

NUMBER AND DATE OF ORDER

DATE OF DELIVERY OR SERVICE

ARTICLES OR SERVICES

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

UNIT PRICE

AMOUNT

COST

PER

Designed using Perform Pro, WHS/DIOR, Aug 96

VOUCHER NUMBER:

SCHEDULE NUMBER:

SHEET NUMBER:

U.S. DEPARTMENT, BUREAU, OR ESTABLISHMENT:

Date of Delivery or Service. Enter 2 digit month, 2 digit day and 4 digit year.:

Date of Order. Line 1 of 21. Enter 2 digit month, 2 digit day and 4 digit year.:

Date of Order. Line 2 of 21. Enter 2 digit month, 2 digit day and 4 digit year.:

Date of Order. Line 3 of 21. Enter 2 digit month, 2 digit day and 4 digit year.:

Date of Order. Line 4 of 21. Enter 2 digit month, 2 digit day and 4 digit year.:

Date of Order. Line 5 of 21. Enter 2 digit month, 2 digit day and 4 digit year.:

Date of Order. Line 6 of 21. Enter 2 digit month, 2 digit day and 4 digit year.:

Date of Order. Line 7 of 21. Enter 2 digit month, 2 digit day and 4 digit year.:

Date of Order. Line 8 of 21. Enter 2 digit month, 2 digit day and 4 digit year.:

Date of Order. Line 9 of 21. Enter 2 digit month, 2 digit day and 4 digit year.:

Date of Order. Line 10 of 21. Enter 2 digit month, 2 digit day and 4 digit year.:

Date of Order. Line 11 of 21. Enter 2 digit month, 2 digit day and 4 digit year.:

Date of Order. Line 12 of 21. Enter 2 digit month, 2 digit day and 4 digit year.:

Date of Order. Line 13 of 21. Enter 2 digit month, 2 digit day and 4 digit year.:

Date of Order. Line 14 of 21. Enter 2 digit month, 2 digit day and 4 digit year.:

Date of Order. Line 15 of 21. Enter 2 digit month, 2 digit day and 4 digit year.:

Date of Order. Line 16 of 21. Enter 2 digit month, 2 digit day and 4 digit year.:

Date of Order. Line 17 of 21. Enter 2 digit month, 2 digit day and 4 digit year.:

Date of Order. Line 18 of 21. Enter 2 digit month, 2 digit day and 4 digit year.:

Date of Order. Line 19 of 21. Enter 2 digit month, 2 digit day and 4 digit year.:

Date of Order. Line 20 of 21. Enter 2 digit month, 2 digit day and 4 digit year.:

Date of Order. Line 21 of 21. Enter 2 digit month, 2 digit day and 4 digit year.:

Number of Order. Line 1 of 21:

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

Number of Order. Line 2 of 21:

Number of Order. Line 3 of 21:

Number of Order. Line 4 of 21:

Number of Order. Line 5 of 21:

Number of Order. Line 6 of 21:

Number of Order. Line 7 of 21:

Number of Order. Line 8 of 21:

Number of Order. Line 9 of 21:

Number of Order. Line 10 of 21:

Number of Order. Line 11 of 21:

Number of Order. Line 12 of 21:

Number of Order. Line 13 of 21:

Number of Order. Line 14 of 21:

Number of Order. Line 15 of 21:

Number of Order. Line 16 of 21:

Number of Order. Line 17 of 21:

Number of Order. Line 18 of 21:

Number of Order. Line 19 of 21:

Number of Order. Line 20 of 21:

Number of Order. Line 21 of 21:

When stated in foreign currency, insert name of currency:

Amount:

Per:

Unit Price. Cost.:

Quantity:

File details come from the government source that posted it. Updated Jun 30, 2020.