3(F) - Standard Form 1035 Continuation Sheet SAMPLE.pdf

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11TH CIRCUIT - USMS COURT SECURITY OFFICERS SERVICES
Solicitation number
DJM-14-A32-R-0006
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FORMS 3(A-G)

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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: 12345678
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.: 2012-10-31
Date of Delivery or Service. Enter 2 digit month, 2 digit day and 4 digit year.: 2012-10-31
Date of Delivery or Service. Enter 2 digit month, 2 digit day and 4 digit year.: 2012-10-31
Date of Delivery or Service. Enter 2 digit month, 2 digit day and 4 digit year.: 2012-10-31
Date of Delivery or Service. Enter 2 digit month, 2 digit day and 4 digit year.: 2012-10-31
Date of Delivery or Service. Enter 2 digit month, 2 digit day and 4 digit year.: 2012-10-31
Date of Delivery or Service. 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.:
Date of Delivery or Service. 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.:
Date of Delivery or Service. 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.:
Date of Delivery or Service. 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.:
Date of Delivery or Service. 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.:
Date of Delivery or Service. 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.:
Date of Delivery or Service. 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.:
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):

Anywhere - 100 1st Street - Reg Hours CSO ARTICLES OR SERVICES (Enter description, item number of contract or Federal supply schedule, and other information deemed necessary):

Anywhere - 100 1st Street - Reg Hours LCSO

ARTICLES OR SERVICES (Enter description, item number of contract or Federal supply schedule, and other information deemed necessary): Anywhere - 100 1st Street - District Supervisor
ARTICLES OR SERVICES (Enter description, item number of contract or Federal supply schedule, and other information deemed necessary): Anywhere - 100 1st Street - Night Differential 5%
ARTICLES OR SERVICES (Enter description, item number of contract or Federal supply schedule, and other information deemed necessary): Anywhere 2 - 200 2nd Street - Reg Hours CSO
ARTICLES OR SERVICES (Enter description, item number of contract or Federal supply schedule, and other information deemed necessary): Anywhere 2 - 200 2nd Street - Reg Hours LCSO
ARTICLES OR SERVICES (Enter description, item number of contract or Federal supply schedule, and other information deemed necessary):
ARTICLES OR SERVICES (Enter description, item number of contract or Federal supply schedule, and other information deemed necessary):
ARTICLES OR SERVICES (Enter description, item number of contract or Federal supply schedule, and other information deemed necessary):
ARTICLES OR SERVICES (Enter description, item number of contract or Federal supply schedule, and other information deemed necessary):
ARTICLES OR SERVICES (Enter description, item number of contract or Federal supply schedule, and other information deemed necessary):
ARTICLES OR SERVICES (Enter description, item number of contract or Federal supply schedule, and other information deemed necessary):
ARTICLES OR SERVICES (Enter description, item number of contract or Federal supply schedule, and other information deemed necessary):
ARTICLES OR SERVICES (Enter description, item number of contract or Federal supply schedule, and other information deemed necessary):
ARTICLES OR SERVICES (Enter description, item number of contract or Federal supply schedule, and other information deemed necessary):
ARTICLES OR SERVICES (Enter description, item number of contract or Federal supply schedule, and other information deemed necessary): TOTAL (on Form 1034)
ARTICLES OR SERVICES (Enter description, item number of contract or Federal supply schedule, and other information deemed necessary):
ARTICLES OR SERVICES (Enter description, item number of contract or Federal supply schedule, and other information deemed necessary):
ARTICLES OR SERVICES (Enter description, item number of contract or Federal supply schedule, and other information deemed necessary):
ARTICLES OR SERVICES (Enter description, item number of contract or Federal supply schedule, and other information deemed necessary):
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: 24000.00000000
Amount: 24000.00000000
Amount: 2000.00000000
Amount: 100.00000000
Amount: 25000.00000000
Amount: 25000.00000000
Amount:
Amount:
Amount:
Amount:
Amount:
Amount:
Amount:
Amount:
Amount:
Amount: 110000.00000000
Amount:
Amount:
Amount:
Amount:
Amount:
Per:
Per:
Per:
Per:
Per:
Per:
Per:
Per:
Per:
Per:
Per:
Per:
Per:
Per:
Per:
Per:
Per:
Per:
Per:
Per:
Per:
Unit Price. Cost.: 1.00000000
Unit Price. Cost.: 1.00000000
Unit Price. Cost.: 1.00000000
Unit Price. Cost.: 1.00000000
Unit Price. Cost.: 1.00000000
Unit Price. Cost.: 1.00000000
Unit Price. Cost.:
Unit Price. Cost.:
Unit Price. Cost.:
Unit Price. Cost.:
Unit Price. Cost.:
Unit Price. Cost.:
Unit Price. Cost.:
Unit Price. Cost.:
Unit Price. Cost.:
Unit Price. Cost.: 1.00000000
Unit Price. Cost.:
Unit Price. Cost.:
Unit Price. Cost.:
Unit Price. Cost.:
Unit Price. Cost.:
Quantity: 24000
Quantity: 24000
Quantity: 2000
Quantity: 100
Quantity: 25000
Quantity: 25000
Quantity:
Quantity:
Quantity:
Quantity:
Quantity:
Quantity:
Quantity:
Quantity:
Quantity:
Quantity: 110000
Quantity:
Quantity:
Quantity:
Quantity:
Quantity:

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