ETL System Cards 1332KP21PNEEB0043 SF1449.pdf
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- 1332KP21PNEEB0043
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TRAN.TRANG.THUY.139506
Digitally signed by
TRAN.TRANG.THUY.1395069876
Date: 2021.08.31 07:50:15 -04'00'
STANDARD FORM 1449 (REV. 2/2012) BACK
19.
ITEM NO.
20.
SCHEDULE OF SUPPLIES/SERVICES
21.
QUANTITY
22.
UNIT
23.
UNIT PRICE
24.
AMOUNT
32a. QUANTITY IN COLUMN 21 HAS BEEN
RECEIVED INSPECTED ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:
41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT
32b. SIGNATURE OF AUTHORIZED GOVERNMENT
REPRESENTATIVE
32c. DATE
41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE
42a. RECEIVED BY (Print)
42b. RECEIVED AT (Location)
42c. DATE REC'D (YY/MM/DD) 42d. TOTAL CONTAINERS
40. PAID BY
32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT
REPRESENTATIVE
32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f. TELPHONE NUMBER OF AUTHORZED GOVERNMENT REPRESENTATIVE
32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE
33. SHIP NUMBER 34. VOUCHER NUMBER 35. AMOUNT VERIFIED
CORRECT FOR
PARTIAL FINAL
37. CHECK NUMBER
38. S/R ACCOUNT NO. 39. S/R VOUCHER NUMBER
36. PAYMENT
COMPLETE PARTIAL FINAL
1332KP21PNEEB0043
SCHEDULE Continued
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
Reference Quote# NE-EB3000-21-01097 ETL System Cards
0001 Per SON and quote.
Accounting and Appropriation Data:
14.21.V8N2SP1.P00.1083.050120000.
4002000300000000.31262535.000000 $33,314.37
PR NUMBER: NE-EB3000-21-01097
DELIVERY DATE: 11/09/2021
Period of Performance: 08/31/2021 to 11/09/2021 Pricing Option: Firm-Fixed-Price
1.00 EA 33,314.37 33,314.37
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Table of Contents
Clauses
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CLAUSES
Clauses
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