PR4911129_St_Regis_Hotel_Doha_2015.pdf

DRAFT ORDER FOR SUPPLIES OR SERVICES

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

1. DATE OF ORDER 2. CONTRACT NO.(If any)

SQA10016D0001

6. SHIP TO:

DOHA_19005

3. ORDER NO.

SQA10016M0069

4. REQUISITION/REFERENCE NO.

PR4911129

a. NAME OF CONSIGNEE

AMERICAN EMBASSY DOHA

5. ISSUING OFFICE (Address correspondence to)

POST BOX NO 2399, 22 FEBRUARY STREET ATTN: GENERAL

SERVICES OFFICE

DOHA,

Contact Name: Firas T Bashir Phone:

Email: BashirFT@state.gov

b. STREET ADDRESS

POST BOX NO 2399, 22 FEBRUARY STREET

ATTN: GSO/WAREHOUSE

c. CITY

DOHA

d. STATE

e. ZIP CODE

f. SHIP VIA

7. TO: 8. TYPE OF ORDER

a. NAME OF CONTRACTOR

SALES MANAGER

DUNS NUMBER

123456787

CONTACT PHONE NUMBER

+974 4446 0017

E-MAIL:

FAX:

a. PURCHASE ORDER

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.

b. DELIVERY ORDER -- 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.

b. COMPANY NAME

THE ST. REGIS DOHA HOTEL

c. STREET ADDRESS

P.O. BOX: 14435

d. CITY

DOHA

e. STATE

f. ZIP CODE

10. REQUISITIONING OFFICE

ATTN: GSO/PROCUREMENT

9.ACCOUNTING AND APPROPRIATION DATA

See line item detail. $214,909.39USD

11. BUSINESS CLASSIFICATION (Check appropriate box(es)) 12. F.O.B. POINT Destination

a. SMALL b. OTHER THAN SMALL c. DISADVANTAGED

d. WOMEN-OWNED e. HUBZone f. SERVICE-DISABLED VETERAN-OWNED

g. WOMEN-OWNED SMALL BUSINESS (WOSB) ELIGIBLE UNDER

THE WOMEN-OWNED SMALL BUSINESS PROGRAM

h. EDWOSB

13. PLACE OF 14. GOVERNMENT B/L NO.

15. DELIVER TO F.O.B. POINT ON OR BEFORE (Date) 02 Dec 2015

16. DISCOUNT TERMS

a. INSPECTION

b. ACCEPTANCE

17. SCHEDULE (See reverse for Rejections)

ITEM NO.

(a)

SUPPLIES OR SERVICES

(b)

QUANTITY

ORDERED

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

QUANTITY ACCEPTED

(g)

SEE LINE ITEM DETAIL

SEE BILLING

INSTRUCTIONS ON

REVERSE

18. SHIPPING POINT 19. GROSS SHIPPING

WEIGHT

20. INVOICE NO. 17(h) TOT.

(Cont. pages)

21. MAIL INVOICE TO:

a. NAME

AMERICAN EMBASSY DOHA

b. STREET ADDRESS (or P.O. Box)

AMERICAN EMBASSY 22 FEBRUARY ST PO BOX 239

FINANCIAL MANAGEMENT OFFICE

782,700.00QAR

17(i)

(GRAND TOTAL)

c. CITY

DOHA

d. STATE e. ZIP CODE

22. UNITED STATES OF AMERICA BY (Signature)

23. NAME Typed

TITLE: CONTRACTING/ORDERING OFFICER

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION NOT USABLE

DRAFT OPTIONAL FORM 347(REV. 9/2012)

Prescribed by GSA/FAR 48 CFR 53.213(f)

Page: 1 of 2

DRAFT ORDER FOR SUPPLIES OR SERVICES

SCHEDULE - CONTINUATION

PAGE NO.

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

DATE OF ORDER

TITLE

FLOTUS Visit - Room Reservation for USSS

CONTRACT NO.

SQA10016D0001

ORDER NO.

ITEM NO.

(a)

SUPPLIES OR SERVICES

(b)

QUANTITY

ORDERED

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

QUANTITY

ACCEPTED

(g)

0001 FLOTUS Visit: Grand Deluxe Single Room (90 Rooms)/(total 736 room nights) reserved at St.

Regis for USSS between Oct 21 and Nov 6, 2015 per attached Summary List.

Fiscal Data:

772800.00QAR 7004-2016--70___604000000-16---

PPD-1480004-2172-012312-----

736.00 day 1,050.00QAR 772,800.00QAR

0002 FLOTUS Visit: (2) Deluxe Single Room (total :12 nights) reserved at St. Regis for USSS between Oct 21 and Nov 6, 2015 per attached Summary List.

Fiscal Data:

9900.00QAR ---------------

12.00 day 825.00QAR 9,900.00QAR

TOTAL CARRIED FORWARD TO 1ST PAGE (ITEM 17h) 782,700.00QAR

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION NOT USABLE

DRAFT OPTIONAL FORM 348

(REV. 9/2012)

Prescribed by GSA - FAR (48 CFR) 53.213(f)

Page: 2 of 2