Sol_68HE0526Q0019.pdf
PDF 90 KB Posted
- Attached to
- MADE IN AMERICA REQUEST FOR INFORMATION
- Solicitation number
- 68HE0526Q0019
- Issued by
-
Environmental Protection Agency Region 5
About this file
This is an Optional Form 347 (OF 347), a federal Order for Supplies or Services form prescribed by the General Services Administration under 48 CFR 53.213(f). The form is a blank template designed to document purchase orders issued under existing federal contracts. It serves as the primary document for issuing delivery orders and contains standardized fields for capturing essential procurement information.
The form includes sections for order identification (order number, contract number, date of order, and requisition reference number); issuing office and contractor information with complete address fields; delivery destination details; business classification checkboxes for small business categories including small business, disadvantaged business, women-owned small business (WOSB), service-disabled veteran-owned, HUBZone, and EDWOSB designations; and an itemized schedule for supplies or services with columns for item number, description, quantity ordered, unit, unit price, amount, and quantity accepted. Additional fields capture shipping details (F.O.B. point, shipping point, gross weight), inspection and acceptance locations, discount terms, invoice information, and mail-to address for invoicing. The form includes space for the contracting or ordering officer's signature and typed name with title. As a standard government form template, it does not reference specific products, services, response dates, pricing terms, or particular federal agencies, but rather provides the framework for any federal ordering activity conducted under an existing contract vehicle.
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Other files
| File | Type | Posted |
|---|---|---|
| 1_Balance_Salient_Characteristics_FY26.docx | DOCX document |
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Text version
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)
12. F.O.B. POINT
ITEM NO.
(a)
SUPPLIES OR SERVICES
(b)
QUANTITY
ORDERED
(c)
UNIT
(d)
UNIT
PRICE
(e)
AMOUNT
(f)
QUANTITY
ACCEPTED
(g)
68HE0526Q0019
f. SERVICE-DISABLED
VETERAN-OWNED
e. HUBZone
g. WOMEN-OWNED SMALL BUSINESS (WOSB)
ELIGIBLE UNDER THE WOSB PROGRAM
h. EDWOSB
Admin Office:
Region 5 US Environmental Protection Agency 77 West Jackson Boulevard Chicago IL 60604-3507
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
22. UNITED STATES OF
AMERICA BY (Signature)
23. NAME (Typed)
TITLE: CONTRACTING/ORDERING OFFICER
OPTIONAL FORM 347 (Rev. 2/2012)
Prescribed by GSA/FAR 48 CFR 53.213(f)
AUTHORIZED FOR LOCAL REPRODUCTION
PREVIOUS EDITION NOT USABLE
File details come from the government source that posted it. Updated .