Exhibit_A_Sample_OF_347_Delivery_Order.pdf

ORDER FOR SUPPLIES OR SERVICES

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

1. DATE OF ORDER

30 Jan 2013

2. CONTRACT NO.(If any)

SUK56010D0316

6. SHIP TO:

LONDO19006

3. ORDER NO.

SUK56013F0086

4. REQUISITION/REFERENCE NO.

PR2314014

a. NAME OF CONSIGNEE

AMERICAN EMBASSY LONDON

5. ISSUING OFFICE (Address correspondence to)

24 GROSVENOR SQUARE ATTN: GSO/PROCUREMENT

LONDON,

W1A 1AE

Contact Name: John Avey Phone: 44-20-7499-9007 Email: AveyJN@state.gov

b. STREET ADDRESS

24 GROSVENOR SQUARE

ATTN: RECEIVING OFFICE

c. CITY

LONDON

d. STATE

e. ZIP CODE

W1A 1AE

f. SHIP VIA

7. TO: 8. TYPE OF ORDER

a. NAME OF CONTRACTOR

ANTHONY WITHERS GREEN

DUNS NUMBER

123456787

CONTACT PHONE NUMBER

07802 210241

E-MAIL:

AWG@TRISTARWORLDWIDE.COM

FAX:

01895 432098

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

TRISTAR WORLDWIDE CHAUFFEUR SERVICES

c. STREET ADDRESS

HORTON ROAD WEST DRAYTON

d. CITY

MIDDLESEX

e. STATE

f. ZIP CODE

UB7 8BQ

10. REQUISITIONING OFFICE

ATTN: GSO/MOTOR POOL

9.ACCOUNTING AND APPROPRIATION DATA

See line item detail. $1,845.96USD

Funds Certification Officer Signature:

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

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

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

12 Feb 2013

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 LONDON

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

FMC BOX 34, 24 GROSVENOR SQUARE

ATTN: FMC

£1,174.03GBP

17(i)

(GRAND TOTAL)

c. CITY

LONDON

d. STATE e. ZIP CODE

W1A 1AE

22. UNITED STATES OF AMERICA BY (Signature)

30 Jan 2013

23. NAME Typed

Andrew Sisk

TITLE: CONTRACTING/ORDERING OFFICER

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION NOT USABLE

OPTIONAL FORM 347 (REV. 9/2012)

Prescribed by GSA/FAR 48 CFR 53.213(f)

Page: 1 of 2

ORDER FOR SUPPLIES OR SERVICES

SCHEDULE - CONTINUATION

PAGE NO.

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

DATE OF ORDER

30 Jan 2013

TITLE

Chief Justice Bryer Visit to London (Tristar)

CONTRACT NO.

SUK56010D0316

ORDER NO.

ITEM NO.

(a)

SUPPLIES OR SERVICES

(b)

QUANTITY

ORDERED

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

QUANTITY

ACCEPTED

(g)

0001 Chief Justice Bryer Visit to London (Tristar)

4 Sedan vehicles.

Charge to Fund Strip Below All prices are estimates and all plus VAT.

19-x-6809-0000-00-4232-42329X0720-2589

Tax: £195.67GBP

Fiscal Data:

£195.67GBP 1900-2013--19___X68090000-4232-EUR--

-42323X9954-2589---- (Tax)

£978.36GBP 1900-2013--19___X68090000-4232-EUR--

-42323X9954-2589----

4.00 each £244.59GBP £978.36GBP

TOTAL

TAX TOTAL

GRAND TOTAL CARRIED FORWARD TO 1ST PAGE (ITEM 17h)

£978.36GBP

£195.67GBP

£1,174.03GBP

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION NOT USABLE

OPTIONAL

FORM 348

(REV.

9/2012)

Prescribed by

GSA - FAR (48

CFR) 53.213(f)

Page: 2 of 2