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PURCHASE REQUISITION |
|
Originator |
Approvals
as Applicable |
Manager |
Dir. of Program
Mgt. | |
Deliver To |
Total Est. Value |
Division Head |
Director |
|
|
Buyer Code | Delivery Required 09/29/2005 |
Delivery Promised |
F Origin - PPY & CHG. O Origin - FRT. Allowed B Destination |
Ship Via |
Payment Terms | |||||
Item No. |
OBS | Project/WBS | Trans Code |
QTY | U/M | Description | Unit Price |
Total Price | ||
---|---|---|---|---|---|---|---|---|---|---|
1 | 1.1.01.20.00.80 | P0004.03.03.01 | 0545-002 | 1 | ea. | IR Narrow Bandpass Filter
N03380-6 (Cold Scan required - Line Item 4) (See attached for further details) |
$325.00 | $325.00 | ||
2 | 1.1.01.20.00.80 | P0004.03.03.01 | 0545-002 | 1 | ea. | IR Narrow Bandpass Filter
N03903-9 (Cold Scan required - Line Item 4) (See attached for further details) |
$325.00 | $325.00 | ||
3 | 1.1.01.20.00.80 | P0004.03.03.01 | 0545-002 | 1 | ea. | IR Narrow Bandpass Filter
N04505-4 (Cold Scan required - Line Item 4) (See attached for further details) |
$325.00 | $325.00 | ||
4 | 1.1.01.20.00.80 | P0004.03.03.01 | 0545-002 | 3 | ea. | Custom Scans Primary Transmission Region Scan SS-T2 |
$450.00 | $1,350.00 |
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Confirming Order
To: DO NOT DUPLICATE |
Maryland Sales
Tax IS NOT Applicable |
Govt. Property
Requirements Mult. Bar Code [ ] DD 1419 Req'd Yes [ } No [ ] |
TOTAL | |
VENDOR: (Name,
Address) Code No.
________________ Attention:_______________________________________________ |
SHIP
TO: Attention: ______________________________________________ | |||
GSA Schedule IS [ ]
IS NOT [ ] applicable RE: GSA Schedule No _________________________ |
BUYER:______________________________________ DATE: ______________________________________ |