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Project (0704-0817), Washington, DC 20503.
PLEASE DO NOT RETURN YOUR FORM TO EITHER OF THESE ADDRESSES. SEND YOUR COMPLETED FORM TO THE PROCUREMENT OFFICIAL IDENTIFIED IN ITEM 6.
DACW07-96-P-0705 96SEP16
SPNCOO-6249-1070
U.S. ARMY ENGINEER DISTRICT, SF, COE ATTN: CESPN-CT 333 MARKET ST. RM 704 SAN FRANCISCO, CA 94105-2197 Ofelia (Offel) R. Rosales B01 415 977 8499
See block 6 [x] DEST [ ] OTHER (See Schedule)
THE WELCH CO. ATTN: Mr. Rod Welch 440 DAVIS CT #1602 SAN FRANCISCO, CA 94111 2496
See Schedule [x] SMALL [ ] SMALL DISADVANTAGED [ ] WOMEN-OWNED
0% 00 Days Net 030 BLOCK 15 BELOW
U.S. ARMY ENGINEER DISTRICT, SF, COE ATTN: Mr. Thompson F. Keesling 333 MARKET ST. RM. 816 DACW0796P0705 SAN FRANCISCO CA 94105-2197
PURCHASE x Reference your WRITTEN/ORAL/TELECON to _________________ furnish the following on terms specified herein.
ACCEPTANCE. THE CONTRACTOR HEREBY ACCEPTS THE OFFER REPRESENTED BY THE
NUMBERED PURCHASE ORDER AS IT MAY PREVIUSLY HAVE BEEN OR IS NOW MODIFIED,
SUBJECT TO ALL OF THE TERMS AND CONDITIONS SET FORTH, AND AGREES TO
PERFORM THE SAME.
---------------------------- -------------------- ------------------
NAME OF CONTRACTOR SIGNATURE DATE SIGNED
(YYMMDD)
"A NAME="> 0105 ----------------------------
TYPED NAME AND TITLE
17. ACCOUNTING AND APPROPRIATION DATA/LOCAL USE
96X3112 CG S90643 BB21131COMOOWJC 285 GA Award Oblig Amt US$ 23,384
18. ITEM NO. 19. SCHEDULE OF SUPPLIES/SERVICE
SEE ATTACHED INDEX OF CONTRACT CLAUSES DATED 16FEB90 INCORPORATED HEREIN
20. QUANTITY 21. 22. UNIT PRICE 23. AMOUNT ORDERED/ACCEPTED * UNIT
* If quanitity accepted by the Government
is same as quantity ordered, indicate
by x. If different, enter actual
quantity accepted below quantity
ordered and encircle.
24. UNITED STATES OF AMERICA 25. TOTAL $ 23384.00
/s/R.M. McNab 96/09/16
BY: R. McNab K05 (??)
26. QUANTITY IN COLUMN 20 HAS BEEN 27. SHIP NO. 28. D.O. VOUCHER NO.
[ ]INSPECTED [ ]RECEIVED [ ] PARTIAL
[ ]ACCEPTED AND CONFORMS TO [ ] FINAL CONTRACT EXCEPT AS NOTED
----------- -----------------------------
DATE SIGNATURE OF AUTHORIZED REP
29. DIFFERENCES 30. INITIALS
31. PAYMENT 32. PAID BY 33. AMT VERIFIED CORRECT FOR
[ ] COMPLETE [ ] PARTIAL [ ] FINAL 34. CHECK NUMBER
35. <01WS BILL OF LADING NO.
36. I certify this account is correct and proper for payment
----------- -----------------------------
DATE SIGNATURE OF AUTHORIZED REP
37. REC'D AT 38. RECEIVED BY (Print) 39. DATE REC'D
(YYMMDD)
40. TOTAL CONT. 41. S/R ACCOUNT NUMBER 42. S/R VOUCHER NO.
ITEM DESCRIPTION OF SUPPLY OR SERVICES QUANTITY UNIT TOTAL COST
0001 Scope of Work
a) Attend and document weekly contractor/Government joint meetings
b) Produce weekly joint meeting notes (2 work days after each meeting) c) Research historical documentation to develop "Communication Metrics" traceability files (60 days from contract execution). d) Assist Government representatives in meetings (other than item a, above), recording discussions and provide "Communication Metrics" documentation and training.
Meetings 22 4 88 Drafts 22 2 44 Finals 22 1 22 COE Reviews 22 1 22 Follow up/training, research 22 2 44 ----- 220
Cost per hour 100 x 220 22,000 Mileage shows 1200 x $.32 384 Reproduction 1,000 -------- $23,384
COE Point of Contact: Thompson (Tom) F. Keesling @ 415 977 8473