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09/25/03 THU 12:1B FAX 1 541 683 6767 ELTG BLM PROCUREMENT-IRM tgl0oz <br /> AGE OF PAGES <br /> ORDER FOR SUPPLIES OR SERVICES <br /> j IMP ~ k wl h n <br /> 1. DATE OF ORDER 2. CONTRACT NO. (If any) 6_ Sfii1P TO. Mafiys•fiAsCra$g • <br /> 09!24/2003 a_ NAME OF CONSIGNEE <br /> <br /> _ 3. G;` '`?R NO. A. REQUISITION/REFERENCE NO, BLM EUGENE DISTRICT OFFICE <br /> ~~P030074 b. STREET ADDRESS <br /> 5. ISSUING OFFICE (Address corresppndence to) 2890 CHAD DR <br /> PO 84X 10226 <br /> BLM EUGENE DISTRICT OFFICE <br /> 2890 CHAD DR ~1. STATE e. ZIP CODE <br /> PO BOX 10226 c. CITY <br /> EUGENE OR 974-40-2226 <br /> ~ EUGENE OR 974dp-2226 <br /> I' 7 TQ: f- SHIP VIA <br /> I a. NAME OF CONTRACTOR NIA <br /> 8, TYPE OF ORDER <br /> b. CDMPANY NAME X? a. PURCHASE ? <br /> ~ CITY OF EUGENE REFERENCEYDUR: b. DELIV)=RY -Except fqr billing <br /> instructions on the 2verse, this <br /> ~ c. STREET ADDRESS <br /> 858 PEARL STREET delivery order is subject to <br /> instrucctiens contained on this side <br /> j Please fumisB the (ollaWln9 on the terms and Doty of Utis Toren and Is issued <br /> candilions speclfled on both sides of this order and sub)ect tq the terms and tondilions <br /> d. CITY 8- STATE f. ZIP CODE on the artached sheet, if any, including delivery as of the above-numbered contract. <br /> EUGENE OR 97401 indicated. <br /> 9. ACCOUNTING AND APPROPRIATION DATA 10. REQUISITIONING OFFICE <br /> 2003- - -OR095- •2522- -2823JM- - -MF40- - - - - p,3L -IOh'[x5ton, 541-520-2159 <br /> 11. BUSINESS CLASSIFICATION (Check appropriate box(es)) <br /> ? a. SMALL b. OTHER THAN SMALL ~ c. DISADVANTAGED ? d. WOMEN-OWNED <br /> 12, f=.O,B. POINT 14. GOVERNMENT B/L NO. 15. DELlvER TO F.O.B. POINT 16. DISCOUNT TERMS <br /> Destination ON OR BEFORE (Date) 10 days <br /> 13. PLACE OF NIA 12/31/2003 20 days <br /> a. INGPECTION b. ACCEPTANCE 30 days <br /> D( +ATION DESTINATION days <br /> 17. SCHEDUL<" See reverse for 17e'aatlons <br /> QUANTITY uN17 QUANTITY <br /> ITEM NO. SUPPLIES OR SERVICES ORDERED UNIT PR(GE AMOUNT ACCEPTED <br /> (2) (c) (d) (e) (f) (9) <br /> SEE LINE ITEM DETAIL <br /> *Ai=tachmen,t 1 is made a pare of tha_s ord r <br /> 18. SHIPPING POINT 19. GROSS SHIPPING WEIGHT 20. INVOICE O. <br /> 17(h) TOT. <br /> SE'E BILLING 21. MAIL INVOICE TO:MarlyS M. Craig (Goof. <br /> INS7'RUC7lONB a. NAME pages) <br /> ON BLM EUGENE DISTRICT OFFICE <br /> REVERSE b_ STREET ADDRESS (orP.O. Sox) <br /> 2890 CHAD DR,PO BOX 10226 17(I) <br /> $4,812.00 GRAND <br /> d, STATE e. ZIP CODE TaTAL <br /> c. CITY <br /> EUGENE OR 87440-2226 <br /> 2 . :ITEp STATES OF 23. NAME (Typed) <br /> aMERICA BY (Si?gnatura) Marlys M, Craig <br /> / / TITLE: CONTRACl'ING/ORDERING QFFIGER <br /> NSN 754D-0t-152-8083 OPTIONAL FORM 347 (REV. 6195) <br /> Previous cdilion not usshle Prtvcribed 6y GSAIFAR 48 GFR 53,z~3(p) <br /> <br />