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ORDER FOR SUPPLIES OR
SERVICES
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1. CONTRACT/PURCH. ORDER/
AGREEMENT NO.
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2. DELIVERY ORDER/ CALL
NO.
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3. DATE OF
ORDER/CALL
( YYYYMMMDD
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4. REQ./PURCH. REQUEST NO.
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5. PRIORITY
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0012
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See Schedule
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A4A
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M67854-07-D-5031
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2009 Apr 08
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6. ISSUED BY
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CODE
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M67854
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7. ADMINISTERED BY (if other than
6)
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CODE
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S1103A
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8. DELIVERY
FOB
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COMMANDING GENERAL
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DCMA ATLANTA
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MARINE CORPS SYSTEMS
COMMAND
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ATTN: DIANNE ROBERTS, 2300 LAKE
PARK DRIV
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x
DESTINATION
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ATTN: MRAP/CARL V.
BRADSHAW
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SUITE 300
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o
OTHER
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2200 LESTER STREET
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SMYNRA, GA 30080
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SCD: A
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QUANTICO, VA
22134-5010
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(See Schedule if other)
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9.CONTRACTOR
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CODE
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1EFH8
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FACILITY
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10. DELIVER TO FOB POINT
BY (Date)
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11. X IF BUSINESS
IS
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(
YYYYMMMDD )
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o
SMALL
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SEE SCHEDULE
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o
SMALL
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DISADVANTAGED
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NAME
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FORCE PROTECTION INDUSTRIES,
(INC)
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12. DISCOUNT
TERMS
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o
WOMEN-OWNED
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AND
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OTIS BYRD
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Net 30 days
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ADDRESS
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9801 HWY 78 STE 3
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LADSON, SC
29456-3802
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13. MAIL INVOICES TO THE ADDRESS IN
BLOCK
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See Item 15
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14. SHIP TO
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CODE
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15. PAYMENT WILL BE MADE
BY
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CODE
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HQ0338
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DFAS COLUMBUS SOUTH ENTITLEMENT
OPS
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MARK ALL
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P.O. BOX 182264
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PACKAGES AND PAPERS
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SEE SCHEDULE
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COLUMBUS, OH 43218-2264
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WITH IDENTIFICATION
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NUMBERS IN
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BLOCKS 1 AND 2
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16. TYPE
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DELIVERY/CALL
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x
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This delivery order/call is issued on
another Government agency or in accordance with and subject to
terms and conditions of above numbered contract.
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OF
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PURCHASE
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Reference your quote dated
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ORDER
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Furnish the following on terms
specified herein. REF:
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ACCEPTANCE. THE CONTRACTOR HEREBY
ACCEPTS THE OFFER REPRESENTED BY THE NUMBERED PURCHASE ORDER AS IT
MAY PREVIOUSLY HAVE BEEN OR IS NOW MODIFIED, SUBJECT TO ALL OF THE
TERMS AND CONDITIONS SET FORTH, AND AGREES TO PERFORM THE
SAME.
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Force Protection Industries,
Inc.
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/s/ Otis Byrd
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Otis Byrd,
Vice President of Contracts
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2009/4/09
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NAME OF CONTRACTOR
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SIGNATURE
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TYPED NAME AND TITLE
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DATE SIGNED
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( YYYYMMMDD
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x
If this box is marked, supplier must
sign Acceptance and return the following number of copies:
1
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17. ACCOUNTING AND APPROPRIATION DATA
/ LOCAL USE
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See Schedule
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20.QUANTITY
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ORDERED/
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18. ITEM NO.
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19. SCHEDULE OF
SUPPLIES/SERVICES
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ACCEPTED*
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21. UNIT
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22. UNIT PRICE
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23. AMOUNT
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SEE SCHEDULE
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*If quantity accepted by the
government is
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24. UNITED STATES OF
AMERICA
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25. TOTAL
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$158,113,017.00
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same as quantity ordered, indicate
by X. If
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TEL:540-242-3035
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26. DIFFERENCES
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different, enter actual quantity
accepted
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EMAIL:carl.bradshaw@usmc.mil
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/s/ Carl V. Bradshaw
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below quantity ordered and
encircle.
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BY:CARL V. BRADSHAW
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CONTRACTING / ORDERING
OFFICER
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27a. QUANTITY IN COLUMN 20 HAS
BEEN
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o
INSPECTED
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RECEIVED
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o
ACCEPTED, AND CONFORMS TO
THE
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CONTRACT
EXCEPT AS NOTED
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b. SIGNATURE OF AUTHORIZED GOVERNMENT
REPRESENTATIVE
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c. DATE
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d. PRINTED NAME AND TITLE OF
AUTHORIZED
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( YYYYMMMDD )
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GOVERNMENT REPRESENTATIVE
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e. MAILING ADDRESS OF AUTHORIZED
GOVERNMENT REPRESENTATIVE
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28. SHIP NO.
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29. DO VOUCHER NO.
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30. INITIALS
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f. TELEPHONE NUMBER
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g. E-MAIL ADDRESS
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o
PARTIAL
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32 PAID BY
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33. AMOUNT VERIFIED CORRECT
FOR
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o
FINAL
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36. I certify this account is
correct and proper for payment
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31. PAYMENT
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34. CHECK NUMBER
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a. DATE
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b. SIGNATURE AND TITLE OF CERTIFYING
OFFICER
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o
COMPLETE
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35. BILL OF LADING NO.
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( YYYYMMMDD )
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o
PARTIAL
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o
FINAL
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37. RECEIVED AT
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38. RECEIVED BY
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39. DATE RECEIVED
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40. TOTAL
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41. S/R ACCOUNT NO.
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42. S/R VOUCHER NO.
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( YYYYMMMDD )
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CONTAINERS
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DD Form 1155, DEC 2001
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PREVIOUS EDITION IS
OBSOLETE.
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