INSTALLATION DATE Base “X” TO: CONTRACTING OFFICER CLASS Deployed Contingency Contracting Officer CCO THROUGH: CONTRACT, PURCHASE ORDER OR DELIVERY ORDER NO. CPTS (FM) Deployed FROM: (Insert RC/CC, If applicable) Supporting LG or MSG IT IS REQUESTED THAT THE SUPPLIES AND SERVICES ENUMERATED BELOW AND IN THE ATTACHED LIST, BE PURCHASED FOR FOR DELIVERY TO NOT LATER THAN Customer (Supported Org) Base or otherwise Today + 12 hrs “X” specified ESTIMATED ESTIMATED ITEM DESCRIPTION OF MATERIAL OR SERVICES TO BE PURCHASED QUANTITY UNIT UNIT PRICE COST Bottled Drinking Water, 1.5 Liter Ea 5.00 Cost in US Dollars TOTAL PURPOSE 5000 Inbound Troops need drinking water DATE SIGNATURE TYPED NAME AND GRADE OF REQUESTING OFFICIAL Org N. Need, , USAF Today TELEPHONE USCENTAF A4-ALG DSN 965-5813 SIGNATURE DATE TYPED NAME AND GRADE OF APPROVING OFFICIAL Today B. B. Mann, , USAF TELEPHONE USCENTAF A4-ALG DSN 965-5813 I certify that the supplies and services listed above and in the attached list are properly chargeable to the following allotments, the available balances of which are sufficient to cover the cost thereof, and the funds have been committed. ACCOUNTING CLASSIFICATION AMOUNT 5753400 305 7826 9984ZA 010000 59200 27596F 667100 FB4866 ESP: ZA ACRN:AA $50,000.00 FSR:001212 PSR:098989 DSR:309341
INSTALLATION Base “X” DATE TO: CONTRACTING OFFICER Deployed Contingency Contracting Officer CCO CLASS THROUGH: CPTS (FM) Deployed CONTRACT, PURCHASE ORDER OR DELIVERY ORDER NO. FROM: (Insert RC/CC, If applicable) Supporting LG or MSG IT IS REQUESTED THAT THE SUPPLIES AND SERVICES ENUMERATED BELOW AND IN THE ATTACHED LIST, BE PURCHASED FOR Customer (Supported Org) FOR DELIVERY TO Base “X” or otherwise specified NOT LATER THAN Today + 12 hrs ITEM DESCRIPTION OF MATERIAL OR SERVICES TO BE PURCHASED QUANTITY UNIT ESTIMATED UNIT PRICE ESTIMATED COST Bottled Drinking Water, 1.5 Liter Ea 5.00 Cost in US Dollars TOTAL PURPOSE 5000 Inbound Troops need drinking water DATE Today TYPED NAME AND GRADE OF REQUESTING OFFICIAL Org N. Need, , USAF SIGNATURE USCENTAF A4-ALG TELEPHONE DSN 965-5813 DATE Today TYPED NAME AND GRADE OF APPROVING OFFICIAL B. B. Mann, , USAF USCENTAF A4-ALG SIGNATURE TELEPHONE DSN 965-5813 I certify that the supplies and services listed above and in the attached list are properly chargeable to the following allotments, the available balances of which are sufficient to cover the cost thereof, and the funds have been committed. ACCOUNTING CLASSIFICATION 5753400 305 7826 9984ZA 010000 59200 27596F 667100 FB4866 ESP: ZA ACRN:AA FSR:001212 PSR:098989 DSR:309341 AMOUNT $50,000.00
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