U.S. USDA Form usda-ad-700

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U.S. USDA Form usda-ad-700
1. REQUESTING OFFICE
TO: (Procurement Office)
PROCUREMENT REQUEST
INSTRUCTIONS: Agencies must provide
entires in unshaded areas. See reverse.
3
CONTRACT NUMBER
2
RECEIVING
OFFICE NO.
4
ORDER
DATE
(If Applicable)
5
6
UNIT
CODE
7
FUND
CODE
8
PURCHASE/DELIVERY
ORDER NUMBER
9
1A. PROCUREMENT REQUEST NO.
SUB.
1B. DATE
CHECK ONE
10. TO: (Seller)
11. SHIP TO: (Consignee and Destination)
Purchase
Order
Delivery
Order
12
LINE
ITEM
INSIDE DELIVERY REQUESTED
13
ACT.
CODE
14
15
BUDGET
OBJECT
DESCRIPTION
16
ACC.
LINE
17
QUANTITY
18
UNIT
ISSUE
19
20
UNIT PRICE
AMOUNT
For additional information, please contact:
TECHNICAL CONTACT
21 FOB POINT
TELEPHONE NO.
22 DISCOUNT TERMS
23 REQUIRED DELIVERY
23A NEGOTIATED DELIVERY
Sub-Total
26 ESTIMATED
FREIGHT
24 SHIP VIA
(Do not use
ASAP)
28
ACC.
LINE
2
27
TOTAL
29 ACCOUNTING CLASSIFICATION
A
B
5
10
RECOMMENDED SOURCE(S) (If necessary, use attachment)
C
5
D
3
4
E
1
4
25
1
2
30
31
DISTRIBUTION
2
AMOUNT
I certify that the above items are necessary for use in the public service.
TITLE
SIGNATURE OF AUTHORIZED REPRESENTATIVE
This form was electronically produced by National Production Services Staff
AD-700 (4-82)
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