U.S. USDA Form usda-rus-281
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid
OMB control numbers for this information collection are 0572-0059 and 0572-NEW. The time required to complete this information is estimated to average 15 minutes per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.
BORROWER DESIGNATION
CONTRACT NO.
U. S. DEPARTMENT OF AGRICULTURE
RURAL UTILITIES SERVICE
TABULATION OF MATERIALS FURNISHED BY BORROWER
(Actual Cost to Borrower and Amount Chargeable to Contractor)
DESCRIPTION OF ITEM
RUS DESIGNATION
1
QUANTITY
ACTUAL COST TO BORROWER
UNIT COST
NAME OF ITEM
2
3
4
EXTENDED COST
AMOUNT CHARGEABLE TO
CONTRACTOR AT CONTRACT PRICE
UNIT PRICE
5
EXTENDED PRICE
6
7
-
TOTAL
The above tabulation is correct to the best of our knowledge and belief.
BORROWER'S ENGINEER
DATE
NAME OF BORROWER
CONTRACTOR
DATE
RUS Form 281( Rev. 5-61)
By
PRESIDENT
DATE
BY
NET
DIFFERENCE
a