ACCEPTANCE OF MIPR
1. TO (Requiring Activity Address)(Include ZIP Code)
2. MIPR NUMBER
3. AMENDMENT NO.
4. DATE (MIPR Signature Date)
5. AMOUNT (As Listed on the MIPR)
6. The MIPR identified above is accepted and the items requested will be provided as follows: (Check as Applicable)
a.
ALL ITEMS WILL BE PROVIDED THROUGH REIMBURSEMENT (Category I)
b.
ALL ITEMS WILL BE PROCURED BY THE DIRECT CITATION OF FUNDS (Category II)
c.
ITEMS WILL BE PROVIDED BY BOTH CATEGORY I AND CATEGORY II AS INDICATED BELOW
THIS ACCEPTANCE, FOR CATEGORY I ITEMS, IS QUALIFIED BECAUSE OF ANTICIPATED CONTINGENCIES AS TO FINAL PRICE. CHANGES
d.
IN THIS ACCEPTANCE FIGURE WILL BE FURNISHED PERIODICALLY UPON DETERMINATION OF DEFINITIZED PRICES, BUT PRIOR TO
SUBMISSION OF BILLINGS.
7.
MIPR
ITEM
NUMBER(S) IDENTIFIED IN BLOCK 13, "REMARKS" IS
NOT
ACCEPTED (IS REJECTED) FOR THE REASONS INDICATED.
8.
9.
TO BE PROVIDED THROUGH REIMBURSEMENT
TO BE PROCURED BY DIRECT CITATION OF FUNDS
CATEGORY I
CATEGORY II
ITEM NO.
QUANTITY
ESTIMATED PRICE
ITEM NO.
QUANTITY
ESTIMATED PRICE
a.
b.
c.
a.
b.
c.
$0.00
$0.00
d. TOTAL ESTIMATED PRICE
e. TOTAL ESTIMATED PRICE
10. ANTICIPATED DATE OF OBLIGATION FOR CATEGORY II ITEMS
11. GRAND TOTAL ESTIMATED PRICE OF ALL ITEMS
$0.00
12. FUNDS DATA (Check if Applicable)
ARE REQUIRED (See justification in Block 13)
a.
ADDITIONAL FUNDS IN THE AMOUNT OF $
ARE NOT REQUIRED AND MAY BE WITHDRAWN
b.
FUNDS IN THE AMOUNT OF $
13. REMARKS
14. ACCEPTING ACTIVITY (Complete Address)
15. TYPED NAME AND TITLE OF AUTHORIZED OFFICIAL
16. SIGNATURE
17. DATE
PREVIOUS EDITION WILL BE USED UNTIL EXHAUSTED.
Adobe Designer 8.0
DD FORM 448-2, JUL 71
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