Optional Form 347 - Order For Supplies Or Services Page 2

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SUPPLEMENTAL INVOICING INFORMATION

f desired, this order (or a copy thereof) may be used by the Contractor as the Contractor's invoice, instead of a separate invoice, provided the following

statement, (signed and dated) is on (or attached to) the order: "Payment is requested in the amount of $

. No other invoice will be submitted."

However, if the Contractor wishes to submit an invoice, the following information must be provided: contract number (if any), order number, item number(s),

description of supplies or service, sizes, quantities, unit prices, and extended totals. Prepaid shipping costs will be indicated as a separate item on the

invoice. Where shipping costs exceed $10 (except for parcel post), the billing must be supported by a bill of lading or receipt. When several orders are

invoiced to an ordering activity during the same billing period, consolidated periodic billings are encouraged.

RECEIVING REPORT

inspected,

accepted,

received by me

Quantity in the "Quantity Accepted" column on the face of this order has been:

and conforms to contract. Items listed below have been rejected for the reasons indicated.

SHIPMENT

DATE RECEIVED

SIGNATURE OF AUTHORIZED U.S. GOV'T REP.

DATE

PARTIAL