Dd Form 448 - Military Interdepartmental Purchase Request Page 2
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1
2ACCEPTANCE OF MIPR
1. TO (REQUIRING ACTIVITY ADDRESS)(INCLUDE ZIP CODE)
2. MIPR NO.
3. AMENDMENT NO.
Washington Headquarters Services
DWAM41882
BASIC
Room 1155, The Pentagon
Washington, DC 20301-1155
4. DATE (MIPR SIGNATURE DATE)
5. AMOUNT (AS LISTED ON THE MIPR)
FIN BPN: DODH91269
01-Aug-14
$26,800.00
6. THE MIPR IDENTIFIED ABOVE IS ACCEPTED AND THE ITEMS REQUESTED WILL BE PROVIDED AS FOLLOWS: (CHECK AS APPLICABLE )
A. X 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
D.
THIS ACCEPTANCE, FOR CATEGORY I ITEMS, IS QUALIFIED BECAUSE OF ANTICIPATED CONTINGENCIES AS
CHANGES, IN THIS ACCEPTANCE FIGURE WILL BE FURNISHED PERIODICIALLY UPON DETERMINATION OF
TO FINAL PRICE,
PRICES, BUT PRIOR TO SUBMISSION OF BILLINGS.
DEFINITIZED
7.
MIPR ITEM NUMBER(S) IDENTIFIED IN BLOCK 13, "REMARKS" IS NOT ACCEPTED (IS REJECTED) FOR THE REASONS INDICATED.
8.
TO BE PROVIDED THROUGH REIMBURSEMENT
9.
TO BE PROVIDED THROUGH DIRECT CITE
CATEGORY I
CATEGORY II
ITEM NO.
QUANTITY
ESTIMATED PRICE
ITEM NO.
QUANTITY
ESTIMATED PRICE
A.
B.
A.
B.
C.
C.
BSC
$26,800.00
D. TOTAL ESTIMATED PRICE:
E. TOTAL ESTIMATED PRICE:
$26,800.00
10. ANTICIPATED DATE OF OBLIGATION FOR CATEGORY II ITEMS
11. GRAND TOTAL ESTIMATED PRICE OF ALL ITEMS
$26,800.00
12. FUNDS DATA ( CHECK IF APPLICABLE )
A.
ADDITIONAL FUNDS IN THE AMOUNT OF $ _____________________ ARE REQUIRED (SEE JUSTIFICATION IN
BLOCK 13)
B.
FUNDS IN THE AMOUNT OF $ ___________________________ ARE NOT REQUIRED AND MAY BE WITHDRAWN
13. REMARKS
9740400.1120 P4923 0403 253H 96KM97 049447 DWAM41882
14. ACCEPTING ACTIVITY (COMPLETE ADDRESS)
15. TYPED NAME AND AUTHORIZING OFFICIAL
16. SIGNATURE
17. DATE
PREVIOUS EDITION WILL BE USED UNTIL EXHAUSTED.
DD FORM 448-2, JUL 71 (EG)
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