ORDER FOR SUPPLIES OR SERVICES/REQUEST FOR QUOTATIONS (Nonappropriated Funds)
(FOR PURCHASES OF $10,000 OR LESS)
For use of this form, see AR 215-4; the proponent agency is DCSPER
appropriated funds of the United States shall
become due or be paid the contractor by
reason of this delivery/purchase order.
(Check Appropriate Item)
Order for Supplies or Services-No
This is not an order. Supplies are of domestic origin unless otherwise indicated by the quoter. The
fund reserves the right to consider quotations or modifications thereof received after the date indicated
should such action be in the interest of the fund. This is a request for information and quotations
furnished are not offers. When quoting complete blocks 9, 10, 15a, 20, 21, 22. If you are unable to
quote, please advise. This request does not commit the fund to pay any cost incurred in preparation of
this quotation or to procure or contract for supplies or services.
Request for Quotation No.
copies of this quote by:
1. CONTRACT/PUR ORDER NO.
2. DELIVERY ORDER NO.
4. PURCHASE REQUEST NO.
5. ISSUED BY
6. ADMINISTERED BY (If other than 5)
7. NAME AND ADDRESS OF CONTRACTOR/QUOTER
8. DELIVER TO DESTINATION BY:
(See Schedule if
9. DELIVERY FOB
10. DISCOUNT TERMS
11. SHIP TO
12. PAYMENT WILL BE MADE BY
13. MAIL INVOICE
TYPE OF ORDER
DELIVERY-This delivery order is subject to instructions contained on this form only and is issued on another Government agency or in
accordance with and subject to terms and conditions of above numbered contract.
PURCHASE-Reference your quote
furnish the following on terms specified herein. Contract Clauses and Special Requirements, both attached; and delivery as indicated.