SFUND RECORDS CTR

5103-00005) •;

AMERICAN SAMOA GOVERNMENT PAGO PAGO, AMERICAN SAMOA 96799

UNIT PRICE ADJUSTMENT

SFUND'RECORDS CTR

83224740

In reply refer to:

Stock No: fcfep -OO -Lto -23*?0

1. Regn/P.O.No.

2. Quantity Received

3. Invoice Value

4. Ocean Freight

5. Total Value 3 & 4

6. Quantity old Stock

7. Unit Cost of Line 6

8. Total Value of Line 6

9. 10% of Line 8

10. Less Value of Line 9 from Line 8

11. Total Quantity of Line 2 & 6

12. Total Value of Line 5 & 10

13. Plus 10% of Line 12

14. Total Value of Line 12 & 13

15. Line 11 into Line 14

16. New Adjusted of Unit Price

REMARKS:

Date: ^4, ms

\Z--af-

ic4-cy.

III. i&

13,11

I ,7-11-54

10,403.%/

__________ 12-1 -CY

12. S

I, 7-4^-LD

^ilZ-.gS

_________ 113> .3>*i

H3>.g.s-cy.

..'.I

£.

AMERICAN SAMOA GOVERNMENT

PAGO PAGO, Af ’ "(CAN SAMOA

-w;-v -/cv- -

* ■- ... ... ■■ ■'' *- ?,

PR NO.

■ ?TERMS-"-.""-

■ VNEJ/A

/AavT’0"

■jiife" ao-foFOB, CIE. OR ClF, (FOB POINT)'■

A;"- H'aos /SAN.-FRANC. l nCO

TWS NUMBER vusr APPEAR CM AU_ PACKAGES AND PAPERS RELATED TD THiS CRCER ^P.a Na AND/OR CONTRACT No.

•R41503.--

DATE WANTED

01/ :j;PAGE.

Sr!-PRCCURHi';EHT

; P 4. 8 AND A- GOVT

'pagov/acqOOaH/Canoa 9

//o V

'•OOP

Bill. to:; — - , . ;:v--.

ACCOUNTS PAYABLE DIVISION ■ z.

AMERICAN SAMOA GOVERNMENT

' AMERICAN SAMOA, 96799 . ..

VT:aOio- X•: a - fi. '..-U.,' i.C-’V.;."-'.

FF:F>'F,F ' 1 ' pPsFsVFF

' 0 V: V-V ! "••o-noo/o-oo. '.-TF :ta r.ca

■o/;v ' *x" %V.

SPECIAL SHIPPING INSTRUCTIONS:'

" AC-V !■ 0*0*-/ ..'A„;y.'-T*'VyAC

j:

IMPORTANT.NOTICE: V :'. . ■ • •: . 1 _ _____FOR PROMPT PAYMENT OF YOUR INVOICE, THE PURCHASE ORDER

NUMBER ABOVE' MUST APPEAR ON- ALL INVOICES, B/L, INDIVIDUAL PACKAGE/& SHIPPING CONTAINERS. - ■

ITEM SUPPLIES OR SERVICES

., . ,L =

.us. ,iGULF I CO.-; Vi 50- ■■ YOUNG/

UNIT PRICE , , AMOUNT.

—.■■ ....

QTY. REC'D

LAFAcrrv. per lroiNP-

4M‘$

C.O’.PVO 1 ! ; .'-‘A . WATH.OECRP.L3,3YE.T0NO . ' vj ' A: .

VP Hr V LLaBl. A VL.Y Ni;?oo>...

>> -L'. v y"cyl Oneera i ■ F; ‘:VOA:; — . T:0 ; ’• V -300

:V .PEP '■ 0/C." D 0NV: LUCA.--r—onvco 0:-"- -• t\~:: .. - ,»

3.. ;icV i L.L >-!• 'V 0 v: 0/;

T'V A;V ERICAA VC-VV':AOp'rT

ra 7/W)3 >

FREIGHT EST.

TOTAL:

•; V ''• . • • :

u.U

. A •’ • 1■kj-K'-. >.V- ;

p*. ■:? '.V. . " - .•••

YvOFOUIO

IMPORTANT V S^^^,p/STO:;:i /

A tv .

'/•..A - -• ,

A FA ''F; .-..'V/A'-A' O'FFFAV : A V-'-'

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O' : :\\ -vO'/'■■•■VV'.'.'.o'.vO v--W v / :o;v';pv

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.•> "'-r'/Ev'"c:T>vV''':v;-VV:-:-.1

V L'H l Ai-(PROCUREMENT OFFICER) "~—AMERICAN SAMOA GOVERNMENT

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VO-i:'V'.V.;,;;Ov.: V./O.V -O'7. ---O.t' ■■ Tf

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ORIGINATING DEPARTMENT.■ ’V- ,.. ' 'V ■

/y/

/

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a

ACCOUNT.No:;-' -;;.7&QriW?::*

p.r no.': ; ............. . .

:f DEPARTMENT^-;v^ . yl .y/a?*-

Qffice/of- ProcUremen.ty-PURCHASE ORDER DATE ' , •

-- 1/13/94 -

THIS NUMBER MUST APPEAR ON ALL .. PACKAGES AND PAPERS RELATED TO -V

?:•£ THIS ORDER ^pr> CONCERNS:-

*-V*. P.O. No. AND/OR CONTRACT No.:---

P041203-M . *’■

TO: ' ' " ................... . ' ............ ■ •*.

David K. Lindeauth Co;, Irsc- ' ;y.”:-v ~ _ 240 Valley Drive V

; • Brisbane', California 94005. :

,\ri •8 7 r

L -DATE:OF CHANGE NOTICE'-} ''^3/8/94^.^;^-:'^

SPECIAL SHIPPING INSTRUCTIONS.

FOR INTERMEDIATE HANDLING?- .-'. '.T L ' : . ............- -

' □ SHIP TO □ CONTACT.'

E DO NOT INSURE: THIS ORDER INSURED BY HARTFORD .

INSURANCE COMPANY (PAGO PAGO AMERICAN SAMOA)

FH PLEASE PREPAY INSURANCE,ON ALL PACKAGES ’ :?■

J—r> SENT VIA SURFACE OR AIRMAIL^. = %. ,X -V;,

Xflr v-■V e _

. - aK-

- ' W-

ITEM No. - SUPPUESiOR SERVICES* UNIT ^ AMOUNT

' INCREASE S8LIGAII0N v

L Lj

>1,043.04

* iv.-i 1'i*.«**., r ^

r\

1 J^ ^ t^ \ ' ^ *

NOTE: THIS CHANGE NOTICE IS ISSUED TO COVER UNDERESTIMATEDl FREIGHT ON ORIGINAL P.O. 41203-M. , ~

~ ..

> ,-yy; .. .-'•VVdVVV-.’fky't-iV ■ 'IMPORTANT NOTICE

FOR PROMPT PAYMENT OF- YOUR INVOICE.THE FOLLOWING MARKS MUST APPEAR ONL ALL INVOICES. B/L. INDIVIDUAL PACKAGES AND SHIPPING CONTAINERS. . V.-:. S ’ .-

IMPnPTANIT 4 AIR MAIL ALL CORRESPONDENCE, livirwn I MIN I ™ .. . BILLS OF LADING 4 CARRIER RECEIPTS'. PROCUREMENT OFFICER - .

TO V : AMERICAN SAMOA GOVERNMENT - A. : - ~ PAGO PAGO, AMERICAN SAMOA 96799 ' ”

RECEIVED FROM SUPPLY OPERATION DIVISION

TTEM(ST ll_____ — V_____ :----------It—i_______ -

SHIPPED VIA

RECT) BY L_

.DATE

.DATE

CHECKED AND RELEASED BY‘

xf&fa HUN KIN

(PROCUREMENT OFFICER)AMERICAN SAMOA GOVERNMENT

SHIPPING & REC. COPY

V ?:7 PURCHAsOlQU ISJ II.QN ■ A )cAN SAMOA GOVERNMENT

PAu-VAGO, AMERICAN SAMOA, 96799

I ACCOUNT,N,/S753Q-5994

t i ^ 2 DEPARTMENT ^ 9 P * 3 TODAY S1DATE ^ *- * ( * ,

■ 1 / f1 Procurement Office' : Jan. 11. 1994

4. ORIGINATOR'S NAME 4 TELEPHONE:NUMBER

M.A. LELAUTI - ' ' ‘

S DELIVER TO ‘ • ,

Shipping & Receiving.

* + B REQUESTEI

HkOUISiriON- NUMBER •. •

6. DA IE WANTED

ASAP-

10020:

v

7. SUGGESTED VENDOR-'<

V.

David, K.jLindemuthCo., Inc.-

,V

240 Valay Drive '

Brisbane j California?’ 94005 . r

REQUESTED METHOD OF SHIPMENT

^□-SURFACE , ’ -""□(AIR FREIGHT* 1 '

/•□/SURFACE MAIL'

□ AIRMAIL _ ‘ ■ -

□ OTHER

ITEM*' . - PART No. AND/OR DESCRIPTION ’ •' ;• ,• QUANTITY ‘ ESTIMATED **■

UNIT PRICE (IF KNOWN)

TOTAL ESTI- 9. £ofi PROCUREMENT ONLY

No.. . MODEL No. 4 SERIAL No. OF ITEM.FOR WHICH PARTS ARE OROERED ,. : ' DESlREO/ • - ’

(IF KNOWN) PRICE ' . TOTAL

■.r- .V-V"-'-" -■ - V\- :.-vv . &■*?': O' ■

/ ,

$9,350..

'■'7 - . 7- '' ■

1. - GAS, CHLORINE, Commercial.grade, low pre-

AO O •7* 103.89 0 ‘

ssure liquef ied..150 pound capacity, per 7 , ’7---,..7 v V -.7' . ■

cylinder. For chlorinating water supply , ' ’ 77.-' ".'•'7 . V ;

system. (REFILLABLE CYLINDER) ‘ v ;? 7' •*..

’V*' 'h\; ■

"EMPTY CXLINDERS SHIPPED ABORRD POLYNESIA7.-‘f:;7;:7'y ‘

V-205N UNDER B/LADING PLLU22136 DTD. ' ' " . "• ' ..

1/10/94. EMPTIES ARE TO BE REFILLED &"" ■ -V'7 : -

■ RETURN TO AMERICAN SAMOA GOB * T." •

7777 t'_"7 ■ 'V'7.

r. . ■ ; ; 7/" - *'^..7 estimated shipping charges

1,495.1

TOTAL REQUEST$10,845

10;. Jf- i i S\ |jly / r / \9 ** Q/fJ *

ENINGnftNO APPROVAL SIGNATURES

L DIJiSlO»kP^BOlAL Q-S1 ,(

MULIAGA' Air rELAOTl Supply Branch Manager

11. DEPT. approvai^v*QOO-jio.o

tm; 'seIji

Chief Procurement Officer

12. PROCUREMENT SCREENING-

A safe/

11 BUDGET APPROVAL 14. GOVERNOR APPROVAL

PROCUREMENT OFFICE USEONLY7

IS, PROCUREMENT REVIEW COMMITTEETX ^ 16 ATTORNEY GENERAL * £ 1T. PURCHASE,ORDER No. s.i- . 18. PURCHASE ORDER ISSUED. . ... . . , 7

’ ~4/Z d3-A? ///319. SHIPPING INFORMATION S*' 20. VENDOR

—< INSTRUCTIONS.1 COMPLETE BLOCKS 1THROUGH 7 AS INDICATED - . .2 CHECK REQUESTED METHOD OF SHIPMENTTN BLOCK V - v '3 ALWAYS GIVE PART NUMBER AND/OR BRIEF DESCRIPTION OF ITEM. BE SURE TO GIVE QUANTITY DESIRED AND

ESTIMATED UNIT AND TOTAL PRICE IF KNOWN SHOW ESTIMATED SHIPPING CHARGES.- . ‘Bi

PROCUREMENT (WHITE) RETURN TO ORIGINATOR (YELLOW ) ORIGINATOR FILE (PINKJ DEPARTMENT FILE (GOLD) 7

1 f I • *i ^ *ASeTFORM.

10/84

o o

PURCHASE ORDER

CHANGE NOTICE

AMERICAN SAMOA GOVERNMENT

PAGO PAGO, AMERICAN SAMOA. ■ ..

ACCOUNT No. -7530-5994

P.R. No.

DEPARTMENT.Office of Procurement

TERMS

PURCHASE ORDER OATE

1/13/94□ F.0.8. □ C/F' □ CIF. POINT

THIS NUM8ER MUST APPEAR ON ALL PACKAGES ANO PAPERS RELATEO TO THIS ORDER CONCERNS:

P.a Na AND/OR CONTRACT No.

P041203-M

TO:

D3v1d K. Undarauth Co..,' Inc.

240 Valley Driver

Brisbane, California 94005 V

SPECIAL SHIPPING INSTRUCTIONSTlT-f-*

i ‘

i DATE OF:CHANGE NOTICE

125/26/95; -FOR INTERMEDIATE HANDUNG

□ SHIP TO ' Q CONTACT

□ DO NOT INSURE. THIS ORDER INSURED BY HARTFORD INSURANCE COMPANY (PAGO PAGO AMERICAN SAMOA)

I I PLEASE PREPAY INSURANCE ON AU PACKAGES1—* 1 SENT VIA SURFACE OR AIR MAIL.

ITEM No. SUPPLIES OR SERVICES UNIT UNIT

PRICE

CANCEL BALANCE 13 cyl $1,870.9»

NOTE: THIS CHANGE N0TICEIIS ISSUED TO CANCEL 8ALh OF ORIGINAL P.0. 41203.

NCE

IMPORTANT NOTICE

FOR PROMPT PAYMENT OF YOUR INVOICE-THE FOLLOWING MARKS MUST APPEAR ON ALL INVOICES. B/L, INDIVIDUAL PACKAGES AND SHIPPING CONTAINERS.

IMPORTANT | AIR MAIL ALL CORRESPONDENCE, BILLS OF LADING & CARRIER RECEIPTS

. PROCUREMENT OFFICER .TO 0 AMERICAN SAMOA GOVERNMENT 4

~ PAGO PAGO, AMERICAN SAMOA 96799 ™

RECEIVED FROM SUPPLY OPERATION DIVISION

ITEM(S) ________ ■■ '• .—--"/

SHIPPED VIA

RECD. BY __

.DATE

.DATE..

CHECKED AND RELEASED BY

TU8fe-HUHKWL--s(PROCUREMENT OFFICER)

AMERICAN SAMOA GOVERNMENT

v n

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