ORDER FOR SUPPLIES OR SERVICES PAGE OF IMPORTANT: Mark all ckages and papers with contract andlor order numbers. 1 2 1. DATE OF ORDER 2. CONTRACT ND. 8! egg) 5. SHIP TO. 013 01/19/2013 3 NAME OFCONSICNEE :1 ORDER NO. 4. REOUISITIONIREFERENCE ND. Indlcated 0? call 5. ISSUING OFFICE {Address cmspondenca to} b. STREET ADDRESS ICEfDetention Compliance Remowals Immigration and Customs Enforcement Office of Acquisition Management 301 I Street, WASHINGTON DC 20536 u. STATE OZIPCODE 3 NAME CONTRACTOR CHARLOTTE COUNTY 0F 3. TYPE OF ORDER ?3 COMPANY ?m5 a. PURCHASE b. DELIVERY G. STREET ADDRESS REFERENCE YOURExcept for billing instructions on the reverse. this delivery order is subject In instructions coma-Red on this Side only of this term and Is Please furnish lhe lollownng on the terms issued subject to the terms and and commons Specn?ied on both sides of conditions at the I1 CITY 1 STATE f_ ZIP CODE lhIs order and on the attached sheet. if contract. PUNTA GOR DE. FL 3 3 8 2 am. includmn deII'VerV as Indicated. 9. ACCOUNTING ANDAPPROPRIATION DATA IS. REOUISITIONING OFFICE Indicated on call 11. BUSINESS CLASSIFICATION (Check approp?'aia boxfesll 12. FOB. POINT SMALL b. THER THAN SMALL . . a a. DISADVANTAGED [In WOMEN omen Des mat um I SERVICEDISABLEU g. WOMEN-OMED SMALL BUSINESS Epmsg VETERANOIIVNED ELIGIBLE UNDER THE WDSG PROGRAM 13. PLACE OF 14. GOVERNMENT NO. 15. DELIVER To FOB. POINT 1S. DISCOUNT TERMS ON OR BEFORE ram; 3. INSPECTION b. ACCEPTANCE Indica ted on call Destination Destination Indicated on call SCHEDULE {Set l'ar Rejections] QUANTITY UNIT DUANTITV ITEM NO. SUPPLIES OR SERVICES ORDERED UNIT PRICE AMOUNT ACCEPTED la} {bl Id} tel ill tel DUNS Numhe The purpose 15 Basrc Ordering Agreement is to al low ICE reasonable access to all detainees or inmates for purposes of interviewing such individuals for immig rat ion enforcement purposes . Pa yment Continued IS. SHIPPING POINT 19. GROSS SHIPPING WEIGHT 2D. INVOICE NO. Eml- (Cont. Raga-Si 21. MAIL INVOICE TO SI. NAME Indicated on call $0.00 SEE BILLING Imsmucrms DIV REVERSE (or PO. Box] 17m GRAND TOTAL c. CITY . STATE 9. ZIP CODE 5 0 0 22. UNITED STATES OF 23. NAME pod} AMERICA BY {Signamral TITLE: CONTRACTINGIORDERING OFFICER AUTHORIZED FOR LOCAL REPRODUCTION PREVIOUS EDITION MDT FORM 347.11.. 2mm amour War: 45 CFR :3 213m 201 108 ORDER FOR SUPPLIES OR SERVICES 2 PAGE NO IMPORTANT: Mm: all packages andpapnra with order mmbers. DATE UF GRDER CONTRACT NO. ITEM NO. SUPPLIESISERVICES ORDER NO. will be made via p-card. QUANTITY CIRDERE UNIT UNIT PRICE AMOUNT QUANTITY ACCEPTED {91 Period of Performance: 011?181'2023 Exempt Action: Sensitive Award: SPII 011?191?2018 to TOTAL CARRIED FORMED TD 1ST PAGE FOR LDCAL REPOIDUCTIDN PREVIOUS EDITION NOT USABLE 201 109 $11 00 OPTIONAL FORM 343 WI nun-magmas": crmsuum