Fillable Printable Order For Supplies Or Services
Fillable Printable Order For Supplies Or Services
Order For Supplies Or Services
ORDER FOR SUPPLIES OR SERVICES
PAGE OF PAGES
IMPORTANT: Mark all packages and papers with contract and/or order numbers.
1. DATE OF ORDER
2. CONTRACT NUMBER (If any)
3. ORDER NUMBER
4. REQUISITION/REFERENCE NUMBER
5. ISSUING OFFICE (Address correspondence to)
6. SHIP TO:
a. NAME OF CONSIGNEE
b. STREET ADDRESS
c. CITY
d. STATE
e. ZIP CODE
f. SHIP VIA
8. TYPE OF ORDER
a. PURCHASE
REFERENCE YOUR:
7. TO:
a. NAME OF CONTRACTOR
b. COMPANY NAME
c. STREET ADDRESS
d. CITY e. STATE f. ZIP CODE
b. DELIVERY -- Except for billing
instructions on the reverse, this delivery
order is subject to instructions contained
on this side only of this form and is
issued subject to the terms and
conditions of the above-numbered
contract.
17. SCHEDULE (See reverse for Rejections)
22. UNITED STATES OF
AMERICA BY (Signature)
23. NAME (Typed)
TITLE: CONTRACTING/ORDERING OFFICER
SEE BILLING
INSTRUCTIONS
ON
REVERSE
18. SHIPPING POINT
19. GROSS SHIPPING WEIGHT 20. INVOICE NUMBER
21. MAIL INVOICE TO:
a. NAME
b. STREET ADDRESS (or P.O. Box)
c. CITY
d. STATE e. ZIP CODE
17(h) TOT.
(Cont.
pages)
17(i)
GRAND
TOTAL
OPTIONAL FORM 347 (REV. 2/2012)
Prescribed by GSA/FAR 48 CFR 53.213(f)
9. ACCOUNTING AND APPROPRIATION DATA 10. REQUISITIONING OFFICE
11. BUSINESS CLASSIFICATION (Check appropriate box(es))
a. SMALL
Please furnish the following on the terms and
conditions specified on both sides of this
order and on the attached sheet, if any,
including delivery as indicated.
AUTHORIZED FOR LOCAL REPRODUCTION
PREVIOUS EDITION NOT USABLE
d. WOMEN-OWNED
h. EDWOSB
12. F.O.B. POINT
13. PLACE OF
a. INSPECTION b. ACCEPTANCE
14. GOVERNMENT B/L NUMBER
15. DELIVER TO F.O.B. POINT ON
OR BEFORE (Date)
16. DISCOUNT TERMS
b. OTHER THAN SMALL c. DISADVANTAGED
g. WOMEN-OWNED SMALL BUSINESS (WOSB)
ELIGIBLE UNDER THE WOSB PROGRAM
e. HUBZone
f. SERVICE-DISABLED
VETERAN-OWNED
ITEM
NUMBER
(a)
SUPPLIES OR SERVICES
(b)
QUANTITY
ORDERED
(c)
UNIT
(d)
UNIT
PRICE
(e)
AMOUNT
(f)
QUANTITY
ACCEPTED
(g)
$
SUPPLEMENTAL INVOICING INFORMATION
If 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
SHIPMENT
NUMBER
PARTIAL
FINAL
DATE RECEIVED SIGNATURE OF AUTHORIZED U.S. GOVERNMENT REPRESENTATIVE DATE
TOTAL CONTAINERS
GROSS WEIGHT
RECEIVED AT TITLE
REPORT OF REJECTIONS
ITEM
NUMBER
SUPPLIES OR SERVICES
UNIT
QUANTITY
REJECTED
REASON FOR REJECTION
OPTIONAL FORM 347 (REV. 2/2012) BACK
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.
inspected, accepted, received by me
