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I11 O'K all 138cmg -A And Adders With Mltragt And/,, g,do, ito, drs. <br />1. DATA OF ORDER 2, CONTRACT NO. (If -ay) <br />05/29/2015 EROIG8A -15 -0007 <br />3, ORDER N0, 4, REQUISITION / RRFERENCE N0. <br />n/a <br />S. ISSUING OFFICE (Address oorroepondeno- to) <br />ICE / Detest Mngt /Detest Contract -LAG <br />Immigration and Oustoma Enforcement <br />Office of Acquisition Management <br />24000 Avila Road, Room 3104 <br />Attn: Natasha Nguyen (949)425 -7030 <br />Laguna Ni5ueI CA 92677 <br />7. TO: <br />9. NAME OF CONTRACTOR <br />BANTA ANA CITY OF <br />b. COMPANY NAME <br />o, STREE7ADDRE88 <br />20 CIVIC CENTER PLAZA <br />6, SHIP TO! <br />a. NAME OF CONSIGNEE <br />See IGSA Facility Location <br />b. STREAM ADDRESS <br />a. CITY <br />I. SHIP VIA <br />❑e, PURCHASE <br />REFERENCE YOUR: <br />Flees- furnish the following an the terms <br />-70 and - Adldona epadflod on bath sides of <br />SANTA ANA % $TATE t. ZIP CODE thls order end nn the Atlachod shoat, It any, <br />CA 92701 InclUdldgdallv-ry as Indio -led. <br />B. ACCtlUNTING AND APPROPRIATION DATA TD REQUISITIONING OFFICE <br />17. BUSINESSCLA$81POATION (CAaoA appropd -fa dok(ee)) r Tc, Enforcement & Remc <br />❑ a. SMALL X] It. OTHERTHAN SMALL El a. DISADVANTAGED Lid. WOMEN -OWNED rr--�� <br />IJ e. NUBZcne <br />Qt I WOMEN OSB) <br />RAN -OWNED FLIOIBIEUNDER THE WO33 PROGRAM <br />VETERAN-OWNED E] Ill ECVV08U <br />19. PLAGOOF N. OOVERNMENT2 /L NO, 1SDRLIVERTOFO.S. P, <br />a. INSPECTION b. ACCEPTANCE ON OR BEFORR (Usk) <br />Destination Destination 07/31/2020 <br />17. SCHEDULm <br />a)acr/nPv <br />ITEM NO. SUPPLIES OR SERVICE$ UNIT <br />(a) (b) NIT PRICE <br />dl a) <br />DUNS Nnmber: 069153247 <br />COR POO: Daniel Polnplun, (760) 561 -63 <br />e —'nail at This is a fined rate IGSA to allpply <br />Continued 20. INVOICE N0, ,� 21 MAIL INVOI <br />SE6 -&LING <br />I07OOTIONS b.STREETi <br />ONRavaRAa (Or H.0, BOX) <br />RTilliaton <br />22. UNITED STATES OF — <br />AMERICA BY (81BndAlm) <br />D14S, ICE <br />BurIA11FOrt I:inaance Centel: <br />P.C. Box 1620 <br />Attn: ICE - ERG- FOD -P'LS <br />PAUE OF PAGES <br />1 2 <br />d. STATE I e. ZIP CODE <br />LJ Ix DELIVERY <br />IMOPt for blllin® Inelmollans on the <br />reverse, thls dallvery order Is subject <br />to instructions "tamed on the olda <br />only of this form and In lasu-d <br />aub(eot to An. Gamma and aondhons <br />Of In- Abovs•numbored o,,kaat. <br />Destination <br />AMOUNT <br />0,00 <br />d, 000 <br />VT 05495 -1620 <br />23, NAME mp-d) <br />Roberta .7, 4a11E <br />TITLE! CONTRACTING /ORUER[NG OFFICER <br />25G -45 <br />Net 30 <br />QUANTITY <br />ACCEPTED <br />(0) <br />r] <br />17(1) <br />GRAND <br />TOTAL <br />14 <br />MOM <br />4 Igo <br />