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DI-104ODPR <br />/-.a 7- 20/0 <br />�_O�L_ <br />United States <br />Department ofthe Interior <br />Geological Survey <br />DOWN:PAYMENT REQUEST' <br />Customer Address: <br />NEBRASKA COMMUNITY FOUNDATION NE076 <br />Attention: Chad.Smith <br />POiBOX 83107 <br />LINCOLN, NE 685103107 <br />11pescripaon: JQua <br />Agrectnent #09C3NCF83350005 <br />"Platte River1ecovery implementation program. <br />Page I of 1 <br />V <br />NE076 <br />]J <br />Request N—o--.O.;8335- DPRO02lI <br />RequestDate: 01/2712010 <br />Due Date: 03/28/2010 <br />.Mail -Check To: <br />DOI - USGS <br />BOX 70934 <br />CHARLOTTE NC 28272-0934 <br />11111d Ovemight/EamwMall To- <br />QLP Wholesale Lockbox -:NC 0810 <br />Lockbox #70934 <br />1525 West A Harris Blvd <br />Charlotte, NC 28282 <br />Checks must be made payable to:.' OIJJSGS,and must <br />.Include o Request eNo above. <br />Payments to USGS.may be made' by major credit cards, either by email to <br />ldren: gdxtta@m9LgoV OR by phone (701698.760S). <br />Jl <br />ity Ullit.Price Unit - IssueL_.Amount J <br />$21,332.00 EA $21,732:00 <br />00 <br />I certify that this Down Payment Request is correct, to accordance with the terms of the order/signed agreement, and payment has not been received. <br />Lori,D BuNnk <br />Prepared by: Lori -D Buitink 573-876-1892 Amount Due this Bill: $21,732.00 <br />U.SGS, ACCOUNTING CLASSIFICATION SECTION: <br />A I g # BFY LFY Amoun Fund <br />Rey Src Coss Center <br />09C3NCF83350005 20102011 NE016 $21,732.00 -SIRMR ARN 8335 <br />RolatingSlip: 21,732.00 *Total <br />Created'By- lori D Buitink <br />Su,pervisor. <br />OFMContact. <br />Denis J ShechaWAMUSGS/Dol 703-64&7642 <br />CC: Lori D Buitii* 71N.47-0769903 <br />- --------------- <br />011271201-0 <br />