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( con el motored and proper WERENCUS To

ACCOUNT TCC

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INSTRUCTIONS TO SELLER Aner melalaetary helyntikcation of the Government representative presenting the rahan wukur, wrify the iteminti, incluling quantu. Wait price, anonte wulan diarwunt vtine. Thle furm beland that Cry muy le nei mah rement toolio

your Inruire lag umpleting. - ppt prints, rither the i'w munt leo Farming Awal Works and signing the Weller Wertiun. II would rather oulent your swn invvire, WU XOT SIGX Core 1, but ottare whole wr Invvine Avalite verification and proving for me

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O CASH DATE PALO

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VOUCHER NO.
PALO OY
All manera

1. SELLER'S INVOICI
(to lastrostions a Copy ?)

2 SOLLIR'S COPT OR OLDER

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91-1690-129 Santed Farm In Badder's Math La Application (a) Page 1 of Sindard Form 129

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SPECIÁEN

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TYPE OF OWNERSHIP (See Lotrition as reurs)
MINORITY BUSINESS ENTERPRISE

OTHER THAN MINORITY BUSINESS ENTERPRISE

TE OF BUSINESS (See defnitions en reverse)
MANUFACTURER OR PRODUCER
REGULAR DEALER iton ?

REGULAR DEALER (

**)
SERVICE ESTABLISHMENT
CONSTRUCTION CONCERN

RESEARON AND DEVELOPMENT PRO
SURPLUS DEALER (Check this bar ū you ere eis e dealer in emplu nud)

SIZE OF BUSINESS (See detritions or reverse)
SMALL BUSINESS CONCERN

I OTHER THAN SMALL BUSINESS CONCERN

() AVERAGE NUMBER OF EMPLOYEES noted To AVERAGE ANNUAL SALON MECEIPTS POW 11 you are mall busineu

ingheter FOR FOUR PRECEDING CALEN MECEDING TNRCE FISCAL YEARS concen, min (.) and (d):

DÁR QUARTERS

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MANUFACTURING

DATE

AMOUNT

14

SECURITY CLEARANCE (Il applicadle, check Aighest clearance authorized)
FOR TOP SECRET SECRET CONFIDENTIAL NAMES OF AGENCIES WNICN GRANTED SECURITY CLEARANCES (include datee)
KEY PERSONNEL
PLANT ONLY
THIS SPACE FOR USE IT THE GOVERNMENT

CERTIFICATION
I certify that information supplied herein including #ll pagre attached)
is correct and that neither the applicant nor any person . CONEN) in any
connection with the applicant as principal or once, so far . Anown
now debarred or otherwise declared ineligible by any agency of the Federal
Government from bidding for furnishing materials, supplies, of vervies to the
Government or any agency thereot.
SIGNATURE

NAME AND TITLE OF PERSON AUTHORIZED TO SIGN Tupe *** **)

129-105

STANDARD FORM IN (REV. 2->) Prescribed by USA FPR (41 CPN) 1-16 003

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KNOW ALL MEN BY THESE PRESENTS, That we, the Principal and Swety (les) hereto, are Armly bound to the United States of America (hereinafter called the Government) in such penal sum or sums as shall be sus. ficicnt to indemnify the Government in case of the defaiut of the said Principal as hereinafter set forth, for the payment of which we bind ourselves, our heirs, executors, administrators, and succesors, jointly and severally.

THE CONDITION OF THIS OBLIGATION IS SUCH, that whereas the principal contemplates submitting bids from time to time during the fiscal year above shown to the kidpastarat or agency named above for furnishing supplies or services to the Government and desires that in such blets submitted for opening during said fiscal year be covered by a single bond instead of b344 xerana dil bid dond for cach bid.

Now, THEREFORE, if the Principal por accomande bythe Government of any such bid within the period specified therein for acceptance simt 60 diasts ir ne period is specified), shall execute such further contractual documents, if any, and traand sa may be required by the terms of the bid as accepted within the time specified (ten (10) dux fo period is specified) after receipt of forms by him, or in the event of failure so to exccute such further Healtractual documents and give such bond(s), if the Principal shall pay the Government for any cost of pleculing the work which exceeds the amount of his bid, then the above obligation shall be void and of no effect.

IN WITNESS WHEREOF, the Principal and Surety(les) have executed this bid bond and have adxed their seals on the date set forth above.

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