Page: 1 of 4

19AF2021P0589

ORDER FOR SUPPLIES OR SERVICES

IMPORTANT: Mark all packages and papers with contract and/or order numbers. PAGE OF PAGES
Page 1
1. DATE OF ORDER 2. CONTRACT NO.(If any) 6. SHIP TO:
27 Jul 2021 19AF2021P0589, KABUL
3. ORDER NO. 4. REQUISITION/REFERENCE NO. a. NAME OF CONSIGNEE
19AF2021P0589 PR10063574 ATTN: GSO/WAREHOUSE

5. ISSUING OFFICE (Address correspondence to) b. STREET ADDRESS

AMERICAN EMBASSY KABUL GREAT MASOUD ROAD
GREAT MASOUD ROAD ATTN: GSO/PROCUREMENT
KABUL, c. CITY d. STATE e. ZIP CODE
KABUL
Contact Name: Silvia Sicorschi
Phone: f. SHIP VIA
Email: SicorschiS@state.gov
7. TO: 8. TYPE OF ORDER

a. NAME OF CONTRACTOR CONTACT PHONE NUMBER a. PURCHASE ORDER b. DELIVERY ORDER -- Except for billing
ENG AHMAD 93(0) 798 782 501 REFERENCE YOUR: _______ instructions on the reverse, this delivery order
is subject to instructions contained on this side
DUNS NUMBER E-MAIL:
Please furnish the following on the terms and conditions only of this form and is issued subject to the
123456787 gtcc.afg@gmail.com specified on both sides of this order and on the attached sheet, terms and conditions of the above-numbered
FAX: if any, including delivery as indicated. contract.

b. COMPANY NAME
Green Tree Construction Supply Co
Legal Name: Green Tree Construction & Supply Co

c. STREET ADDRESS
AFGANISTAN KABUL

d. CITY e. STATE f. ZIP CODE 10. REQUISITIONING OFFICE

AMERICAN EMBASSY KABUL
9.ACCOUNTING AND APPROPRIATION DATA ATTN: FACILITIES
See line item detail. $7,900.00USD

Funds Certification Officer Signature:

11. BUSINESS CLASSIFICATION (Check appropriate box(es)) 12. F.O.B. POINT

a. SMALL b. OTHER THAN SMALL c. DISADVANTAGED Destination
d. WOMEN-OWNED e. HUBZone f. SERVICE-DISABLED VETERAN-OWNED
g. WOMEN-OWNED SMALL BUSINESS (WOSB) ELIGIBLE UNDER h. EDWOSB
THE WOMEN-OWNED SMALL BUSINESS PROGRAM
13. PLACE OF 14. GOVERNMENT B/L NO. 15. DELIVER TO F.O.B. POINT ON OR BEFORE (Date) 16. DISCOUNT TERMS
a. INSPECTION b. ACCEPTANCE 15 Aug 2021

17. SCHEDULE (See reverse for Rejections)

ITEM NO. SUPPLIES OR SERVICES QUANTITY UNIT UNIT PRICE AMOUNT QUANTITY ACCEPTED
(a) (b) ORDERED (d) (e) (f) (g)
(c)

SEE LINE ITEM DETAIL

SEE BILLING 18. SHIPPING POINT 19. GROSS SHIPPING 20. INVOICE NO. 17(h) TOT.
WEIGHT (Cont. pages)
21. MAIL INVOICE TO:
INSTRUCTIONS ON
REVERSE
a. NAME
AMERICAN EMBASSY KABUL
b. STREET ADDRESS (or P.O. Box) 7,900.00USD (AFG) 17(i)
GREAT MASOUD ROAD (KabulFMCDBO@state.gov) (GRAND TOTAL)
ATTN: FMC
c. CITY d. STATE e. ZIP CODE
KABUL
22. UNITED STATES OF AMERICA BY (Signature) 23. NAME Typed
Miguel Danzot

TITLE: CONTRACTING/ORDERING OFFICER

27 Jul 2021

AUTHORIZED FOR LOCAL REPRODUCTION OPTIONAL FORM 347(REV. 9/2012)

PREVIOUS EDITION NOT USABLE Prescribed by GSA/FAR 48 CFR 53.213(f)
 Page: 2 of 4
19AF2021P0589

ORDER FOR SUPPLIES OR SERVICES PAGE NO.

SCHEDULE - CONTINUATION
IMPORTANT: Mark all packages and papers with contract and/or order numbers.
DATE OF ORDER TITLE CONTRACT NO. ORDER NO.
27 Jul 2021 FMS-Electrical Parts For Stock-M&R-OFM 19AF2021P0589

ITEM NO. SUPPLIES OR SERVICES QUANTITY UNIT UNIT PRICE AMOUNT QUANTITY
(a) (b) ORDERED (d) (e) (f) ACCEPTED
(c) (g)

0001 1/2" liquid tight connector 100.00 each 0.70USD (AFG) 70.00USD (AFG)

Fiscal Data:
70.00USD (AFG) 1900-2021--19___X0535000C-2604-OBO-
-7904-19AF2021P0589-2652-XJZMSUST---------

0002 2" electrical PVC pipe schedule 40 900.00 foot 1.40USD (AFG) 1,260.00USD (AFG)

Fiscal Data:
1260.00USD (AFG) 1900-2021--19___X0535000C-2604-OBO-
-7904-19AF2021P0589-2652-XJZMSUST---------

0003 3/4" electrical PVC pipe schedule 40 450.00 foot 0.80USD (AFG) 360.00USD (AFG)

Fiscal Data:
360.00USD (AFG) 1900-2021--19___X0535000C-2604-OBO-
-7904-19AF2021P0589-2652-XJZMSUST---------

0004 Square box 4X4"X2 1/2",knockout 1/2" and 3/4", 200.00 each 2.80USD (AFG) 560.00USD (AFG)

Fiscal Data:
560.00USD (AFG) 1900-2021--19___X0535000C-2604-OBO-
-7904-19AF2021P0589-2652-XJZMSUST---------

0005 Square box 4X4"X1 1/2",knockout 1/2" and 3/4", 200.00 each 2.80USD (AFG) 560.00USD (AFG)

Fiscal Data:
560.00USD (AFG) 1900-2021--19___X0535000C-2604-OBO-
-7904-19AF2021P0589-2652-XJZMSUST---------

0006 Hubbell doublex receptacle 220v,20amp 250.00 each 2.50USD (AFG) 625.00USD (AFG)

Fiscal Data:
625.00USD (AFG) 1900-2021--19___X0535000C-2604-OBO-
-7904-19AF2021P0589-2652-XJZMSUST---------

0007 PVC cable gland BMX-22-W 150.00 each 1.30USD (AFG) 195.00USD (AFG)

Fiscal Data:
195.00USD (AFG) 1900-2021--19___X0535000C-2604-OBO-
-7904-19AF2021P0589-2652-XJZMSUST---------

0008 PVC cable gland BMX-24-W 150.00 each 1.30USD (AFG) 195.00USD (AFG)

Fiscal Data:
195.00USD (AFG) 1900-2021--19___X0535000C-2604-OBO-
-7904-19AF2021P0589-2652-XJZMSUST---------

0009 1/2" one hole clamp 1,000.00 each 0.12USD (AFG) 120.00USD (AFG)

Fiscal Data:
120.00USD (AFG) 1900-2021--19___X0535000C-2604-OBO-
-7904-19AF2021P0589-2652-XJZMSUST---------
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19AF2021P0589

0010 3/8' one hole clamp 600.00 each 0.30USD (AFG) 180.00USD (AFG)

Fiscal Data:
180.00USD (AFG) 1900-2021--19___X0535000C-2604-OBO-
-7904-19AF2021P0589-2652-XJZMSUST---------

0011 1" EMT uni strut clamp 200.00 each 0.90USD (AFG) 180.00USD (AFG)

Fiscal Data:
180.00USD (AFG) 1900-2021--19___X0535000C-2604-OBO-
-7904-19AF2021P0589-2652-XJZMSUST---------

0012 2" EMT uni strut clamp 150.00 each 1.40USD (AFG) 210.00USD (AFG)

Fiscal Data:
210.00USD (AFG) 1900-2021--19___X0535000C-2604-OBO-
-7904-19AF2021P0589-2652-XJZMSUST---------

0013 RACO metal electrical box for inside drywall 50.00 each 2.90USD (AFG) 145.00USD (AFG)
3"X2"X21/2",1gang

Fiscal Data:
145.00USD (AFG) 1900-2021--19___X0535000C-2604-OBO-
-7904-19AF2021P0589-2652-XJZMSUST---------

0014 Scotch electrical tape orange color 20.00 each 7.00USD (AFG) 140.00USD (AFG)

Fiscal Data:
140.00USD (AFG) 1900-2021--19___X0535000C-2604-OBO-
-7904-19AF2021P0589-2652-XJZMSUST---------

0015 Scotch electrical tape Yellow color 20.00 each 7.00USD (AFG) 140.00USD (AFG)

Fiscal Data:
140.00USD (AFG) 1900-2021--19___X0535000C-2604-OBO-
-7904-19AF2021P0589-2652-XJZMSUST---------

0016 Scotch electrical tape Brown color 20.00 each 7.00USD (AFG) 140.00USD (AFG)

Fiscal Data:
140.00USD (AFG) 1900-2021--19___X0535000C-2604-OBO-
-7904-19AF2021P0589-2652-XJZMSUST---------

0017 Scotch electrical tape White color 20.00 each 7.00USD (AFG) 140.00USD (AFG)

Fiscal Data:
140.00USD (AFG) 1900-2021--19___X0535000C-2604-OBO-
-7904-19AF2021P0589-2652-XJZMSUST---------

0018 Scotch electrical tape ground color 20.00 each 7.00USD (AFG) 140.00USD (AFG)

Fiscal Data:
140.00USD (AFG) 1900-2021--19___X0535000C-2604-OBO-
-7904-19AF2021P0589-2652-XJZMSUST---------

0019 Weatherproof LED spotlight fixture 50w,220v 30.00 each 29.00USD (AFG) 870.00USD (AFG)

Fiscal Data:
870.00USD (AFG) 1900-2021--19___X0535000C-2604-OBO-
-7904-19AF2021P0589-2652-XJZMSUST---------
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19AF2021P0589
0020 Weatherproof LED spotlight fixture 100w,220v 20.00 each 58.00USD (AFG) 1,160.00USD (AFG)

Fiscal Data:
1160.00USD (AFG) 1900-2021--19___X0535000C-2604-OBO-
-7904-19AF2021P0589-2652-XJZMSUST---------

0021 Weatherproof LED spotlight fixture 30w,220v 10.00 each 16.00USD (AFG) 160.00USD (AFG)

Fiscal Data:
160.00USD (AFG) 1900-2021--19___X0535000C-2604-OBO-
-7904-19AF2021P0589-2652-XJZMSUST---------

0022 HUBBELL doublex receptacle wall plate stainless 50.00 each 3.00USD (AFG) 150.00USD (AFG)
cover

Fiscal Data:
150.00USD (AFG) 1900-2021--19___X0535000C-2604-OBO-
-7904-19AF2021P0589-2652-XJZMSUST---------

0023 Delivery Charges 1.00 lump sum 200.00USD (AFG) 200.00USD (AFG)

Fiscal Data:
200.00USD (AFG) 1900-2021--19___X0535000C-2604-OBO-
-7904-19AF2021P0589-2201-XJZMSUST---------

TOTAL CARRIED FORWARD TO 1ST PAGE (ITEM 17h) 7,900.00USD (AFG)

AUTHORIZED FOR LOCAL REPRODUCTION OPTIONAL FORM 348 (REV. 9/2012)

PREVIOUS EDITION NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.213(f)