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1. Contract Number 2. Invoice Date 3. Mobile Food Service Unit ID No. 4. Invoice No.
DAILY MEAL ORDER/INVOICE AG-024B-05-9017 06/15/05 K-1 1
MOBILE FOOD SERVICES 5. Incident Name 6. Job Code 7. Resource Order No. / Request No. 8. Benefiting Unit, Region / Agency
Big Bad Fire P6BKIB OR-SIF-000011 E-7 Wenatchee NF/R6/USFS
9. Paying Unit 10. Contractor Name and Address
INCIDENT BUSINESS-CONTRACTS Blagg’s Food Service
ALBUQUERQUE SERVICE CENTER 21885 Highway
101B SUN AVENUE NE Bella Vista, CA 96008
ALBUQUERQUE, NM 87109
11. 12. 13. 11. 12. 13.
Serve/ Menu and Menu Approvals Serve/ Menu and Menu Approvals
Meals C/I/D Major Items & Signatures Meals C/I/D Major Items & Signatures
Ordered Times* Ordered Times*
Breakfast Sack
Lunch
Government Representative Contractor Representative Government Representative Contractor Representative
Cold Can Dinner
Breakfast
600 1800
- 120i 1300
Government Representative Contractor Representative 720c 1445 Government Representative Contractor Representative
14. 15. Number and Price of meals For Payment Purpose 16.
Actual Number of Meal and Prices Price Per Meal
Meals Served / Time Totals
Breakfast -0-
Breakfast @ Price $ 13.25 $ -0-
Cold Can Br -0-
Cold Can Breakfast @ Price $ 14.25 $ -0-
Sack Lunch -0-
Sack Lunch @ Price $ 13.95 $ -0-
Dinner -0-
648 Dinner @ Price $ 19.15 $ 12,409.20
Subtotal: $ 12,409.20
17. Unit Description 18. 19. Mileage 20. Usage / Relocation Service 21.
and Number Location No. Price No. Price/Fee Totals
From: Redding, CA 420 mi. $ 14.25 Mileage
Kitchen $ 5,985.00
Unit K-1
To: Wenatchee, WA Relocation Fee
1 $ 600.00 Usage Fee $ 600.00
HandWashing HW-1
Station
22. SUPPLEMENTAL FOODS AND BEVERAGES (total from 1276-B) $ 0
23. MISCELLANEOUS CHARGES AND CREDITS (total from 1276-B) $ 0
24. TOTAL INVOICE AMOUNT $ 18,994.20
* Serve / Cancel / Increase / Decrease Times
25. REMARKS
Dinner order increased by 120 at 1300 hrs. Dinner order then cancelled by 720 at 1445. Contractor arrived at the incident on time and began
preparations, however they were unable to meet delivery schedule because the Government delayed selecting a location for the contractor to set-up.
90% rule applies to the number of meals ordered. Beginning Odometer Reading 156580, Ending Odometer Reading 157000.
26. I certify that the above mentioned services have been received 27. I certify that this bill is correct and payment has not been received
(Government Representative) (Contractor Representative)
Name (print / sign), Title, Work Address & Phone No. Name (print / sign), Title & Phone No.
Mike Government, FDUL Mike Government (208) Joe Contractor, Manager Joe Contractor (555)
387-5665 783-6556
1276-A (1/05)
1. Contract Number 2. Invoice Date 3. Mobile Food Service Unit ID No. 4. Invoice No.
DAILY MEAL ORDER/INVOICE AG-024B-05-9017 06/16/05 K-1 2
MOBILE FOOD SERVICES 5. Incident Name 6. Job Code 7. Resource Order No. / Request No. 8. Benefiting Unit, Region / Agency
Big Bad Fire P6BKIB OR-SIF-000011 E-7 Wenatchee NF/R6/USFS
9. Paying Unit 10. Contractor Name and Address
INCIDENT BUSINESS-CONTRACTS Blagg’s Food Service
ALBUQUERQUE SERVICE CENTER 21885 Highway
101B SUN AVENUE NE Bella Vista, CA 96008
ALBUQUERQUE, NM 87109
11. 12. 13. 11. 12. 13.
Serve/ Menu and Menu Approvals Serve/ Menu and Menu Approvals
Meals C/I/D Major Items & Signatures Meals C/I/D Major Items & Signatures
Ordered Times* Ordered Times*
Breakfast Sack
Lunch
800 0600 720 0500
Government Representative Contractor Representative Government Representative Contractor Representative
Cold Can Dinner
Breakfast
800 1700
-
Government Representative Contractor Representative Government Representative Contractor Representative
14. 15. Number and Price of meals For Payment Purpose 16.
Actual Number of Meal and Prices Price Per Meal
Meals Served / Time Totals
Breakfast 715 / 0600
720 Breakfast @ Price $ 13.25 $ 9,540.00
Cold Can Br -0-
Cold Can Breakfast @ Price $ 14.25 $ -0-
Sack Lunch 720 / 0500
720 Sack Lunch @ Price $ 13.95 $ 10,044.00
Dinner 750 / 1700
750 Dinner @ Price $ 19.15 $ 14,362.50
Subtotal: $ 33,946.00
17. Unit Description 18. 19. Mileage 20. Usage / Relocation Service 21.
and Number Location No. Price No. Price/Fee Totals
Kitchen From: Mileage
Unit
To: Relocation Fee
1 $ 600.00 Usage Fee $ 600.00
HandWashing HW-1
Station
22. SUPPLEMENTAL FOODS AND BEVERAGES (total from 1276-B) $ 0
23. MISCELLANEOUS CHARGES AND CREDITS (total from 1276-B) $ -340.00
24. TOTAL INVOICE AMOUNT $ 34,206.50
* Serve / Cancel / Increase / Decrease Times
25. REMARKS
All meals ordered 6/15 @ 1500 hrs.
26. I certify that the above mentioned services have been received 27. I certify that this bill is correct and payment has not been received
(Government Representative) (Contractor Representative)
Name (print / sign), Title, Work Address & Phone No. Name (print / sign), Title & Phone No.
Mike Government, FDUL Mike Government (208) Joe Contractor, Manager Joe Contractor (555)
387-5665 783-6556
1276-A (1/05)
DAILY MEAL ORDER/INVOICE – MOBILE FOOD SERVICES (CONTINUATION SHEET)
28. SUPPLEMENTAL FOODS AND BEVERAGES
Date Ordered Food Unit Leader Contractor Invoice No.
6/16/05 Mike Government Blagg’s Food Service Unit K-1 2
Item Unit Units Units Date Received Unit Extended
Ordered Received & Initials Price Price
Fruit Juices (48/case) (5-6 oz. each) case $ $
Milk (48/case) (8 oz. each) case $ $
Bottled Sports Type Drink ounce $ $
Brewed Coffee (outside incident dining area) gallon $ $
Hot Chocolate (outside incident dining area) gallon $ $
Tea (iced or hot) (outside incident dining area) gallon $ $
Bottled Water ounce $ $
Trail Mix ounce $ $
Granola Bars ounce $ $
Salted Peanuts ounce $ $
Salted Mixed Nuts ounce $ $
Yogurt ounce $ $
Fresh Apples (minimum size 100 count) case $ $
Fresh oranges (minimum size 88 count) case $ $
Fresh Whole Bananas pound $ $
Dried Apricots (pre-packaged) ounce $ $
Dried Prunes (pre-packaged) ounce $ $
Dried Banana Chips (pre-packaged) ounce $ $
Soup for 25 persons gallon $ $
Stew for 25 persons gallon $ $
Dinner Rolls (wheat and/or white) dozen $ $
Ice pound $ $
Ground Coffee pound $ $
TOTAL: $
29. MISCELLANEOUS CHARGES AND CREDITS
Item Description Amount
Optional Refer 10 sq. ft. @ $2.00/sq. ft. $ 20.00
Space
$
W.O. #1 $3.00 deduction for 120 sack lunches see remarks below $ -360.00
$
TOTAL: $ -$340.00
30. REMARKS
Optional Refer space needed to store excess sack lunches. Gov’t. refer not available.
120 sack lunches did not provide 2nd entrée as required. Contractor agrees to $3.00 deduction/sack lunch for this
deficiency.
31. I certify that the above charges and/or credits are correct.
Government Representative and Date 6/16/05 Contractor Representative and date 6/16/05
Mike Government, FDUL Mike Government Joe Contractor, Manager Joe Contractor (555)
(208) 387-5665 783-6556
1276-B (1/05)
1. Contract Number 2. Invoice Date 3. Mobile Food Service Unit ID No. 4. Invoice No.
DAILY MEAL ORDER/INVOICE AG-024B-05-9017 06/17/05 K-1 3
MOBILE FOOD SERVICES 5. Incident Name 6. Job Code 7. Resource Order No. / Request No. 8. Benefiting Unit, Region / Agency
Big Bad Fire P6BKIB OR-SIF-000011 E-7 Wenatchee NF/R6/USFS
9. Paying Unit 10. Contractor Name and Address
INCIDENT BUSINESS-CONTRACTS Blagg’s Food Service
ALBUQUERQUE SERVICE CENTER 21885 Highway
101B SUN AVENUE NE Bella Vista, CA 96008
ALBUQUERQUE, NM 87109
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