MEAL, RELIGIOUS, KOSH

ORDER FOR SUPPLIES OR SERVICES 1. CONTRACT/PURCH ORDER/AGREEMENT NO. 2. DELIVERY ORDER/CALL NO. 4. REQUISITION/PURCH REQUEST NO.3. DATE OF ORDER/CALL (YYYYMMMDD) 5. PRIORITY 6. ISSUED BY 7. ADMINISTERED BY (If other than 6) 8. DELIVERY FOB CODE CODE 9. CONTRACTOR FACILITY CODE NAME AND ADDRESS 10. DELIVER TO FOB POINT BY (Date) (YYYYMMMDD) 12. DISCOUNT TERMS 13. MAIL INVOICES TO THE ADDRESS IN BLOCK DESTINATION OTHER (See Schedule if other) 11. X IF BUSINESS IS SMALL SMALL DISAD- VANTAGED WOMEN-OWNED 14. SHIP TO 15. PAYMENT WILL BE MADE BY MARK ALL PACKAGES AND PAPERS WITH IDENTIFICATION NUMBERS IN BLOCKS 1 AND 2. CODE 16. TYPE OF ORDER DELIVERY/ CALL This delivery order/call is issued on another Government agency or in accordance with and subject to terms and conditions of above numbered contract. PURCHASE Reference your furnish the following on terms specified herein. ACCEPTANCE. THE CONTRACTOR HEREBY ACCEPTS THE OFFER REPRESENTED BY THE NUMBERED PURCHASE ORDER AS IT MAY PREVIOUSLY

HAVE BEEN OR IS NOW MODIFIED, SUBJECT TO ALL OF THE TERMS AND CONDITIONS SET FORTH, AND AGREES TO PERFORM THE SAME. NAME OF CONTRACTOR SIGNATURE TYPED NAME AND TITLE DATE SIGNED (YYYYMMMDD) If this box is marked, supplier must sign Acceptance and return the following number of copies: 17. ACCOUNTING AND APPROPRIATION DATA/LOCAL USE 18. ITEM NO. 19. SCHEDULE OF SUPPLIES/SERVICES 20. QUANTITY ORDERED/ ACCEPTED* 21. UNIT 22. UNIT PRICE 23. AMOUNT * If quantity accepted by the Government is same as quantity ordered, indicate by X. If different, enter actual quantity accepted below quantity ordered and encircle. 24. UNITED STATES OF AMERICA CONTRACTING/ORDERING OFFICER 25. TOTAL 26. DIFFERENCES 27a. QUANTITY IN COLUMN 20 HAS BEEN INSPECTED RECEIVED ACCEPTED, AND CONFORMS TO THE CONTRACT EXCEPT AS NOTED: b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVEc. DATE (YYYYMMMDD) e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 28. SHIP. NO. 29. D.O. VOUCHER NO. 30. INITIALS 32. PAID BY FINAL PARTIAL 33. AMOUNT VERIFIED CORRECT FOR f. TELEPHONE NUMBER g. E-MAIL ADDRESS 36. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT. a. DATE (YYYYMMMDD) b. SIGNATURE AND TITLE OF CERTIFYING OFFICER DD FORM 1155, DEC 2001 37. RECEIVED AT 38. RECEIVED BY (Print) 39. DATE RECEIVED (YYYYMMMDD) PREVIOUS EDITION IS OBSOLETE. 31. PAYMENT COMPLETE PARTIAL FINAL 40. TOTAL CON- TAINERS 41. S/R ACCOUNT NUMBER 42. S/R VOUCHER NO. 34. CHECK NUMBER 35. BILL OF LADING NO. SPE3S1-24-D-5002 SPE3S1-24-F-0507 2024 MAR 03 7006603918 DLA TROOP SUPPORT SUBSISTENCE SUPPLY CHAIN 700 ROBBINS AVENUE PHILADELPHIA PA 19111-5096 USA Criticality: C Pre-Award Survey : None 81N32 X HEALTHWAY GROUP BY LABRIUTE LLC DBA HEALTHWAY GROUP 520 JAMES ST LAKEWOOD NJ 08701-4052 USA 2024 MAR 18 Net 30 days X SEE SCHEDULE, DO NOT SHIP TO ADDRESSES ON THIS PAGE DEF FIN AND ACCOUNTING SVC BSM P O BOX 182317 COLUMBUS OH 43218-2317 USA X BX: 97X4930 5CBX 001 2620 S33189 $56,540.00 SPE3S1 SPE3S1 DO-P3 SL4701 DLA TROOP SUPPORT SUBSISTENCE SUPPLY CHAIN 700 ROBBINS AVENUE PHILADELPHIA PA 19111-5096 USA Local Admin: Jayson Marbach Tel: 215-737-7346-X-7346 Email: Jayson.1.Marbach@dla.mil Submit Invoices IAW DFARS 252.232-7003 Jasmine Brown CODE Adobe Professional 8.0 PAGE 1 OF Jasmine Brown JASMINE.BROWN@DLA.MIL 2024 MAR 03 200 2 See Section B. Terms and Conditions in accordance with Basic Contract CONTINUATION SHEET REFERENCE NO. OF DOCUMENT BEING CONTINUED: PAGE 2 OF 2 PAGES SPE3S1-24-D-5002-SPE3S1-24-F-0507 SECTION B DO Counter: 000022 PR: 7006603918 SUPPLIES/SERVICES: 8970015248003 SEE BASIC MEAL,RELIGIOUS,KOSH CLIN BASIC QUANTITY UI UNIT PRICE DOLLAR VALUE DELIVERY REF DATE CLIN . 0001 0002 200.000 BX 282.7000 56540.00 2024 MAR 18 QTY VARIANCE: PLUS 0.00% MINUS 0.00% INSPECTION POINT: DESTINATION ACCEPTANCE POINT: DESTINATION DELIVER FOB: DESTINATION FOB PAYMENT METHOD: CONTRACTOR PARCEL POST ADDRESS: W36N0Q W6YB USALRCTR FT LIBERTY BLDG J1854 WAREHOUSE ROAD FORT LIBERTY NC 28310-0000 US SHIP BY TRACEABLE MEANS. DO NOT USE PARCEL POST. FREIGHT SHIPPING ADDRESS: W36N0Q W6YB USALRCTR FT LIBERTY BLDG J1854 WAREHOUSE ROAD FORT LIBERTY NC 28310-0000 US M/F: (TCN) W36N0Q33496181 RDD: 078 PROJ: TP 3 SUPP ADD: W36N0Q SIG: J FOR GOVERNMENT USE ONLY: (IPD) 09 DIC: A0A DIST: ADV: FC: 45 W36N0Q33496181 GOVT USE External External External Customer RDD/ ITEM PR PRLI PR PRLI Material Need Ship Date . 0001 7006603918 0001 N/A N/A N/A N/A * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *