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{~'h~ Form must be prepared by Contractor, al~d attach t'o Purchase Order.) <br />:od User: O~ ComPrador: L ~ W ~ e ~ C e ~ a r ~ h a I ] <br /> <br /> Item Base Ua~t Pr~e, Pa: ~-GAC Contract: ~ A: <br /> ~p~on Cost Co~e' D~ac~ptiou ) C~ <br /> <br /> .... $~ .b~O~at Fr~m ~d~lto~ai S~e~t(s): <br /> <br /> Uupubl~haO Opt;on~ ~utiz~ below'and attach ~di~io~al sheet(~) if ~ ;~s~ry) ,, , <br /> <br /> Codo ~scrip~on Cost Code Descrip~on Coat <br /> <br /> I From AdSttlanal <br /> Subto~.aI <br /> Cheek: 'fatal cO~t of Uno'bilabial Opfion~ (C) a~no; ~;~d 2~ of ~ ~ Price pl~ ~l~sh~ ~o~ <br /> <br /> ~er P~cc <br /> <br /> ~ubtotal <br /> <br /> Unit Cost of I~em B~fo:e Fe~ & Non-~qulpmen~ Charges (A+~+C+D) <br /> X <br /> Quantity Order~ <br /> <br /> ~I-GAC F~e Calculatio~ (From Current Fee Table) Subtotal F: <br /> Non-Equipment Charges (Tr~de-In, Extended Wartsnty~ eic.) <br /> <br /> , <br /> <br /> NOD 3.q.~ qq~H~>4~N ~q Zg~ogs~L ~0:0I E00E/O~/II <br /> <br /> <br />