Attachment
Reading Room Production, p.405 · reading_room:exh:00114
Page text: p.405 · original PDF
- Date
- — (unknown precision)
- Type
- attachment · document
BUREAU OF THE
Fiscal Service
LEAD. TRANSFORM. DELIVER.
UNITED STATES GOVERNMENT INTERAGENCY x Whine
AGREEMENT (IAA)
pl
Agreement Between Federal Agencies
Order Requirements and Funding Information (Order) Section
IAA Number
00000
Servicing Agency's Agreement
GT&C #
Order #
Amendment # / Mod #
Tracking Number (Optional)
35. Funding Clauses /Instructions (Optional) (State and/or list funding clauses/instructions)
Subject to the Availability of Funds
36. Delivery /Shipping Information for Products (Optional)
Agency Name
Point of Contact (POC) Name & Title
POC Email Address
Delivery Address / Room Number
POC Telephone Number
Special Shipping Information
APPROVALS AND CONTACT INFORMATION
37. Program Officials
The Program Officials, as identified by the Requesting Agency and Servicing Agency, must ensure that the scope of
work is properly defined and can be fulfilled for this Order. The Program Official may or may not be the Contracting
Officer depending on each agency's IAA business process.
Requesting Agency
Servicing Agency
Name
John J. McGowan, Ph.D.
Title
Deputy Director
for Science Mgmt & Operations
Telephone Number
I
I
Fax Number
Email Address
--__]
ER
@ 9... gov
SIGNATURE
Date Signed
38. Funding Officials -- The Funds Approving Officials, as identified by the Requesting Agency and Servicing Agency,
certify that the funds are accurately cited and can be properly accounted for per the purposes set forth in the Order. The
Requesting Agency Funding Official signs to obligate funds. The Servicing Agency Funding Official signs to start the work,
and to bill, collect, and properly account for funds from the Requesting Agency, in accordance with the agreement.
Requesting Agency
Servicing Agency
Name
jWayne Crum
Sandra Cover
Title
Financial Management Officer, NIAID
Telephone Number
[I
I
Fax Number
--
Email Address
I
219.0.
gov
SIGNATURE
Ayre lx--
er
Acting Ores, OFA
Date Signed
ae: Toad, oY Age 206 0201 PM Ease Dayint Tne
Se ie (een
FS Form 7600B (04-12)
Department of the Treasury I Bureau of the Fiscal Service
September 2016 - page 4 of 5