Dd Form 1155 PDF Details

In the realm of government procurement and contracting, the DD Form 1155 stands as a crucial document facilitating the order of supplies or services within various departments and agencies. This form encompasses a wide range of information necessary for the smooth execution of contracts, from the basic specifics of the contract or purchase order number to intricate details like delivery terms, contractor codes, and payment instructions. Additionally, it serves as a binding agreement between the issuing body and the contractor, affirming the contractor's acceptance of the terms and agreeing to fulfill the requirements specified. Not only does it detail the ordered supplies or services with their quantities and unit prices, but it also outlines inspection and acceptance procedures, ensuring that delivered items meet the contract standards. Moreover, the DD Form 1155 facilitates financial transactions by including payment details, which are critical for ensuring timely and correct payments to contractors. With fields designated for both government and contractor use, such as accounting and appropriation data, and instructions for shipping and invoicing, this form is indispensable in maintaining order and accountability in governmental acquisitions.

QuestionAnswer
Form NameDd Form 1155
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesdd1155 form, dd 1155, PURCH, CERTIFYING

Form Preview Example

ORDER FOR SUPPLIES OR SERVICES

PAGE 1 OF

1. CONTRACT/PURCH ORDER/AGREEMENT NO.

2. DELIVERY ORDER/CALL NO.

 

3. DATE OF ORDER/CALL

4. REQUISITION/PURCH REQUEST NO.

5. PRIORITY

 

 

 

 

(YYYYMMMDD)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6. ISSUED BY

CODE

 

7. ADMINISTERED BY (If other than 6)

CODE

 

8. DELIVERY FOB

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DESTINATION

 

 

 

 

 

 

 

 

 

 

OTHER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(See Schedule if

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

other)

 

 

 

 

 

 

 

 

 

9. CONTRACTOR

CODE

 

FACILITY

 

10. DELIVER TO FOB POINT BY (Date)

11. X IF BUSINESS IS

 

 

 

(YYYYMMMDD)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SMALL

 

 

 

 

 

 

 

 

 

 

SMALL DISAD-

 

 

 

 

 

 

12. DISCOUNT TERMS

 

NAME

 

 

 

 

 

 

VANTAGED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WOMEN-OWNED

AND

 

 

 

 

 

 

 

 

 

ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13. MAIL INVOICES TO THE ADDRESS IN BLOCK

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14. SHIP TO

CODE

15. PAYMENT WILL BE MADE BY

CODE

MARK ALL

PACKAGES AND

PAPERS WITH IDENTIFICATION NUMBERS IN BLOCKS 1 AND 2.

TYPE OF

ORDER

DELIVERY/

 

This delivery order/call is issued on another Government agency or in accordance w ith and subject to terms and conditions of above numbered contract.

CALL

 

 

 

 

 

 

 

 

 

 

PURCHASE

 

Reference your

furnish the follow ing 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 CONTRACTORSIGNATURETYPED NAME AND TITLEDATE SIGNED

(YYYYMMMDD)

If this box is marked, supplier must sign Acceptance and return the follow ing number of copies:

17. ACCOUNTING AND APPROPRIATION DATA/LOCAL USE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

20. QUANTITY

21.

 

 

 

 

 

18. ITEM NO.

 

 

 

 

19. SCHEDULE OF SUPPLIES/SERVICES

 

 

 

 

ORDERED/

 

22. UNIT PRICE

23. AMOUNT

 

 

 

 

 

 

 

 

 

UNIT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ACCEPTED*

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$0.00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$0.00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$0.00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

* If quantity accepted by the Government is

 

24. UNITED STATES OF AMERICA

 

 

 

 

 

 

 

 

25. TOTAL

$0.00

 

same as quantity ordered, indicate by X.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

29.

 

 

If different, enter actual quantity accepted

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DIFFERENCES

 

 

below quantity ordered and encircle.

 

BY:

 

 

CONTRACTING/ORDERING OFFICER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

26. QUANTITY IN COLUMN 20 HAS BEEN

 

 

 

 

27. SHIP. NO.

 

 

28. D.O. VOUCHER NO.

 

30. INITIALS

 

 

 

INSPECTED

 

 

 

RECEIVED

 

ACCEPTED, AND CONFORMS TO THE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CONTRACT EXCEPT AS NOTED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PARTIAL

 

 

32. PAID BY

 

 

 

33. AMOUNT VERIFIED CORRECT FOR

 

 

 

 

 

 

 

 

 

 

 

 

 

FINAL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

31. PAYMENT

 

 

 

 

 

 

34. CHECK NUMBER

 

 

DATE

 

SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

36. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT.

 

COMPLETE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PARTIAL

 

 

 

 

 

 

35. BILL OF LADING NO.

 

 

 

 

 

 

 

 

 

FINAL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE

 

 

 

SIGNATURE AND TITLE OF CERTIFYING OFFICER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

37. RECEIVED

38. RECEIVED BY (Print)

 

 

39. DATE RECEIVED

40. TOTAL CON-

 

 

41. S/R ACCOUNT NUMBER

 

42. S/R VOUCHER NO.

 

 

AT

 

 

 

 

 

 

 

(YYYYMMMDD)

 

TAINERS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DD FORM 1155, JAN 1998

PREVIOUS EDITION MAY BE USED.

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