How to Fill Out DD Form 1155 (DEC 2001), Order for Supplies or Services

Table of Contents
  1. DD Form 1155 at a glance
  2. A filled-in DD Form 1155 example: a purchase order for copy paper
  3. How to fill out DD Form 1155, box by box
  4. More rules for DD Form 1155
  5. Common questions about DD Form 1155
  6. Sources

DD Form 1155 at a glance

What it is: This is the ORDER FOR SUPPLIES OR SERVICES form.

A filled-in DD Form 1155 example: a purchase order for copy paper

DD Form 1155 example filled out, example: a purchase order for copy paper
The Example Contracting Office issues a purchase order to Sample Supply Co. This example is a PURCHASE order, so the DELIVERY ORDER/CALL NO. stays empty, the DELIVERY/CALL TYPE OF ORDER box is not marked and the Reference your line stays empty. ADMINISTERED BY stays empty because the form asks for it only if other than ISSUED BY. No discount applies, so DISCOUNT TERMS stays empty, and PAYMENT WILL BE MADE BY is left to the paying office. ACCOUNTING AND APPROPRIATION DATA stays empty in this example. The supplier is a small business, so the SMALL box is checked and the SMALL DISADVANTAGED and WOMEN-OWNED boxes stay empty. The amount is the quantity times the unit price, and the total is the sum of the amounts. The contracting officer's BY line, the Government acceptance of boxes 28 to 31 and the inspection and payment boxes are left for the Government to fill. Every name, code, date, number and amount is made up. Open the picture to see it full size.

How to fill out DD Form 1155, box by box

Tap a group of boxes to open it, and a picture to see it full size.

Order number, delivery order or call number and date of order or call
DD Form 1155 example filled out, order number, delivery order or call number and date of order or call

Write the CONTRACT/PURCH ORDER/AGREEMENT NO., the DELIVERY ORDER/CALL NO. and the DATE OF ORDER/CALL (YYYYMMMDD).

Requisition or purch request number and priority
DD Form 1155 example filled out, requisition or purch request number and priority

Write the REQUISITION/PURCH REQUEST NO. and the PRIORITY.

Issued by, administered by and delivery fob
DD Form 1155 example filled out, issued by, administered by and delivery fob

Write the ISSUED BY CODE and the ADMINISTERED BY (If other than 6) CODE, and check DELIVERY FOB DESTINATION or OTHER (See Schedule if other).

Contractor code, facility, name and address
DD Form 1155 example filled out, contractor code, facility, name and address

Write the CONTRACTOR CODE, the FACILITY and the NAME AND ADDRESS of the contractor.

Deliver to, discount terms, invoices, ship to and payment will be made by
DD Form 1155 example filled out, deliver to, discount terms, invoices, ship to and payment will be made by

Write deliver to fob point by (Date) (YYYYMMMDD), the discount terms, the block number to mail invoices to the address in, the ship to code and the payment will be made by code. Mark all packages and papers with identification numbers in blocks 1 and 2.

If business is small, small disadvantaged or women-owned
DD Form 1155 example filled out, if business is small, small disadvantaged or women-owned

Check X if business is SMALL, SMALL DISADVANTAGED or WOMEN-OWNED.

Type of order and acceptance
DD Form 1155 example filled out, type of order and acceptance

Check the TYPE OF ORDER: DELIVERY/CALL, when this delivery order/call is issued on another Government agency or in accordance with and subject to terms and conditions of above numbered contract, or PURCHASE.

Under ACCEPTANCE, the contractor 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; the contractor signs, and writes TYPED NAME AND TITLE and DATE SIGNED (YYYYMMMDD).

If this box is marked, supplier must sign Acceptance and return the following number of copies.

Schedule of supplies or services
DD Form 1155 example filled out, schedule of supplies or services

Write the ITEM NO., SCHEDULE OF SUPPLIES/SERVICES, QUANTITY ORDERED/ACCEPTED*, UNIT, UNIT PRICE and AMOUNT for each line.

In 20. QUANTITY ORDERED/ ACCEPTED*: 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.

Write the TOTAL.

Government representative
DD Form 1155 example filled out, government representative

The authorized government representative checks that the quantity in column 20 has been inspected, received or accepted, and conforms to the contract except as noted, and signs, writes the date (YYYYMMMDD), printed name and title, mailing address, telephone number and e-mail address.

Payment certification
DD Form 1155 example filled out, payment certification

For PAYMENT, the certifying officer signs: I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT; the certifying officer writes the DATE (YYYYMMMDD) and the SIGNATURE AND TITLE.

More rules for DD Form 1155

The CONTRACTING/ORDERING OFFICER signs on the BY line.

Common questions about DD Form 1155

What is a DD Form 1155 used for?

This is the ORDER FOR SUPPLIES OR SERVICES form.

Sources

[1] DD Form 1155 (DEC 2001), Order for Supplies or Services (the Official source link on this page).

DD Form 1155 PDF Details

Mark all packages and papers with identification numbers in blocks 1 and 2.

Quantity accepted, same as ordered: if quantity accepted by the Government is same as quantity ordered, indicate by X.

Quantity accepted, different from ordered: if different, enter actual quantity accepted below quantity ordered and encircle.

Date of order or call: enter it as YYYYMMMDD.

QuestionAnswer
Form NameDD Form 1155
Form Length1 page
Fillable?Yes
Fillable fields118
Avg. time to fill out20 min
EditionDEC 2001
Prescribed byDFARS 253.213
Other namesDD Form 1155, DD 1155, DD1155, Form 1155, 1155 form, Order for Supplies or Services
Official sourceDD Form 1155 (Rev DEC 2001), Department of Defense

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