Attachments

+------------------------------------+--------+------------+-----------+
| > ![](m                            |        | > **Return | > **A     |
| edia/image1.wmf){width="2.40625in" |        | > Copy     | ttachment |
| > height="0.4375in"}               |        | > to:**    | > 7**     |
|                                    |        |            | >         |
|                                    |        |            | > **Bank  |
|                                    |        |            | > of      |
|                                    |        |            | >         |
|                                    |        |            | America** |
|                                    |        |            | >         |
|                                    |        |            | > **G     |
|                                    |        |            | overnment |
|                                    |        |            | > Card    |
|                                    |        |            | >         |
|                                    |        |            |  Services |
|                                    |        |            | > Unit**  |
|                                    |        |            | >         |
|                                    |        |            | > **P.O.  |
|                                    |        |            | > Box     |
|                                    |        |            | > 53142** |
|                                    |        |            | >         |
|                                    |        |            | > *       |
|                                    |        |            | *Phoenix, |
|                                    |        |            | > AZ      |
|                                    |        |            | > 850     |
|                                    |        |            | 72-3142** |
+------------------------------------+--------+------------+-----------+

**Fax Number 888-678-6046**

36

+------------------------------+---------------------------------------+
| > **Dispute Form**           |                                       |
+------------------------------+---------------------------------------+

Name Merchant

Account \# Transaction Date

Posting Date Amount

Reference No. Daytime Phone

Signature

I have examined the charge(s) made to my account and wish to dispute the
above items for the following reason: \*\*PLEASE CHECK ONLY ONE\*\*

1\. I certify that the charge(s) listed above was not made by me or a
person authorized by me to use my card. I did not receive any goods or
services from this transaction nor did any person authorized by me.

2\. Although I did engage in a transaction with the above merchant, I
have no knowledge of the particular transaction noted above and it was
not authorized by me or anyone representing me. My cards were in my
possession at the time of the above transaction. The correct transaction
took place on \_\_\_\_\_\_\_\_\_\_ (date) in the amount of \$
\_\_\_\_\_\_\_\_\_\_.

3\. Although I did engage in the above transaction (complete ONE of the
following statements and provide as much detail as possible to support
your statement):

a\. The dollar amount of the sale was increased from \$
\_\_\_\_\_\_\_\_\_\_ to \$ \_\_\_\_\_\_\_\_\_\_. I am enclosing a copy
of my charge card sales receipt, which reflects the correct dollar
amount.

b\. I dispute the entire charge or a portion of it in the amount of \$
\_\_\_\_\_\_\_\_\_\_. I have contacted the merchant and asked that a
credit be applied to my account. (Please provide details of the
circumstances surrounding this transaction and your calculations used to
derive the correct amount, if amount is less than the total billed to
you account.)

c\. I have never received the merchandise. I expected to receive it
during the week of \_\_\_\_\_\_\_\_\_\_ (date). I have since contacted
the merchant and asked that a credit be applied to my account.

d\. All or part of the shipped or delivered merchandise was defective or
damaged when received. I returned the merchandise on
\_\_\_\_\_\_\_\_\_\_ (date) but have not received a credit for the
amount of \$ \_\_\_\_\_\_\_\_\_\_. I am enclosing a detailed statement
describing the defects of the merchandise and I am enclosing a copy of
my proof of return (receipt from UPS, FedEx, Post Office, a credit
voucher form the merchant, etc.). In addition, enclosed is an itemized
list of the merchandise received, the items returned and the cost of
each item.

e\. The above transaction is a duplication of an authorized transaction
that took place on \_\_\_\_\_\_\_\_\_\_ (posting date). The reference
number of the authorized transaction as shown on my charge card
statement is \_\_\_\_\_\_\_\_\_\_.

f\. I am enclosing a detailed explanation of the reason(s) the merchant
was not able or willing to provide the requested merchandise/services. I
am also providing details of my attempts to resolve this matter with the
merchant, including date(s) and the merchant response(s).

4\. I received a credit slip, but it was applied to my account as a
charge. I am enclosing a copy of this credit slip.

5\. I received a credit slip, but it was applied to my account. I am
enclosing a copy of this credit slip.

6\. I notified the merchant on \_\_\_\_\_\_\_\_\_\_ (date) to cancel
preauthorized recurring charges (i.e., insurance premium, membership
fee). I have canceled with the merchant and am enclosing a copy of my
dated correspondence to the merchant, if available.

The merchant provided me with the cancellation number:
\_\_\_\_\_\_\_\_\_\_

7\. I guaranteed a hotel reservation for late arrival and subsequently
cancelled it on \_\_\_\_\_\_\_\_\_\_ (date) at \_\_\_\_\_\_\_\_\_\_
(AM/PM).

8\. Other: please explain below.

I am enclosing a copy of all related documents, including any credit
vouchers, sales receipts, work invoices, and contracts that I may have
received, along with details of my attempts to resolve this matter with
the merchant.

![](media/image2.wmf){width="2.40625in" height="0.4375in"}

37

Instructions for Dispute Form

+----------------------------+-----------------------------------------+
| > **Purpose**              | > Cardholders or A/OPC's may use this   |
|                            | > form to dispute charges on their      |
|                            | > charge card.                          |
+----------------------------+-----------------------------------------+

**Instructions**

Please print or type all information and return or fax to the address or
number listed below:

**Bank of America**

**Attn: GCSU**

**P. O. Box 1637**

**Norfolk, VA 23501-1637**

**Fax: (757) 624-6323**

**Toll-free fax: (877) 217-1033**

+-----------------------------------------------------------------------+
| > **Field Descriptions of form elements.**                            |
+-----------------------------------------------------------------------+
| > **Name** -- Enter Card / Account Holder's name.                     |
+-----------------------------------------------------------------------+
| > **Account \#** - Enter 16 digit account number.                     |
+-----------------------------------------------------------------------+
| > **Merchant** -- Enter merchant's name for the disputed charge.      |
+-----------------------------------------------------------------------+
| > **Transaction Date** -- Enter date of disputed transaction.         |
+-----------------------------------------------------------------------+
| > **Posting Date** -- Enter the date the disputed charge posted to    |
| > the account.                                                        |
+-----------------------------------------------------------------------+
| > **Amount** -- Enter the amount of the charge being disputed.        |
+-----------------------------------------------------------------------+
| > **Reference** -- Enter the reference number of the disputed charge. |
+-----------------------------------------------------------------------+
| > **Signature** -- Signature of authorized card / account holder.     |
+-----------------------------------------------------------------------+
| > **Daytime Phone** -- Enter daytime commercial phone number for      |
| > card/account holder.                                                |
+-----------------------------------------------------------------------+
| > **\*\*PLEASE CHECK ONE\*\*** - Select the option that best          |
| > describes the reason for the disputed charge.                       |
+-----------------------------------------------------------------------+

42

**Attachment 8**

**PURCHASE CARD DESTRUCTION FORM**

**(Print or Type)**

**Card No. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Exp.
Date\_\_\_\_\_\_\_\_\_\_\_**

**Name of
Cardholder\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**Reason(s) for Destruction**

Employee Found reported Expired Employee

transferred lost/stolen card card terminated/resigned

Other
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

COMMENTS:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Approving Official's Name
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

(Type or Print)

Approving Official's Signature
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Current Date
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

NOTICE: Cut card in half and dispose/discard appropriately. Do not
return to Bank of America.

**Attachment 9**

**PURCHASE CARD**

**TELEPHONE QUOTATION WORKSHEET**

+----------------------------+-----------------------------------------+
| > **Cardholder Name**      |                                         |
+----------------------------+-----------------------------------------+
| > Government Estimate      |                                         |
+----------------------------+-----------------------------------------+
|                            | > **Accounting and Appropriation Data** |
+----------------------------+-----------------------------------------+
| > **Appropriation Symbol** | > **B&R NumberAmountAllotmentObj.       |
|                            | > ClassAFPCFA**                         |
+----------------------------+-----------------------------------------+
|                            |                                         |
+----------------------------+-----------------------------------------+

**Description:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**Vendor Quotations:**

**Vendor1 Vendor2 Vendor 3**

+---------------------------------+-----------+-----------+-----------+
| > **Vendor Name**               |           |           |           |
+---------------------------------+-----------+-----------+-----------+
| > **Point of Contact**          |           |           |           |
+---------------------------------+-----------+-----------+-----------+
| > **Telephone No.**             |           |           |           |
+---------------------------------+-----------+-----------+-----------+
| > **Price Quote**               |           |           |           |
+---------------------------------+-----------+-----------+-----------+
| > **Delivery Date**             |           |           |           |
+---------------------------------+-----------+-----------+-----------+

**DOE Approving Official:**

**Signature: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**Name: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**Date: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**Attachment 10**

**BANKCARD TELEPHONE ORDER LOG**

**CARDHOLDER NAME:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
PAGE \_\_\_\_ OF \_\_\_\_**

**FOR MONTH OF:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**DATE ORDERED:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**DATE DELIVERED:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**AMOUNT:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**VENDOR AMOUNT:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**DESCRIPTION OF ARTICLES OR SERVICES**

**PROCURED:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

ATTACHMENT 11

+--------------------------+--------+---------------------+----------+
| > U.S. TAX EXEMPTION     | > Read | > DEPARTMENT,       | > SERIAL |
| > CERTIFICATE            | > the  | > AGENCY, OR OFFICE | > NO.    |
|                          | >      |                     |          |
|                          | instru |                     |          |
|                          | ctions |                     |          |
|                          | > on   |                     |          |
|                          | > the  |                     |          |
|                          | > r    |                     |          |
|                          | everse |                     |          |
|                          | > side |                     |          |
+--------------------------+--------+---------------------+----------+
| > ITEM PURCHASED FOR     | > QU   | > UNIT PRICE        |          |
| > EXCLUSIVE USE OF THE   | ANTITY |                     |          |
| > U.S. GOVERNMENT        |        |                     |          |
| > *(Describe)*           |        |                     |          |
+--------------------------+--------+---------------------+----------+
| > VENDOR FROM WHICH      | > NAME | > A tax exemption   | > Amount |
| > PUR-CHASED             |        | > certificate has   | > of Tax |
|                          |        | > not previously    | >        |
|                          |        | > been issued and   | Excluded |
|                          |        | > the described     |          |
|                          |        | > item(s) has       |          |
|                          |        | > (have) been       |          |
|                          |        | > delivered and     |          |
|                          |        | > invoiced pursuant |          |
|                          |        | > to:               |          |
+--------------------------+--------+---------------------+----------+
|                          |        |                     | > State  |
+--------------------------+--------+---------------------+----------+
|                          | > A    |                     | > Local  |
|                          | DDRESS |                     |          |
|                          | >      |                     |          |
|                          | *(No., |                     |          |
|                          | > S    |                     |          |
|                          | treet, |                     |          |
|                          | >      |                     |          |
|                          |  city, |                     |          |
|                          | >      |                     |          |
|                          | State, |                     |          |
|                          | > and  |                     |          |
|                          | > ZIP  |                     |          |
|                          | >      |                     |          |
|                          | Code)* |                     |          |
+--------------------------+--------+---------------------+----------+
| > I certify that the     | > P.O. | > **For             |          |
| > information on this    | > OR   | > Administrative    |          |
| > form is true and       | > CO   | > Office**          |          |
| > correct to the best of | NTRACT |                     |          |
| > my knowledge and       | > NO.  |                     |          |
| > belief.                |        |                     |          |
+--------------------------+--------+---------------------+----------+
| > PURCHASER\'S           | > DATE | > DATES             | > D.O.   |
| >                        |        |                     | >        |
| > SIGNATURE,             |        |                     |  SYMBOL. |
| >                        |        |                     | > NO.    |
| > OFFICE TITLE,          |        |                     |          |
| >                        |        |                     |          |
| > AND ADDRESS            |        |                     |          |
+--------------------------+--------+---------------------+----------+
| > Certified correct and  | > DATE | > VOUCHER NO.       |          |
| > just:                  |        |                     |          |
| >                        |        |                     |          |
| > SIGNATURE AND          |        |                     |          |
| >                        |        |                     |          |
| > TITLE OF VENDOR\'S     |        |                     |          |
| >                        |        |                     |          |
| > REPRESENTATIVE         |        |                     |          |
+--------------------------+--------+---------------------+----------+
|                          |        | > DATE              |          |
+--------------------------+--------+---------------------+----------+

**STANDARD FORM 1094 (REV. 10-83)**

Prescribed by GSA

FAR (48 CFR) 53.229