<table>
<colgroup>
<col style="width: 12%" />
<col style="width: 9%" />
<col style="width: 4%" />
<col style="width: 7%" />
<col style="width: 0%" />
<col style="width: 6%" />
<col style="width: 4%" />
<col style="width: 5%" />
<col style="width: 5%" />
<col style="width: 1%" />
<col style="width: 3%" />
<col style="width: 3%" />
<col style="width: 6%" />
<col style="width: 4%" />
<col style="width: 4%" />
<col style="width: 0%" />
<col style="width: 3%" />
<col style="width: 4%" />
<col style="width: 2%" />
<col style="width: 9%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="14">ORDER FOR SUPPLIES OR SERVICES</td>
<td colspan="6"><strong>PAGE OF PAGES</strong></td>
</tr>
<tr class="even">
<td colspan="14">IMPORTANT: Mark all packages and papers with contract
and/or order numbers.</td>
<td colspan="4"><strong>1</strong></td>
<td colspan="2"><strong>1</strong></td>
</tr>
<tr class="odd">
<td colspan="3">1. DATE OF ORDER</td>
<td colspan="5">2. CONTRACT NO. <em>(If any)</em></td>
<td colspan="12">6. SHIP TO:</td>
</tr>
<tr class="even">
<td colspan="3"><blockquote>
<p><strong>02/27/04</strong></p>
</blockquote></td>
<td colspan="5"><h2 id="section"></h2></td>
<td colspan="12">a. NAME OF CONSIGNEE</td>
</tr>
<tr class="odd">
<td colspan="3">3. ORDER NO.</td>
<td colspan="5">4. REQUISITION/REFERENCE NO.</td>
<td colspan="12"><h2 id="american-embassy">American Embassy</h2></td>
</tr>
<tr class="even">
<td colspan="3"><blockquote>
<p><strong>S-SR100-04-M-0xxx</strong></p>
</blockquote></td>
<td colspan="5"></td>
<td colspan="12">b. STREET ADDRESS</td>
</tr>
<tr class="odd">
<td colspan="8">5. ISSUING OFFICE <em>(Address correspondence
to)</em></td>
<td colspan="12"><h2 id="kneza-milosa-50">Kneza Milosa 50</h2></td>
</tr>
<tr class="even">
<td colspan="8"><blockquote>
<p><strong>American Embassy Belgrade</strong></p>
</blockquote></td>
<td colspan="6">c. CITY</td>
<td colspan="3">d. STATE</td>
<td colspan="3">e. ZIP CODE</td>
</tr>
<tr class="odd">
<td colspan="8"></td>
<td colspan="6"><h2 id="belgrade">Belgrade</h2></td>
<td colspan="3"></td>
<td colspan="3"><blockquote>
<p><strong>11000</strong></p>
</blockquote></td>
</tr>
<tr class="even">
<td colspan="8">7. TO:</td>
<td colspan="12">f. SHIP VIA</td>
</tr>
<tr class="odd">
<td colspan="8">a. NAME OF CONTRACTOR</td>
<td colspan="12"></td>
</tr>
<tr class="even">
<td colspan="8"><h2 id="petar-petrovic">Petar Petrovic</h2></td>
<td colspan="12">8. TYPE OF ORDER</td>
</tr>
<tr class="odd">
<td colspan="8">b. COMPANY NAME</td>
<td colspan="6"> a. PURCHASE</td>
<td colspan="6">[ ] b. DELIVERY -- Except</td>
</tr>
<tr class="even">
<td colspan="8"><h2 id="petrovic-consulting-d.o.o.">PETROVIC CONSULTING
d.o.o.</h2></td>
<td colspan="6">REF YOUR:</td>
<td colspan="6">for billing instructions on the reverse, this</td>
</tr>
<tr class="odd">
<td colspan="8">c. STREET ADDRESS</td>
<td colspan="6">Please furnish the following on the terms</td>
<td colspan="6">delivery order is subject to instructions</td>
</tr>
<tr class="even">
<td colspan="8"><h2 id="glavna-ulica-bb">Glavna ulica bb</h2></td>
<td colspan="6">and conditions specified on both sides of</td>
<td colspan="6">contained on this side only of this form</td>
</tr>
<tr class="odd">
<td colspan="3">d. CITY</td>
<td colspan="2">e. STATE</td>
<td colspan="3">f. ZIP CODE</td>
<td colspan="6">this order and on the attached sheet, if</td>
<td colspan="6">and is issued subject to the terms and</td>
</tr>
<tr class="even">
<td colspan="3"><blockquote>
<p><strong>Grad</strong></p>
</blockquote></td>
<td colspan="2"><h2 id="section-1"></h2></td>
<td colspan="3"><blockquote>
<p><strong>101010</strong></p>
</blockquote></td>
<td colspan="6">any, including delivery as indicated.</td>
<td colspan="6">conditions of the above-numbered contract.</td>
</tr>
<tr class="odd">
<td colspan="8">9. ACCOUNTING AND APPROPRIATION DATA</td>
<td colspan="12"><p>10. REQUISITIONING OFFICE</p>
<h2 id="proc">PROC</h2></td>
</tr>
<tr class="even">
<td colspan="20"><p>11. BUSINESS CLASSIFICATION <em>(Check appropriate
box(es))</em></p>
<blockquote>
<p> a. SMALL b. OTHER THAN SMALL c. DISADVANTAGED d. WOMEN-OWNED</p>
</blockquote></td>
</tr>
<tr class="odd">
<td colspan="6"><p>12. F.O.B. POINT</p>
<blockquote>
<p><strong>See block 6</strong></p>
</blockquote></td>
<td colspan="5">14. GOVERNMENT B/L NO.</td>
<td colspan="5">15. DELIVER TO F.O.B. POINT ON OR BEFORE
<em>(Date)</em></td>
<td colspan="4">16. DISCOUNT TERMS</td>
</tr>
<tr class="even">
<td colspan="6">13. PLACE OF</td>
<td colspan="5"></td>
<td colspan="5"></td>
<td colspan="4"></td>
</tr>
<tr class="odd">
<td colspan="2"><p>a. INSPECTION</p>
<p><strong>See block 6</strong></p></td>
<td colspan="4"><p>b. ACCEPTANCE</p>
<blockquote>
<p><strong>See block 6</strong></p>
</blockquote></td>
<td colspan="5"></td>
<td colspan="5"></td>
<td colspan="4"></td>
</tr>
<tr class="even">
<td colspan="20">17. SCHEDULE <em>(See reverse for Rejections)</em></td>
</tr>
<tr class="odd">
<td><p>ITEM NO.</p>
<p>(a)</p></td>
<td colspan="8"><p>SUPPLIES OR SERVICES</p>
<p>(b)</p></td>
<td colspan="3"><p>QUANTITY</p>
<p>ORDERED</p>
<p>(c)</p></td>
<td><p>UNIT</p>
<p>(d)</p></td>
<td colspan="2"><p>UNIT</p>
<p>PRICE</p>
<p>(e)</p></td>
<td colspan="4"><p>AMOUNT</p>
<p>(f)</p></td>
<td><p>QUANTITY</p>
<p>ACCEPTED</p>
<p>(g)</p></td>
</tr>
<tr class="even">
<td>1</td>
<td colspan="8">Opis robe ili usluge</td>
<td colspan="3">kol</td>
<td></td>
<td colspan="2">0.00</td>
<td colspan="4">0.00</td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td colspan="3">18. SHIPPING POINT</td>
<td colspan="5">19. GROSS SHIPPING WEIGHT</td>
<td colspan="6">20. INVOICE NO.</td>
<td colspan="4"></td>
<td>17(h) TOT.</td>
</tr>
<tr class="even">
<td><em>SEE</em></td>
<td colspan="14">21. MAIL INVOICE TO:</td>
<td colspan="4"></td>
<td><em>(Cont.</em></td>
</tr>
<tr class="odd">
<td><em>BILLING</em></td>
<td colspan="14">a. NAME</td>
<td colspan="4"></td>
<td><em>pages)</em></td>
</tr>
<tr class="even">
<td><em>INSTRUCTIONS</em></td>
<td colspan="14"><h2 id="american-embassy-gso">American Embassy
GSO</h2></td>
<td colspan="4"></td>
<td></td>
</tr>
<tr class="odd">
<td><em>ON</em></td>
<td colspan="14">b. STREET ADDRESS <em>(or P.O. Box)</em></td>
<td colspan="4"></td>
<td></td>
</tr>
<tr class="even">
<td><em>REVERSE</em></td>
<td colspan="14"><blockquote>
<p><strong>Kneza Milosa 50</strong></p>
</blockquote></td>
<td colspan="4"><strong>YUD</strong></td>
<td>17(i)</td>
</tr>
<tr class="odd">
<td></td>
<td colspan="6">c. CITY</td>
<td colspan="3">d. STATE</td>
<td colspan="5">e. ZIP CODE</td>
<td colspan="4"></td>
<td>GRAND</td>
</tr>
<tr class="even">
<td></td>
<td colspan="6"><h2 id="belgrade-1">Belgrade</h2></td>
<td colspan="3"></td>
<td colspan="5"><blockquote>
<p><strong>11000</strong></p>
</blockquote></td>
<td colspan="4"><strong>0.00</strong></td>
<td>TOTAL</td>
</tr>
<tr class="odd">
<td colspan="10"><p>22. UNITED STATES OF</p>
<p>AMERICA BY <em>(Signature)</em></p></td>
<td colspan="10"><p>23. NAME <em>(Typed)</em></p>
<blockquote>
<p><strong>Patricia Perrin, CO</strong></p>
<p>TITLE: CONTRACTING/ORDERING OFFICER</p>
</blockquote></td>
</tr>
</tbody>
</table>

AUTHORIZED FOR LOCAL REPRODUCTION **OPTIONAL FORM 347** (REV. 6/95)

Previous edition not usable Computer Generated Prescribed by GSA/FAR 48
CFR 53.213(e)