PGI 253.213-70 Completion of DD Form

1155, Order for Supplies or Services.

(a) The following instructions are mandatory if—

(1) Contract administration has been assigned outside the purchasing office; or

(2) The contractor is located in the contiguous United States or Canada.

(b) The entity codes (address codes) referenced in this subsection are codes published in—

(1) DoD Activity Address Directory (DODAAD), DoD 4000.25-6-M.

(2) Military Assistance Program Address Directory System (MAPAD), DoD 4000.25-8M.

(3) Commercial and Government Entity (CAGE) Codes Handbook H4/H8.

(c) For orders requiring payment in Canadian currency—

(1) State the contract price in terms of Canadian dollars, followed by the initials CN; e.g.,

$1,647.23CN.

(2) Indicate on the face of the order—

(i) The U.S./Canadian conversion rate in effect at the time of the award; and

(ii) The U.S. dollar equivalent of the Canadian dollar amount.

(d) When the DD Form 1155 includes FMS requirements, clearly mark “FMS Requirement” on its

face. Specify within the order each FMS case identifier code by line or subline item number.

(e) Instructions for DD Form 1155 entries. (Instructions apply to purchase orders, delivery orders,

and calls, except Block 2, which applies only to delivery orders and calls, and Block 12, which

applies only to purchase orders.)

BLOCK

1 Contract/Purch Order/AGREEMENT No.—Enter the Procurement Instrument Identification (PII)

number and, when applicable, the supplementary identification number for contracts, purchase

orders, and agreements as prescribed in DFARS Subpart 204.16.

2 Delivery Order/CALL No.—Enter the PII number for delivery orders/calls, when applicable, as

prescribed in DFARS Subpart 204.16.

3 Date of Order/CALL—Enter the four-position numeric year, three-position alpha month, and twoposition numeric day.

4 Requisition/Purch Request No.—Enter the number authorizing the purchase. When the number

differs by line item, list it in the Schedule and annotate this block, “See Schedule.”

5 PRIORITY—Enter the appropriate Program Identification Code as identified in Schedule I to the
Defense Priorities and Allocations System Regulation.

6 Issued By—Enter the name and address of the issuing office. In the code block, enter the DoDAAD

code for the issuing office. Directly below the address, enter: Buyer/Symbol: followed by the buyer's

name and routing symbol. Directly below the buyer/symbol, enter: Phone: followed by the buyer's

phone number and extension.

7 Administered By—Enter the name and address of the contract administration activity. On purchase

orders retained by purchasing offices for administration, mark this block, “See Block 6.” Enter in the

code block the DODAAD code of the contract administration activity. In the lower right or left-hand

corner, enter the criticality designator code from FAR 42.1105.

8 Delivery FOB—Check the applicable box.

9 Contractor—

(1) Enter the full business name and address of the contractor. Enter in the first code block, the

CAGE code of the contractor.

(2) If it is known that all the work covered by the order is to be performed at an address different

from the address represented by the contractor's code, and any contract administration function will

be required at that facility, enter in the facility code block the organizational entity code for that

facility, i.e., H8-1/H8-2 code for a non-Government entity or DODAAD code for a Government entity.

(Use DODAAD codes only to indicate “performed at” locations for orders specifying services at a

Government location.) If it is known that multiple facilities are involved, enter the codes for all

facilities at which work is to be performed, including the contractor's code if work is performed at

that address, in the Optional Form 336 Continuation Sheet and mark the facility code block with

“See Schedule.”

10 Deliver to FOB Point by (Date)—If a single date of delivery applies to the entire order, enter date

in this block. List multiple delivery dates in the schedule and mark this block “See Schedule.”

11 Mark If Business—Check all applicable blocks.

12 Discount Terms—Enter the discount for prompt payment in terms of percentages and

corresponding days. Express the percentages in whole numbers and decimals, e.g., 3.25% - 10 days;

0.50% - 20 days.

13 Mail Invoices To THE ADDRESS IN BLOCK—Enter a reference to the block number containing

the address to which invoices are to be mailed. When not in Block 6, 7, 14, or 15, insert in Block 13,

“See Schedule.”

14 Ship To—If a single ship-to point applies to the entire order, enter the name and address of that

point in this block and a DODAAD code in the code block. For FMS shipments, enter the MAPAD

code in the code block and an instruction for the contractor to contact the transportation office of

the administering activity to obtain a name and a shipping address. Enter multiple ship-to points in

the Schedule and mark this block, “See Schedule.”

15 Payment Will Be Made By—Enter the name and address of the activity making payment. Enter in

the code block, the DODAAD code of the paying activity. When a purchase card is used for payment,

enter “CRCARD” in the code block.

16 Type of Order—Check the appropriate box. If a purchase order:
(1) Identify the type of quotation, e.g., oral, letter, e-mail, on which the order is based.

(2) Check the box when acceptance of the purchase order is required and enter the number of

copies of the order to be returned to the issuing office.

17 Accounting and Appropriation Data/Local Use—Enter the accounting classification and the

accounting classification reference number(s) in accordance with DFARS 204.7107.

18 Item No.—Enter an item number for each item of supply or service in accordance with DFARS

Subpart 204.71.

19 Schedule of Supplies/Services—The Schedule contains several elements of data. The order and

arrangement of data in the Schedule is mandatory for purchase and delivery orders assigned to the

Defense Contract Management Agency or the military departments for administration and is

encouraged for all orders.

(1) National Stock Number (NSN)—Total item quantity for the line or subline item number followed

by the appropriate national stock number or the word “none” if an NSN has not been assigned. On

the same line and adjacent to NSN, enter the words “Total Item Quantity.” This phrase is used in

conjunction with the total quantity, unit of issue, unit price, and dollar amount of the stock number

or item cited (see entries for Blocks 20, 21, 22, and 23).

(2) Item Identification—Enter first the most descriptive noun or verb of the supplies or services to be

furnished, supplemented by additional description as prescribed in FAR Part 10. If multiple

accounting classifications apply to the contract, enter the accounting classification reference

number.

(3) Quantity Variance—Enter the quantity variance permitted for the line item in terms of

percentages, indicating whether the percentage is plus or minus and if applicable to each

destination.

(4) Inspection/Acceptance—Enter the point at which inspection/acceptance will take place.

(5) Preservation and Packaging—Enter the preservation requirements for the item described. These

requirements may be expressed in terms of MIL-STD-2073-1, DoD Material Procedures for

Development and Application of Packaging Requirements, and MIL-STD-2073-2, Packaging

Requirements, codes. They may also be expressed by reference to applicable specifications.

(6) Packing—When required, enter the packing level designator and specification, standard, or

document in which the requirements are stated or state the specific requirements.

(7) Unitization—When desired by the requiring activity, a requirement for cargo unitization for a

particular destination should be specified for shipments involving two or more shipping containers

having an aggregate total of not less than 20 cubic feet or 200 pounds.

(8) Ship To—Enter the DODAAD or MILSCAP H8-1/H8-2 (cage) as appropriate for the entity code of

the ship-to point on the first line and the corresponding name and address on succeeding lines. If

multiple accounting classifications apply to the same line or subline item, enter the accounting

classification reference number. When several items are to be shipped to the same point, the code

will be listed; but it will not be necessary to repeat the address.

(9) Delivery Date—When multiple delivery dates apply, enter the required date of delivery on the

same line with ship-to code.
(10) Mark For—Enter the DODAAD or MILSCAP H8-1/H8-2 (cage) as appropriate for the entity code

on the first line and name and address of the ultimate recipient of the supplies and services on

succeeding lines.

20 Quantity Ordered/Accepted—Enter the total quantity ordered for the line item. If applicable,

enter the breakdown on quantities for each ship-to point within the line item.

21 Unit—Enter the unit of measure applicable to the line item.

22 Unit Price—Enter the unit price applicable to the line item.

23 Amount—Enter the extended dollar amount (quantity x unit price) for each line item.

24 Contracting/Ordering Officer—Enter the contracting/ordering officer's signature.

25 Total Amount—Enter the total dollar amount for all line items on the order.

26 thru 42 These blocks are used in the receiving and payment functions. Procedures for making

entries are prescribed by the respective departments.

Parent topic: PGI 253.213 Simplified acquisition procedures (SF's 18, 30, 44, 1165, 1449, and OF's

336, 347, and 348).