H--AUTOMATIC FIRE SPRINKLER

19.ITEM NO. 20. SCHEDULE OF SUPPLIES/SERVICES 21. QUANTITY 22. UNIT 23. UNIT PRICE 24. AMOUNT 001 Base Year (1 Jan 2009 - 31 Dec 2009) 1 YR 002 Option Year 1 (1 Jan 2010 - 31 Dec 2010) 1 YR 003 Option Year 2 (1 Jan 2011 - 31 Dec 2011) 1 YR 004 Option Year 3 (1 Jan 2012 - 31 Dec 2012) 1 YR 005 Option Year 4 (1 Jan 2013 - 31 Dec 2013) 1 YR 006 PLEASE INCLUDE BREAKDOWN OF INSPECTIONS 32a. QUANTITY IN COLUMN 21 HAS BEEN RECEIVED INSPECTED ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: 32b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE 33. SHIP NUMBER 34. VOUCHER NUMBER 35. AMOUNT VERIFIED CORRECT FOR 36. PAYMENT I COMPLETE PARTIAL Li FINAL 37. CHECK NUMBER PARTIAL FINAL 38. S/R ACCOUNT NUMBER 39. S/R VOUCHER' UMBER 40. PAID BY 41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT 42a. RECEIVED BY (Print) 41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE 425. RECEIVED AT (Location) 42c. DATE REC'D (YY/MM/DD) 42d. TOTAL CONTAINERS STANDARD FORM 1449 (REV. 3/2005) BACK