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1. CONTRACT ID CODEPENDENT OF SOLICITATION/MODIFICATION OF CONTRACT 2. AMENDMENT/MODIFICATION NO.3. EFFECTIVE DATE0085 6. ISSUED Bodensee Block 16C 06005PAGE OF PAGES21 4. REQUISITION/PURCHASE REQ.

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xde-sc0012704 is a specific form or document related to the Brookhaven National Laboratory, used for administrative purposes.

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Individuals or entities associated with projects or activities at Brookhaven National Laboratory that fall under stipulated guidelines are required to file this document.

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