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1. CONTRACT ID CODEPENDENT OF SOLICITATION/MODIFICATION OF CONTRACT 0001 6. ISSUED BY4. REQUISITION/P PURCHASE REQ. NO.3. EFFECTIVE DATE2. AMENDMENT/MODIFICATION NO.1235. P PROJECT NO.(If applicable)CP101824830May2018

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This form is used to report innovative professional services provided under contract number n00178-04-d-4068-hr04.

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The purpose of this form is to report and document the innovative professional services provided under the specified contract.

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Information such as the details of the innovative professional services provided, dates, descriptions, and costs must be reported on this form.

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