Firestone_RebateProgram_PO

• Water Efficiency Grant Type: Water Conservation Implementation Grant
• Contract/PO #: OE PDA 11-33
• Applicant: Town of Firestone
• Project Name: High Efficiency Rebate Program
• Title: Purchase Order
• Date: 9/20/2010
• County: Weld
• Water Efficiency - Doc Type: Purchase Order

WATER CONSERVATION BOARD
DATE: 09 -20 -10 �,'oF�
PUR SE
1313 SHERMAN STREET, ROOM 721
DENVER , CO 80203
IMPOWANT ORDER
The PO# and lane # must , * STATE OF COLORADO
�
�� MAGGIE VAN CLEEF
appear on a!! invoices,
•
packing sl i ps, cartons
l and
Phone Number: 303-866-3292
correspondence P.0, # OE PDA 110000000 33 Page# 01
Agency Contact: STEVEN S HUL L
Phone Number: 303 8 6 6 3441
ACC : 09-17-10 State Award #
FEIN 840736777 Phone: -
-- BID #
Vendor Contact:
Invoice in Triplicate
Purch iiequi 8:
To: DIVISION . OF WATER CONSERVATI
TO OF FIRESTONE
1313 SHERMAN STREET, ROOM 721
E
DENVER, CO 80203
N
D PO BOX 100
0 FIRESTONE CO 80520
Pa yment w ill be made by this agency
R
Ship DIVISION OF WATER CONSERVATION
iNSTNUCTIONS TO VENDOit
To: 1313 SHERMAN STREET, ROOM 721
I. If for any reason, delivery of this order is del beyond the de{iv ery/Instaustion date DENVER, CO 80203
Shown- please notify the agency contact named at the tap tit. (Right of cancellation Is
reserved In instances in which timely delivery is not made.
2. All chemicals• equipment and materials must conform to the standards regLdred by OSHA.
3. NOTE: Additional terms and conditions on reverse stile
Delivery /installation Date: 0 8 - 31 -11
F•O.B. DESTINATION STATE PAYS NO FREIGHT
SPECIAL INST AXTIaNS:
LINE COMMODITY/ITEM UNIT OF
ITEM CODE MEASUREMENT
QUANTITY UNIT COST TOTAL ITEM COST
col 91843000000
WATER EFFICIENCY GRANT--TOWN
$41,455.00
OF FIRESTONE WILL COMPLETE A
WATER CONSERVATION PLAN. PER
SOW. CMW #23249,
UMENT TOZAL
41,455.00
Date
THIS PO IS ISSUED IN ACCORDANCE WITH STATE AND FEDERAL REGULATIONS
This PO Is effective on the date signed by the authorized individual.
PAx
DP -01 (R- 02/06) \ ff A