Firestone_DMPlan_PO

• Water Efficiency Grant Type: Drought Mitigation Planning Grant
• Contract/PO #: OE PDA 12-21
• Applicant: Town of Firestone
• Project Name: Town of Firestone Drought Mitigation Plan
• Title: Purchase Order
• Date: 9/26/2011
• County: Weld
• Water Efficiency - Doc Type: Purchase Order

WATER CONSERVATION BOARD
1313 SHERMAN STREET, ROOM 721
DENVER, CO 80203
Buyer: _ ALLAN SMITH
Phone Number: 303 - 866 -3292
Agency Contact: STEVEN SHULL
Phone Number: 303 866 3441
DATE- 09 -26 -11
IMPORTANT
The PO# and Line # must
appear on all invoices,
packing slips, cartons
and correspondence
ACC: 09 -23 -11
FEIN 840736777 Phone: - -
Vendor Contact:
Purchase Requisition #:
V TOWN OF FIRESTONE
E
N
D PO BOX 100
O FIRESTONE CO 80520
R
INSTRUCTIONS TO VENDOR:
1. If for any reason, delivery of this order is delayed beyond the delivery /Installation date
shown, please notify the agency contact named at the top left. (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 required by OSHA.
3. NOTE: Additional terms and conditions on reverse side.
SPECIAL INSTRUCTIONS:
Tc PURCHASE
o
* ORDER
*7*
/ 78 STATE OF COLORADO
��
P.O. # OE PDA 12000000021 Page# 01
State Award #
BID #
Invoice in Triplicate
To: DIVISION OF WATER CONSERVATION.
1313 SHERMAN STREET, ROOM 721
DENVER, CO 80203
(Payment will be made by this agency
Ship DIVISION OF WATER CONSERVATION
To: 1313 SHERMAN STREET, ROOM 721
DENVER, CO 80203
Delivery /Installation Date: 07 -31 -12
F.O.B. DESTINATION STATE PAYS NO FREIGHT
LINE COMMODITY /ITEM UNIT OF
ITEM CODE MEASUREMENT OUANTITY UNIT COST TOTAL ITEM COST
001 91843000000
WATER EFFICIENCY GRANT- COMPLETE A DROUGHT MITIGATION PLAN
FOR THE TOWN OF FIRESTONE. PER SOW. CMS #36826.
C(DPY
THIS PO IS ISSUED IN ACCORDANCE WITH STATE AND FEDERAL REGULATIONS
This PO is effective on the date signed by the authorized individual.
EPSPO PAA
DP -01 (R- 02/06)
FOR
$39,031.00
$39,031.00
RADO
5�_ g1�414
lure Date