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WATER CONSERVATION BOARD <br />1313 SHERMAN STREET, ROOM 721 <br />DENVER, CO 80203 <br />Buyer: ALLAN SMI TH <br />Phone Number: 303-866-3292 <br />Agency Contact: STEVEN SHULL <br />Phone Number: 3O3 866 3441 <br />DATE: O%-26-11 <br />IMPORTANT <br />The PO# and Line # must <br />appear on all invoices, <br />packing slips, cartons <br />and correspondence <br />ACC: 07-25-11 <br />FEIN 840303970 Phone: - - <br />Vendor Contact: <br />Purchase Requisition #: <br />v <br />E <br />N <br />D <br />O <br />R <br />RIO GRANDE CANAL WATER USERS ASSOC <br />147 WASHINGTON ST <br />MONTE VISTA CO 81144 <br />INSTRUCTIONS TO VENDOR: <br />1. If tor any reason, delivery of this order is tlelayed beyond the delivery/installation date <br />shown, please notify the agency contact named at the top left. (Right of cancellation is <br />reserved in instances in which timely delivery is not made.) <br />2. All chemicals, equipment and materials must conform fo lhe standards required by OSHA. <br />3. NOTE: Additional terms and conditions on reverse side. <br />SPECIAL INSTRUCTIONS: <br />°��c°`° PURCHASE <br />�� 9° ORDER <br />*�* STATE OF COLORADO <br />* � 76 �` <br />I P.O. # OE PDA 12 0 0 0 0 0 0 012 Page# O 1 <br />State Award # <br />BID # <br />Invoice in Triplicate <br />To: DIVISION OF WATER CONSERVATION <br />1313 SHERMAN STREET, ROOM 721 <br />DENVER, CO 80203 <br />Payment will be made by this agency <br />Ship DIVISION OF WATER CONSERVATION <br />To: 1313 SHERMAN STREET, ROOM 721 <br />DENVER, CO 80203 <br />Delivery/Installation Date: Q 9- Q 1-11 <br />, F.o.B. DESTINATION STATE PAYS NO FREIGHT <br />LINE COMMODITY/ITEM UNIT OF <br />ITEM CODE MEASUREMEHT OUANTITY UNIT CO3T TOTAL ITEM COST <br />001 91843000000 $5,000.00 <br />FEASIBILTY STUDY GRANT TO HELP THE LOAN APPLICANT WITH THE <br />FEASIBILITY STUDY FOR THE LOAN. PER LETTER. CMS#34615. <br />THIS PO IS ISSUED IN ACCORDANCE WITH STATE AND FEDERAL REGULATIONS <br />This PO is effective on the date signed by the authorized individual. <br />EPSPO PAA <br />DP-01 (R-02/O6) <br />THE STATE OF CO ADh�^v�v — <br />-�-t `2�-���C� <br />Autho ized Signature Date <br />