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WATER CONSERVATION BOARD DATE: 04-25-12 /-6v-.c04-0 4 PURCHASE <br /> DENVER,iECOA80203EET, ROOM 721 IMPORTANT �* +R1 (►° <br /> ORDER <br /> The PO#and Line#must \* <br /> *,:76 STATE OF COLORADO <br /> Buyer: ALLAN SMITH appear on all invoices, <br /> packing slips,cartons <br /> Phone Number: 303-866-3292 <br /> and correspondence P.O. # OE PDA 12000000079 Page# 01 <br /> Agency Contact: STEVEN SHULL <br /> Phone Number: 303 866 3441 ACC: 04-24-12 State Award # <br /> FEIN 846094944 Phone: 970-731-2691 BID # <br /> Vendor Contact: , Invoice in Triplicate <br /> Purchase Requisition#: To: DIVISION OF WATER CONSERVATION <br /> 1313 SHERMAN STREET, ROOM 721 <br /> E PAGOSA AREA WATER & SANITN DIST DENVER, CO 80203 <br /> N <br /> D PO BOX 4610 <br /> o PAGOSA SPRINGS CO 81157-4610 Payment will be made by this agency <br /> R Ship DIVISION OF WATER CONSERVATION <br /> INSTRUCTIONS TO VENDOR: To: 1313 SHERMAN STREET, ROOM 721 <br /> 1. If for any reason,delivery of this order is delayed beyond the delivery/installation date DENVER, CO 80203 <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 to the standards required by OSHA. <br /> Delivery/Installation Date: 09-30-12 <br /> 3. NOTE:Additional terms and conditions on reverse side. F.O.B. DESTINATION STATE PAYS NO FREIGHT <br /> SPECIAL INSTRUCTIONS: <br /> LINE COMMODITY/ITEM UNIT OF <br /> ITEM CODE MEASUREMENT QUANTITY UNIT COST TOTAL ITEM COST <br /> 001 91843000000 $21,140 .00 <br /> WATER EFFICIENCY GRANT-DEVELOP A 2012 DROUGHT MANAGEMENT PLA <br /> N FOR THE PAGOSA AREA. PER SOW. CMS#43600. <br /> DOCUMENT TOTAL $21,140.00 <br /> THIS PO IS ISSUED IN ACCORDANCE WITH STATE AND FEDERAL REGULATIONS ,�' F„. . E STATE OF COL ADO <br /> This PO is effective on the date signed by the authorized individual. / � L ' y/�51/.Z-- <br /> EPSPO PAA ' <br /> Authorized Signature Date <br /> DP-01(R-02/06) <br />