13-61 WAS - Purchase Order

• Applicant: Central Colorado Water Conservancy District - Well Augmentation Subdistrict
• Grant Type: Severance Tax
• Fiscal Year ‎(i.e. 2008)‎: 2013
• Project Name: Agricultural Emergency Drought Response
• CWCB Section: Finance
• Contract/PO #: 13-61
• Grants - Doc Type: Contract/Purchase Order

WATER CONSERVATION BOARD
1313 SHERMAN STREET, ROOM 721
DENVER, CO 80203
Buyer: MAGGI E VAN CLEEF
Phone Number: 303 - 866 -3292
Agency Contact: STEVEN SHULL
Phone Number: 303 8 6 6 3441
FEIN 846049901 A
Vendor Contact:
Purchase Requisition #:
DATE: 11-28-12
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PURCHASE
IMPORTANT
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ORDER
The PO# and Line # must
*
*
STATE OF COLORADO
appear on all invoices,
/ e
packing slips, cartons
and correspondence
P.O. # OE PDA
13000000061 Page# 01
ACC: 11-27-12
State Award #
Phone: 970 - 330 -4540 BID #
V CENTRAL COLO WATER CONSERVANCY DIST
E
N WELL AUGMENTATION SUBDISTRICT
D 3209 WEST 28TH STREET
O GREELEY CO 80634
R
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
INSTRUCTIONS TO VENDOR: To: 1313 SHERMAN STREET, ROOM 721
1. If for any reason, delivery of this order Is delayed beyond the delivery /Installation date DENVER, CO 80203
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. Delivery /Installation Date: 06-30-13
s. NOTE: Additional terms and conditions on reverse side. F.O -B. DESTINATION STATE PAYS NO FREIGHT
SPECIAL INSTRUCTIONS:
LINE COMMODITYATEM UNIT OF
ITEM CODE MEASUREMENT QUANTITY UNIT COST TOTAL ITEM COST
001 91843000000
AG EMGERENCY DROUGHT GRNT -TO HELP PAY FOR THE INCREASED COST
TO PURCHASE REPLACEMENT WATER. PER GRANT. CMS #51228.
THIS PO IS ISSUED IN ACCORDANCE WITH STATE AND FEDERAL REGULATIONS FOR THE STATE
This PO is effective on the date signed by the authorized individual.
EPSPO PAA
DP -01 (R- 02/06)
$216,577.68
Date