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°c ` PURCHASE <br /> WATER CONSERVATION BOARD DATE: 01-08-13 ;� '�9Q, <br /> 1313 SHERMAN STREET, ROOM 721 N� 9Y~/+r <br /> DENVER, CO 80203 IMPORTANT *�' (ia) *, ORDER <br /> The PO#and Line#must *�.v*. STATE OF COLORADO <br /> appear on all invoices, * '' <br /> •Buyer: ALLAN SMITH packing slips,cartons <br /> Phone Number: 303-866-3292 and correspondence P.O.# OE PDA 13IBC000015 Page# 01 <br /> Agency Contact: DORI VIGIL <br /> Phone Number: 303 866 3441 ACC: 01-07-13 State Award # <br /> FEIN 846000713 Phone: - - BID# <br /> Vendor Contact: Invoice in Triplicate <br /> Purchase Requisition a: To: DIVISION OF WATER CONSERVATION <br /> 1313 SHERMAN STREET, ROOM 721 <br /> E <br /> • TOWN OF RANGELY DENVER, CO 80203 <br /> N <br /> D 209 EAST MAIN STREET <br /> O RANGELY CO 81648 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: 12-31-13 <br /> 3. NOTE-Additional terms and conditions on reverse side. E02- <br /> 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 $12,500.00 <br /> CMS# 51809 RANGELY RAW WATER IRRIGATION FLOW/STUDY • <br /> DESIGN <br /> DO .M NT TOTAL = $12,500.00 <br /> THIS PO IS ISSUED IN ACCORDANCE WITH STATE AND FEDERAL REGULATIONS +' STATE OF C ORADO <br /> This PO Is effective on the date signed by the authorized individual. // I/v L 1(1) <br /> EPSPO PAA <br /> Authorized Signature Date <br />