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WATER CONSERVATION BOARD DATE: 02-23-12 /7�o/-co;°.9 PURCHASE <br /> 1313 SHERMAN STREET, ROOM 721 � ii�o <br /> DENVER, CO 80203 IMPORTANT (*+i!V42;1,� * ORDER <br /> The PO#and Line#must \*� * STATE OF COLORADO <br /> appear on all invoices, *x` 76 <br /> Buyer: ALLAN SMITH <br /> packing sspo,dencns <br /> Phone Number: 303-866-3292 <br /> and correspondence P.O. # OE PDA 12000000064 Page# 01 <br /> Agency Contact: STEVEN SHULL <br /> Phone Number: 303 866 3441 ACC: 02-22-12 State Award # <br /> FEIN 846000156 Phone: - - BID # <br /> Vendor Contact: Invoice in Triplicate <br /> Purchase Requisition #: To: DIVISION OF WATER CONSERVATION <br /> 1313 SHERMAN STREET, ROOM 721 <br /> E COLO RIVER WATER CONSERVATION DIST DENVER, CO 80203 <br /> N <br /> D PO BOX 1120 <br /> O GLENWOOD SPRINGS CO 81602 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: 06-30-12 <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 $8,000.00 <br /> SEV TAX GRANT-PERFORM A DAM BREACH MODEL & FLOOD INUNDATION <br /> MAP FOR THE RITSCHARD DAM. PER SOW. CMS#41238. <br /> DOCUMENT TOTAL $8, 000 . 00 <br /> THIS PO IS ISSUED IN ACCORDANCE WITH STATE AND FEDERAL REGULATIONS THE STATE COLO DO <br /> This PO is effective on the date signed by the authorized individual. (e,EPSPO PAA ( I ,`4L .23L (�Authorized Signature ✓✓✓Date <br /> DP-01(R-02/06) <br />