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°� c°` PURCHASE <br /> WATER CONSERVATION BOARD DATE: 01-24-12 ,4, T?9� <br /> 1313 SHERMAN STREET, ROOM 721 ,�Q��l� �° <br /> !" i" °) ORDER <br /> DENVER, CO 80203 IMPORTANT * V� *i <br /> The PO#and Line#must `�* ** STATE OF COLORADO <br /> appear on all invoices, <br /> �`��/ <br /> Buyer: ALLAN SMITH <br /> packing slips,cartons <br /> Phone Number: 303-866-3292 <br /> and correspondence P.O. # OE PDA 12000000053 Page# 01 <br /> Agency Contact: STEVEN SHULL <br /> Phone Number: 303 866 3441 ACC: 01-23-12 State Award # <br /> FEIN 840226700 Phone: — — BID # <br /> Vendor Contact: Invoice in Triplicate <br /> Purchase Requisition #: To: DIVISION OF WATER CONSERVATION <br /> 1313 SHERMAN STREET, ROOM 721 <br /> E HIGHLAND DITCH COMPANY DENVER, CO 80203 <br /> N <br /> D 4309 STATE HIGHWAY 66 <br /> 0 LONGMONT CO 80404 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. <br /> "13- 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 $27 , 500. 00 <br /> SEV TAX GRANT-TO COMPLETE A DAM BREACH MODEL FOR THE 6 DAMS <br /> THAT THE COMPANY OPERATES. PER SOW. CMS#40423. <br /> DOCUMENT TOTA = $27, 500.00 <br /> THIS PO IS ISSUED IN ACCORDANCE WITH STATE AND FEDERAL REGULATIONS cos THE STATE OF C AD <br /> This PO is effective on the date signed by the authorized individual. // <br /> EPSPO FAA <br /> &,6-6-- `^ � )/.�LIl(�lAuthorized Signature Date <br /> DP-01(R-02/06) <br />