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°c c°` PURCHASE <br /> WATER CONSERVATION BOARD DATE: 12-10-13 /����.°�� <br /> 1313 SHERMAN STREET, ROOM 721 N tad,`o' <br /> DENVER CO 80203 IMPORTANT (* CIO)•* * ORDER <br /> The PO#and Line#must `� *,, STATE OF COLORADO <br /> appear on all invoices, ti76 <br /> Buyer: ALLAN SMITH <br /> packing slips,cartons <br /> Phone Number: 303-866-3292 <br /> and correspondence P.O. # OE PDA 14000000061 Page# 01 <br /> Agency Contact: STEVEN SHULL <br /> Phone Number: 303 866 3441 ACC: 12-09-13 State Award # <br /> FEIN 484481964 Phone: - - BID # <br /> Vendor Contact: Invoice in Triplicate <br /> Purchase Requisition #: To: DIVISION OF WATER CONSERVATION <br /> 1313 SHERMAN STREET, ROOM 721 <br /> E MOLTZ, V PAUL DENVER, CO 80203 <br /> N <br /> D PO BOX 1914 <br /> O BUENA VI STA CO 81211 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: 06-30-14 <br /> a. 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 OUANTITY UNIT COST TOTAL ITEM COST <br /> 001 91843000000 $5, 600 .00 <br /> SEV TAX GRANT-TROUT CREEK DAM LOCATED @ TROUT CREEK RES TO <br /> THE ARKANSAS RIVER. PER SOW. CMS#63620. <br /> DOCUMENT TOT Ill= $5,600.00 <br /> THIS PO IS ISSUED IN ACCORDANCE WITH STATE AND FEDERAL REGULATIONS .•fj..;HE Sri.TE OF�OIORADO <br /> This PO is effective on the date signed by the authorized individual. `/jJ / L , (/&�1� <br /> EPSPO PAA <br /> Authorized Signature Date <br /> DP-01(R-02/06) <br />