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WATER CONSERVATION BOARD DATE: 02-24-14 �ti°F•co�o�r� PURCHASE <br /> 1313 SHERMAN STREET, ROOM 721 ;N :;� o <br /> IMPORTANT * t 4 *( ORDER <br /> DENVER, CO 80203 The PO#and Line#must * - *, STATE OF COLORADO <br /> appear on all invoices, / 76 ' <br /> Buyer: ALLAN SMITH packing slips,cartons <br /> Phone Number: 303-866-3292 and correspondence P.O. # OE PDA 14000000086 Page# 01 <br /> Agency Contact: STEVEN SHULL <br /> Phone Number: 303 866 3441 ACC: 02-21-14 State Award # <br /> FEIN 846000600 Phone: 303-665-5588 BID# <br /> Vendor Contact: CINDY NI CHOLS Invoice in Triplicate <br /> Purchase Requisition#: To: DIVISION OF WATER CONSERVATION <br /> 1313 SHERMAN STREET, ROOM 721 <br /> ✓ CITY OF LAFAYETTE DENVER, CO 80203 <br /> E <br /> N <br /> D 1290 S PUBLIC RD <br /> O LAFAYETTE CO 80026 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: 02-28-15 <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 $6, 581.25 <br /> WATER EFFICIENT GRANT-REPLACE PRE-RINSE SPRAY NOZZLES FOR 54 <br /> ENTITIES-RESTAURANTS,SCHOOLS,SENIOR HOMES. PER SOW.CMS#65833 <br /> DOCUMENT TOTAL = $6,581.25 <br /> THIS PO IS ISSUED IN ACCORDANCE WITH STATE AND FEDERAL REGULATIONS 9 FO' TE• . O•ADO <br /> This PO is effective on the date signed by the authorized individual. -//^, r/� <br /> EPSPO PAA _ ,e _ — -Ay . a ., : __ c:Q lei <br /> • hort i..aura Dame/ <br /> DP-01(R-02/06) <br />