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°c•`°`° PURCHASE <br /> WATER CONSERVATION BOARD DATE: 03-22-10 �: W+°=�,-9 <br /> 1313 SHERMAN STREET, ROOM 721 Q � � \� <br /> �� <br /> * ORDER <br /> DENVER, CO 80203 IMPORTANT O, <br /> The PO#and Line#must STATE OF COLORADO <br /> appear on all invoices, /`,6 <br /> Buyer: MAGGIE VAN CLEEF packing slips,cartons <br /> Phone Number: 303-866-3292 and correspondence P.O. # OE PDA 10000000099 Page# 01 <br /> Agency Contact: STEVEN SHULL <br /> Phone Number- 303 8 6 6 3441 ACC: 03-19-10 State Award # <br /> FEIN 841606567 Phone: 720-570-2897 BID # <br /> Vendor Contact: Invoice in Triplicate <br /> Purchase Requisition #: To: DIVISION OF WATER CONSERVATION <br /> 1313 SHERMAN STREET, ROOM 721 <br /> E <br /> • COLORADO WATER TRUST DENVER, CO 80203 <br /> N <br /> D 1430 LARIMER STREET SUITE 300 <br /> O DENVER CO 80202 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. DEST I NATION STATE PAYS NO F RE I GHT <br /> SPECIAL INSTRUCTIONS: <br /> LINE COMMODITY/ITEM UNIT OF <br /> ITEM CODE MEASUREMENT QUANTITY UNIT COST TOTAL ITEM COST <br /> 001 91843000000 $65, 000 . 00 <br /> IMPROVE THE EXISTING DIVERSION DAM ON THE CCC DITCH WITH THE <br /> INSTALLATION OF A NEWBURY RIFFLE. PER SOW. CMS#13828 . <br /> DOCUMENT TOTAL = $65, 000 . 00 <br /> THIS PO IS ISSUED IN ACCORDANCE WITH STATE AND FEDERAL REGULATIONS FOR THE STATE OF COLORADO <br /> This PO is effective on the date signed by the authorized individual. / Z <br /> EPSPO PAA / , 7; �� �,� <br /> 'A' '' orized Sign: a Date <br /> DP-01(R-02/06) / <br />