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WATER CONSERVATION BOARD DATE: 06-05-09 11* PURCHASE <br /> 1313 SHERMAN STREET, ROOM 721 �''�� '`.-- <br /> DENVER, CO 80203 IMPORTANT * f 41`.4) r, ORDER <br /> 4(The PO#and Line#must t,- <br /> w 4, STATE OF COLORADO <br /> Buyer MAGGIE VAN CLEEF appear on all invoices, <br /> Phone Number. 303-866-3292 andkcorrresping ondences P.O.# OE PDA 09000000138 Page# 01 <br /> Agency Contact STEVEN SHULL <br /> Phone Ntasber. 303 866 3441 ACC: 06-04-09 State Award# <br /> FEIN 542109792 Phone: 970-463-5739 BID# <br /> Vendor Contact invoice In Triplicate <br /> Purchase Requisition II: To: DIVISION OF WATER CONSERVATION <br /> 1313 SHERMAN STREET, ROOM 721 <br /> ✓ SEDGWICK COUNTY WELL USERS INC DENVER, CO 80203 <br /> E <br /> N <br /> D 2859 COUNTY ROAD 26 <br /> O SEDGWICK CO 80749 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 rescan,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 i$ <br /> reserved In Instances In which timely delivery Is not made.) <br /> P. All chemicals,equipment and materials must conform to the standards required by OSHA. <br /> Deiivery/instaiiation Date 06-30-09 <br /> S. NOTE AddttIo nal terms and oondiderq on reverse viae. <br /> ROA DESTINATION STATE PAYS NO FREIGHT <br /> SPECIAL INSTRUCTIONS: <br /> LINE COMMODITY/ITEM UNIT OF <br /> ITEM CODE MEASURBIENT QUANTITY UNIT COSI TOTAL RHI COST <br /> 001 91843000000 $72,188.00 <br /> AGRICULTURAL EMERGENCY DROUGHT GRANT, PER ATTACHED GRANT <br /> AWARD. <br /> DOCUMENT '% A - S72.188.00 <br /> THIS PO IS ISSUED IN ACCORDANCE WITH STATE AND FEDERAL REGULATIONS FOR THE STATE F,-•'ORADO <br /> This PO is effective on the date signed by the authorized Individual <br /> ace. PM / <br /> / ' .6.2Z.Z.I) <br /> / .1Y.rized gnature <br /> DP-01(R-02/06) 1 <br />