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°—c PURCHASE <br /> � � <br /> WATER CONSERVATION BOARD DATE: 06-12-13 �� "�=°�9 <br /> 1313 SHERMAN STREET, ROOM 721 `'��' ° <br /> ti � o <br /> IMPORTANT **< J * ORDER <br /> DENVER, CO 80203 <br /> The PO# and Line#must STATE OF COLORADO <br /> appear on all invoices, */876 <br /> Buyer: ALLAN SMITH <br /> packing slips,cartons <br /> Phone Number: 303-866-3292 <br /> and correspondence P.O. # OE PDA 13000000112 Page# 01 <br /> Agency Contact: STEVEN SHULL <br /> Phone Number: 303 866 3441 ACC: 0 6-11-13 State Award # <br /> FEIN 840935026 Phone: - - BID # <br /> Vendor Contact: Invoice in Triplicate <br /> Purchase Requisition#: To: DIVISION OF WATER CONSERVATION <br /> 1313 SHERMAN STREET, ROOM 721 <br /> E HERFANO COUNTY WATER CONSERVANCY DT DENVER, CO 80203 <br /> N <br /> D PO BOX 1213 <br /> O LA VETA CO 81055 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. Dell Very/Installation Date: 1 2—31-1 3 <br /> s. 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 $5, 000 .00 <br /> FEASIBILITY SMALL PROJ GRANT HELP PAY FOR LOAN FEASIBILITY <br /> ENGINEERING FOR A CWCB LOAN. PER APPROVAL LETTER. CMS#57329. <br /> DOCUMENT TOTAL = 5 000.00 <br /> THIS PO IS ISSUED IN ACCORDANCE WITH STATE AND FEDERAL REGULATIONS FOR THE STAVOICOLADOThis PO is effective on the date signed by the authorized individual. {/�/EPSPO PAA & Lv" <br /> AutWiz Signature Date <br /> DP•01(R•02/06) <br />