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WATER CONSERVATION BOARD DATE: 08-09-12 Fw°v PURCHASE <br /> 1313 SHERMAN STREET, ROOM 721 Q c..I_, <br /> ` 'i f ORDER <br /> DENVER, CO 80203 IMPORTANT * �� 9 >� <br /> 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 13000000019 Page# 01 <br /> Agency Contact: STEVEN SHULL <br /> Phone Number. 303 866 3441 ACC: 08-08-12 State Award # <br /> FEIN 846000583 Phone: — — BID # <br /> Vendor Contact: Invoice in Triplicate <br /> Purchase Requisition#: To: DIVISION OF WATER CONSERVATION <br /> 1313 SHERMAN STREET, ROOM 721 <br /> ✓ CITY OF ENGLEWOOD DENVER, CO 80203 <br /> E <br /> N <br /> D 1000 ENGLEWOOD PARKWAY <br /> O ENGLEWOOD CO 80110-2373 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: 06-3 0-13 <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 $46,316.00 <br /> WATER EFFICIENCY GRANT-COMPLETE A WATER CONSERVATION PLAN <br /> FOR THE CITY OF ENGLEWOOD. PER SOW. CMS#47735. <br /> DOCUMENT TOTAL = $46,316.00 <br /> THIS PO IS ISSUED IN ACCORDANCE WITH STATE AND FEDERAL REGULATIONS FOR THE STATE OF CO •:ADO <br /> This PO is effective on the date signed by the authorized individual. i <br /> EPSPO PAA 0 ■ ' _e <br /> Auth, ized ign. ure e <br /> DP-01(R-02/06) <br />