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Pn Gt �1 dvJLie"�4 <br /> WATER CONSERVATION BOARD DATE: 03-09-12 � > °?9 PURCHASE <br /> 1313 SHERMAN STREET, ROOM 721 �to <br /> �� V� �` ORDER <br /> DENVER, CO 80203 IMPORTANT *� I,(i*r <br /> The PO#and Line#must STATE OF COLORADO <br /> appear on all invoices, *''76 <br /> Buyer: ALLAN SMI TH <br /> packing slips,cartons <br /> Phone Number: 303-866-3292 <br /> and correspondence P.O. # OE PDA 12000000065 Page# 01 <br /> Agency Contact: STEVEN SHULL <br /> Phone Number: 303 866 3441 ACC: 03-08-12 State Award # <br /> FEIN 840706869 Phone: 719-657-2519 BID # <br /> Vendor Contact: Invoice in Triplicate <br /> Purchase Requisition #: To: DIVISION OF WATER CONSERVATION <br /> 1313 SHERMAN STREET, ROOM 721 <br /> FUCHS RANCHES INC DENVER, CO 80203 <br /> N <br /> D 1620 COUNTY ROAD 14A <br /> 0 DEL NORTE CO 81132 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. Delivery/Installation Date: 06-30-12 <br /> 3. NOTE:Additional terms and conditions on reverse side. F.O.B. DESTINATION STATE PAYS NO FREIGHT <br /> SPECIAL INSTRUCTIONS: <br /> GOODS ARE NOT TO BE DELIVERED, OR SERVICES PERFORMED <br /> PRIOR TO 7/01/2011 <br /> LINE COMMODITY/ITEM UNIT OF <br /> ITEM CODE MEASUREMENT QUANTITY UNIT COST TOTAL ITEM COST <br /> 001 91843000000 $8,000 .00 <br /> SEV TAX GRANT-PERFORM A BREACH STUDY FOR THE FUCHS DAM WHICH <br /> IS DOWNSTREAM OF THE RIO GRANDE RIV. PER SOW. CMS#41799. <br /> DOCUMENT TOT ? $8,000. 00 <br /> THIS PO IS ISSUED IN ACCORDANCE WITH STATE AND FEDERAL REGULATIONS FOR THE STATE OF ,LORADO <br /> This PO is effective on the date signed by the i <br /> authorized d ndividual. �' /� <br /> EPori / <br /> Authorized Signature Date <br /> DP-01 (R-02/06) <br />