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!/Colorado Dept of Transportation OF COlO <br /> DATE:02/18/2016 ti urchase order <br /> 4201 E. Arkansas Ave. �__= =-_y <br /> Denver, Co 80222 0 State of Colorado <br /> IMPORTANT <br /> The PO# and Line# *�* <br /> Buyer: Purch under$5,000 must appear on all <br /> Phone Number: invoices, packing 1876 <br /> Agency Contact: Deborah Penner slips, cartons and PO#421020739 Page# 1 of l <br /> Phone Number: 970-826-3441 correspondence Award#: RECEI E--N <br /> Vendor Master#:2000100 BID#: I``V GG YY <br /> Phone: Invoice MAR 0 2 201 t <br /> Vendor Contact:NMNNIE COLON <br /> TO: CDOT R3 MTCE SUPT CRAIG <br /> v 260 RANNEY ST. "ION OF RECLAMTI%l <br /> E STATE OF COLORADO Craig CO 81625 (AININGANpS4FETY <br /> N 633 17TH ST # 1500 <br /> D DENVER CO 80202-3661 <br /> Payment will be made by this agency <br /> 0 <br /> Ship <br /> INSTRUCTIONS TO VENDOR TO: Colorado Dept of Transportation <br /> 260 RANNEY ST <br /> 1 If for soy reason,deliver of this order is delayed beyond the delivery/Installation date shown.please notify CRAI G CO 81625 <br /> the agency contact named at the top left(Right of cancellation is reserved in instances in which timely deliver <br /> is not made).2.All chemicals,equipment and materials must conform to the standards required by OSHA. Delivery/Installation Date'02/18/2016 <br /> 3.NOTE:Additional terms and conditions on reverse side or at address shmcn in Special Instmetions. ' <br /> SPECIAL INSTRUCTIONS <br /> LINE PRODUCT NUMBER UOM QUANTITY UNIT COST TOTAL ITEM COST <br /> PRODUCT CATEGORY PLANT <br /> DESCRIPTION <br /> 00001 EA 1 323.00 323.00 <br /> 96200 3002 <br /> MYRIN PERMIT <br /> ----------------------------------------------------------------------------------------------------------------------------------------------- <br /> DOCUMENT TOTAL: 323.00 <br /> THIS PO IS ISSUED IN ACCORDANCE WITH STATE AND FEDERAL REGULATIONS FOR THE STATE OF COLORADO <br /> https://www.codot.gov/business/procurement-and-contract- <br /> services/purchase-order-terms-and-conditions/purchase-order-terms- <br /> and-conditions/view Authorized Signature Date <br /> DP-01(R-02/06) <br /> Signature not required if PO transmitted <br /> electronically. <br />