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TATE OF COLORADO <br />PURCHASE REQUISITION <br />ND ADDRESS PURCHASE <br />ORDER NUMBER SUGGESTED VENDOR AND ADDRESS PURCHASE <br />ORDER NUMBER <br />Alpine Mine Construction <br />.8181 CR 203 VENDOR NUMBER VENDOR NUMBEfl <br />Durango, CO zIP 81301 zIP <br />TERMS Tax ID 524-58-9914 FOB TERMS FOB <br />•DOQy~tD~~ °~ ~ ~ ~~~~ <br />~ ~ ~. ~ Ym <br />~ CODE~NO <br />~ y ; <br />~ <br />~ . <br />~ <br />x..~s,.~. .. i :~ .u #r mv <br />~~ ffi. ~x![..l ~ <br />ZB <br />:n.~i. >v <br />. <br />r ~.....+-~~ m ...'..m <br />. ":'. k` k Vii. .~ i ~''. a ~ ~i.. + <br />~' . ~ :''c/m,`.~~1'r <br />+~'u.. <br />+~'u, <br />,~w <br />~ <br />' <br />/(J' <br />() <br />/ <br />/ <br />D D / ~ <br />V 4/ <br />m4 ' <br />~ W <br />V BU <br />D <br />F Y P E <br /> 1' <br />1I <br />1' <br />~, <br />~ <br />L3.LYJ ~ ~ <br />FUND AGENCY ORG SUB-ORG APPR CO DE BS ACCT OBJECT SUB-OBJ REV SRC <br /> 2 7 0 P R A C C C 8 m 1 0 8 ~ 2 3 1 1 m <br />su GB <br />FUNCTI REPORTI PROJ(JOB NO OFFOFF RE <br />m M N R ~ ~ ~ ~ <br />~L~.LJ <br />BILL TO - Name antl Atldress SNIP TO -Name aiM Atltlrass <br />Division of Minerals and Geology Designated Job Site (per specs) <br />1313 Sherman St., Rm. 215 <br />Denver, CO 80203 <br />REQUESTING AGENCY - Name entl Address TELEPHONE PERSON(S) TO CONTACT <br /> - Maggie Van Cleef <br />Same as bill to <br /> FAX <br /> 32-8106 <br />thereby seniy that the supplies a 'cea li e0 are cessary for Ne Bocce r ion Iha agenry and the <br />quantity requested u ffie mimmum e m nd tl area isp avN¢ienf to ar same <br />AUTHO ED <br />ITEM <br />NO. QUANTITY U IT ! COMMODI MBER AND <br />COMPLETE DESCRIPTION OF ITEM OR SERVICE UNIT <br />LOST AMOUNT <br /> ttt <br />f <br />~ REFERENCE PRICE AGREEMENT A <br /> JJ <br />I { L & L Energy/Blue Flame Forfeiture <br /> I Project/Maintenance <br />4 <br /> Permit No. C-81-053 <br />i <br />i <br /> <br />1 <br />1 S <br />~ Job ~ Mobilization/Demobilization <br />N/A <br />$ 390.00 <br />2 1 Job I Mat Placement <br />E N/A 1180.00 <br /> <br />3 <br />8 f <br />Hours ~ Track mounted backhoe w/operator, per <br />$85'.00 <br />680.00 <br /> ~ <br />~ Equipment Rental Specifications, JD 490 <br /> <br /> <br /> <br /> <br /> <br />4 <br /> <br /> <br />E <br />1 <br />3 <br />I F <br />I <br />3 I <br />)j <br />3 r <br />`' $2250.00 <br />