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-- _-- <br />III IIIIIIIIIIIII III ~ - STATE OF COLORADO < ' _ ~~ ' L..~ ~~~-~_° , <br />- PURCHASE REQUISITION <br /> <br />_ :2 - ~ 4 PURLNASE <br />ORDER NUYRER - AGENCY NAME P R NUMBER - <br />~61G~STFD'~NDORAMD"pOp~`r~ - .. - Min d Land Recl. Divisi E S <br />- ... <br />.: ~. ~ -_ F/Y .GATE FUND AGT CD AGENCY NUMBER <br />1 <br />- ~~ VEXpOPNUYRER 90 ~ 4-2-90 4008 t4O~ 34-13-00 <br />i _ A~` • _ tom. ~ . u ~ ... _ <br /> <br />. ~ ~ - ~ ~ ZIP ' ' COMMODITY CC <br />' TERMS FOB ... '~ _ ~ ~~ 71 <br /> RURCNASE ~ <br />G/L ABL <br />ORJ <br />ENCUMBRANCE <br />CC <br />SUGGESTED VENDOR AND ADDRESS ORDER NUMBER MO <br />I ACCT NO ORG UNIT ACCT NO CODE A <br />UNT <br /> N6Si(I 80-00-074 10740 6301 800.00 ~ <br />$11 s1 <br /> VENDOR NUMBER , <br />~ ~ I hereby certify Ihat the aupDlies or services lisletl ere necessary for the succeaslul <br /> operation of the epency entl the quantity requeste0 is the minimum amount entl funtl <br /> tlesipnaletl is auNiCient to cgver same. <br />_ <br />I ZIP <br />TERMS - FOB ~ <br />ntl Atltlreal <br />BILL TO ~ Na <br />e <br />- <br />. <br />( ~ ~' <br />m <br />e <br />~ <br />. - <br />~' <br />',,) <br />~ <br /> s <br />1 <br />~ ! AGE Y HEAD <br /> ,,((~~~~ <br />~ <br />? <br />Mined Land Reclamation WJ 1 J1 Dn REQUESTING AGENCY ~ Name entl Atltlrasa <br />1313 Sherman Street, Rm 215 <br />Denver, CO 80203 _ P4ined Land Reclamation Division <br /> 1313 Shernlan Street, Rm 215 .. - <br />SN1P TO - Nama entl AtltlreiA _ Denver, Col orado ~ 80203 _ - - -. ~- <br />-~ ~ ~ ~ - ~ <br />Same as Requesting.Agency ~ <br />. <br />- PERSON TO CONTACT IOnpinetor of Request) TELEPHONE . <br />- <br />~ <br />. <br />.:: <br />-.. <br />_- <br />Tom Gillis _ _ <br />866-3567' <br />ITEM ~ ~ ~ ~ ~ - :'~ UNIT - ' <br />NO.~~_. QUANTITY -.UNIT COMPLETE DESCRIPTION OF ITEM OR SERVICE -. COST ~-- AMOUNT <br /> - Ref.. Bid Number RN-Goal-Mines-3 :, -. - - -= - '. <br />1 1 :-- Proj. Sunlight Mine Reclamation -:: N/A ' 9:11,800.0 <br /> - Garfield Energy Corporation . <br />' ~• :': Permit No. C-81-046 ~-•.:,;: ~• <br />- <br /> _ .. <br /> :. This project is subject to advertising before <br /> - _ final payment (C.R.S. 38-26-107)... In ' _ - <br /> addition; retainage will be held at 10%. <br /> A17 in accordance with specifications, <br /> drawings terms and conditions of the above <br /> bid and the attached BID SCHEDULE (Line item <br /> Price) sheet, which are made a part here of <br />_ by reference.' <br /> 6252E <br /> Delivery ~ ~ ~ ~ ~ ~~ <br /> ' Req./Req'd: <br />39553-052 t a t <br />