Laserfiche WebLink
STATE OF COLORADO ~/ 'L S <br />III IIIIIIIIIIIIIIII ~'~~ ~'~ <br />PURCHASE REQUISITION /~(/~~ K/~i <br />SUGGESTED VENDOR AND ADDRESS PURCHASE <br />ORDER NUMBER SUGGESTED VENDOR ANO ADDRESS PURCHASE <br />ORDER NUMBER <br />lM. <br />/ <br />(~~ ~ [J <br />VENDOR NUMBER <br />- <br />VENDOR NUMBER <br />ZIP y/'~~7 <br />Y " <br />( ZIP <br />TERMS ~ //1 # '1/~/ <br />/7~ <br />~ <br />III///JJJ ~~// L/ J FOB TERMS FOB <br />OOC. IDD <br />CODE NO. <br />P I I I I (ACCTIACCTP~ 171 tl I I r jYPE <br />FUND AGENCY ORG ~lOCCRG APPR CODE BS ACCT OBJECT <br />KA CC'C~' m / ~ a3 i i <br />TING CAT <br />REV PR AM <br />SUB SUB-OBJ BEV SRS <br />~ LPL J <br />- <br />PROJ/JOB NO <br />~UNCTIO~ <br />m _m N R ~- ~ L_L_.W OFF PEG ACCT <br />BILL TO ~ Name artl Address SHIP TO -Name and Adtlress <br />ol <br />~ U <br />. <br />7 <br />~ <br />~ <br />~„ YIn.:.Ae~als <br />i ~~,~ <br />-~ ~~ 5-~.r,o,r. ~ ~-~s ~ ~~5~ ~~ s, ~ <br />s i <br />i ~ <br />~°~ <br />i <br />oca- <br />~u , Co hod o 3 <br />I REOUEiTiNG AGEHC'i ~ Name and Adprxss iE iEEHONE PERSONS) TO CONTACT <br />i I ~~~-3 5r,7 , I <br />~ FAX (JDrlno r- <br />~ <br />KP <br />g3a-8 /a6 V1 J 1 <br />~ hereby ceniry mal ms supplies or serviros ~~sletl ara necessary Ipr Ibe successlul pperauon of me agency and IM1e <br />quanlitY rsques:e0 is ma minimum amount antl lurq Jasignaled is su0iaem fc cover same. <br />AUTHORIZED SIGNATURE <br />REM QUANTITY UNIT COMMGOITY NUIdBER ANO <br />NO. COMPLETE DESCRIPTION OF ITEM OR SERVICE UNIT AMOUNT r <br />GOST <br />REFERENC'c rRICE AGREEMENT a <br />I i <br />c - g ~ -a39 <br />l Zi oak ~t~~ c.~ ~. i <br />, <br />b ~6.SSN ~ (04.! /bv~ne (,c~e.~~~°71w '~ N~~ ID~/P» <br />I dd <br />~ 7D <br />1 <br />. <br />('ate ~I`x+.J~.~~i.]re ~i Ta~rc"f" I <br /> <br />' REQUESTED DELIVERY DATE ' <br />]9b5]-OS-ttsl <br />WHRE Purcnasmg Copy YELLOW ~ Ac<oums 8 Lomrol Gpoy PINK agency LopY GOlOENROD -Department Gopy <br />