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<br />Check One <br />PURCHASE ORDER <br />E1 Paso <br />DEPARTME'1T OF <br />3170 Century, Colo. <br />County <br />PUBLIC WORKS <br />Spgs., Colo. 80907 <br />~llez (,C~fn.2.r~ D~. <br />3dress ~~ <br />~d ~~~ <br />Gravel <br />Water <br />Soil [y <br />Other (~ <br />NUMBER <br />pia ~ ~ <br />Dated_ •Jfti ~~ 19~ <br />Refer to the above number or <br />provide a cony of this order <br />with any claim you may find <br />necessary to file. <br />declare that I am o•~rner of the real property wherein J ~J' <br />:fists and is located in Township // (s), Range ~D W, <br />action ~7 Quarter SE The Department of <br />~blic Works may purchase from me, ..,o in the quantity <br />timated below, during the period `]~ ~,) /471 to include <br />~,~ aot~/ 9~'~ subject to the following So cial Provisions: _ <br />f none this will be so noted hereon) , c.,. %~ i,~.~,,~i .G ~'/ <br />it of <br />asure <br />~~~ <br />Approx. No. <br />of Units <br />'Z./iGy~/f/~'~'r <br />Cost <br />Per Unit <br />~v <br />/`~'~` ~~ <br />yments to be made monthly by Warrants issued by E1 Paso County based upon <br />e number of unite purchased during prior month. <br />(Signature of Sel r) <br />rchase Order Acquired by, <br />Signature <br />Q ~ , <br />Title <br />s <br />(Purchasing Agent) <br />-chase Order Approved by /Jir-`~ ~~ ~1~~/r~ ~ <br />Max L.-Rothschild, P.E. <br />Director of Public Works/County Engineer <br />