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<br />Check One <br />PURCHASE ORDER <br />E1 Paso <br />DEPARTMENT OF <br />~--3170 /Century, Colo. <br />~%~a~-~ l~-uc <br />ller <br />County <br />PUBLIC WORKS <br />Spgs., Colo. 80907 <br /> <br />Gravel <br />Water <br />Soil [~ <br />Other <br />NUMBER <br />G/ /y ~. <br />Dated '_. ~ ~ 19,~~ <br />Refer to the above number or <br />provide a copy of this order <br />with any claim you may find <br />necessary to file. <br />9eclare that I am o'..mer of the real property wherein ~,~a,~,~J~ <br />fists and is located in Township_ // (s), Range ~n W, <br />.t ion /tf Quarter ' ~~ The Department of <br />~lic Works may purchase from me, in the quantity <br />:imated below, during the period •-^j~~7 „2,3. ~9 pV to include <br />-r <br />•~ ~_/Qk~/ subject to the following Special Pro/~visions: <br />' none this will be so noted hereon) _ l~.~. __~ ~_ i/ AOi ~ -~~1_ . _Jr <br />t of <br />sure <br /> <br />Approx. No. <br />of Unite <br />Cost <br />Per Unit <br />/O 4 <br />~,.. C~ <br />nents to be made monthly by Warrants issued by E1 Paso County based upon <br />number of units purchased during prior month. ~, <br />hale Order Acquired by <br />/ / Signature <br />(l// Titl <br />r ~~ <br />(Purchasing Agent) <br />ease Order Approved <br />~j,~ ~.. <br />Max L.~RO hschild, P.E. <br />Director of Public WorY.a/County Engineer <br />