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EiGNrB ~ ff <br />ccN, 8 it a ~ ~ <br />~/Z/B!T 'E Check One <br />E~CNIS[T ~ <br />.~xyt$[T y <br />PURCHASE ORDER <br />E1 Paso <br />DEPARTMENT OF <br />3170 Century, Colo. <br />// "' • • ~ <br />Eller %/i "Z (• /'l l;;%. <br />County <br />PUBLIC WORSCS <br />Spgs., Colo. 80907 <br />~ '. f <br />idress ~r <<<r <br />i ' <br /> .G U <br />Grave l <br />Water <br />soil [] <br />Other 0 <br /> <br />UMBER !:, <br />/ <br />' <br />N E <br /> <br />/6asN <br />Dated !•~C< <•' ~ ~' 19 ~.~ <br />Refer to the above number or <br />provide a copy of this order <br />with any claim you may find <br />necessar to file. <br />declare that I am owner of the real p rooerty wherein .-Cfi<<<•c% <br />:fists and is located in Township ~f (s), Range • y~ ~ W, <br />+ction ~.k Quarter `~,!` ~ The Department of <br />blic Works may purchase from me, ,Ut nr^~c'~ in the vuantity <br />timated below, during the period ./~- / ~- % Y to include <br />~ - / ~- ~~~ subject to the following Special Provisions: , <br /> <br />f none this will be so noted hereon). y <br />/:~ , <br />.~ ,c r~..r ~ r'~~'.c;<</ <br /> <br />it of <br />asure <br />~. <br />~c (,~C ~~C~i~ <br />Approx. No. <br />of Units <br />~,/ <br />Cost <br />Per Unit <br />~~~ Y <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 />~,~,1 ~~~~ ri1~.ti~~i <br />(Signature of Seller) <br />*chase Order Acouired by l(?'~(J ~/ (</!j (~ <br />Signatur~ <br />~; <br />/ Tit <br />~ G `~` <br />(Purchasing Agent) <br />•chase Order Approved by /J7-~~ ~ `~ lly~ ~ ~~ "~ <br />Max L. RotfisEhild, P.E. <br />Director of Public Works/County Engineer <br />