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• Gravel <br />Check One Water <br />soil p <br />Other (~ <br />PURCHASE ORDER NUMBER I1 <br />E1 Paso County ~°1~77 <br />DEPARTMENT OF PUBLIC WORKS <br />3170 Century, Colo. Spgs., Colo. 80907 <br />9dr~ess ~ / <br />I-3•~7= ws3 <br />Dated ~h - a 7 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-+~mer of the real roaerty wherein / J'4''"''~ <br />Lists and is located in Township ~~ (s), Range F/ W, <br />action / 7 Quarter SI.U The Department of <br />iblic Works may purchase from me, ors-~.~ in the quantity <br />atimated below, during the period /lr--a7- ~9 to include <br />/f- ,17- ~'U subject to the foll wing Special Provisions: <br />[ f none this will be so noted hereon) . ~~ .-,-•0-7 ~C~ .P~.ep..~' y'~, f' <br />iit of <br />~asure <br />~~ <br />Approx. No. <br />of Units <br />~ ~~ <br />Cost <br />Per Unit <br />~~~ <br />~yments to be made monthly by Warrants issued by E1 Paso County based upon <br />ie number of units aurchased during prior month. <br />(Signature of Seller) <br />.rchase Order Acquired by <br />Signature <br />Gtr ~ <br />Tit <br />(Purchasing Agent) <br />~~ <br />rchase Order Approved by /Jr,.. ~ ___~ •.~ - <br />Max If Rothschild, P,E. <br />Director of Public Works/County Engineer <br />