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_ L. <br />• <br />Check One <br />PURCHASE ORDER <br />E1 Paso <br />DEPARTMENT OF <br />3170 Century, Colo. <br />County <br />PUBLIC WORKS <br />Spgs., Colo. 80907 <br />ress ~-~'` 3 C~~X 6a <br />A~ ~~ ~•-s Cnrri ~o9Gc~ <br />Date <br />9~ <br />Refer~tyfS the above number or <br />provide a copy of this order <br />with any claim you may find <br />necessary to file. <br />eclare that I am o•.~mer of the real property wherein ~iL~t-..e~ <br />sts and is located in Township ~~ (s), Range ~ 7 W. <br />tion ~ `/ Quarter i{/Ok'TN E fi The Department of <br />lic Works may purchase from me, in the quantity <br />imated below, durin$~the periodJy ~ 'U to include <br />/~-~'~~ subject to a following S e ial Pr visions: <br />c <br />none this will so noted hereoq). e`~cs.~io f itlc,. .+~~-..-G•~.1,7`~ic.c,Cf~L~ <br />t of <br />sure <br />~2-t <br />~ r~t~ <br />2k~ita,~~ <br />~~"' " <br />Approx. No. <br />of Units <br />/ ' /... <br />Cost <br />Per Unit <br />SU <br />~l r~ ca.•-~~ <br />nents to be made monthly by Warrants issued by E1 Paso County based upon <br />number of units purchased during prior month. <br />~~ T ~1 P „~~DVn n,wn-r+ o ~ <br />(Signature of Seller) <br />:hase Order Acquired by t~ <br />Signature <br />Title <br />Gs <br />(Purchasing Agent) <br />phase Order Approved <br />Director of Public Works/County Engineer <br />Max L. R6fh child, P.E. <br />Gravel. <br />Water <br />Soil [] <br />Other (~ <br />NUMBER <br />7/ 3 y/ <br />