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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 />aller ~~~"~"" ~`~! <br />9dr~ess ~ / <br />~`' ~,~ l~t•u ~v Y~ b'aF <br />I -3`r7- 9YJ3 <br />Gravel <br />Water <br />Soil (] <br />Other t7 <br />NUMBER ~ Z <br />/ai7~ <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'aner of the real rooerty wherein ~ J'4'"""-/ <br />Gists and is located in Township ~~ (s), Range 6/ W, <br />action / 7 Quarter S W The Department of <br />iblic Works may purchase from me, ~u-.-~ in the quantity <br />~timated below, during the period /C~~~7- ~9 to include <br />/f- ,17- P y subject to the foll wing Special Provisions: <br />:f none this will be so noted hereon) . .~ ~-,r7 ~e .PiLte.~.~' y"~, Li <br />pit of <br />~asure <br />~~ <br />Approx. No. <br />of Unite <br />~ ~~ <br />Coat <br />Per Unit <br />~~~ <br />l <br />yments to be made monthly by Warrants issued by E1 Paso County based upon <br />e number of units aurchased during prior month. <br />~_ <br />(Signature of Seller) <br />rchase Order Acquired by <br />Signature <br />k~-~• Tit <br />(Purchasing Agent) <br />rchase Order Approved <br />~--~ - <br />by ~t,.. ~ ,._C •r - ~ <br />Max If Rothschild, P.E. <br />Director of Public Works/County Engineer <br />