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,. , <br />~ ;° <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 />eller I ~ n~c~n~~~ ~ . /fc-~ iJ~~=~~ <br />i <br />ddress ~- <br />(~C 7~ ~/,,~ CE'~~,/c'~~d~i <br />~~~~~ <br />Approx. No. <br />of Unite <br />declare that I am owner of the real property wherein /7.u-~~ <br />xists and is located in Township (s), Range / S W, <br />ection~ Quarter ~i The Department of <br />ublic Works may purchase from me, .,..~ in the quantity <br />stimated below, during the period '3 /) ~ to include <br />'S /)- f~/ subject to the following Special Provisions: <br />I f none this will ~e so noted hereon) .. l.-~ r ~ ~ !~ ~~-L•i-,~~. ~: ~'~ <br />nit of <br />easure <br /> <br />3ad~3 <br />Dated_~~~/T ~ 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 />Cost <br />Per Unit <br />~~~~-~~ <br />lob <br />ayments to be made monthly by Warrants issued by E1 Paso County based upon <br />he number of units purchased during prior month. <br />urchase Order Acouired <br />(Signature of ller) <br />~~ ~~~~J <br />ignature <br />i y.vr <br />Title <br />(Purchasing Agent) <br />Y. <br />~rchase Order Approved <br />y' <br />c., _ , <br />Max L:"Rothschild, P: . <br />Director of Public Worka/County Engineer <br />Gravel P <br />Water <br />Soil d <br />Other (~ <br />NUMBER <br />