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<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 E/aTG,~,e ~ Po~oE~es <br />9dress '\ / ~ <br />Ci~c.K~i nl CoLu, ~D$of~ <br />Gravel <br />Water <br />Soil [] <br />Other (~ <br />NUMBER I~ <br />Od33~ <br />Dated ~ - Q' 19 79 <br />Refer to the above number or <br />provide a copy of this order <br />with any claim you may find <br />necessary to file. <br />declare that I am owner of the real property wherein ~r~I2~4VtL <br />:fists and is located in Township ~~ (s), Range ~i U W, <br />action ~ 3 Quarter /(/,l'V The Department of <br />iblic Works may purchase from me, ~ P_A /cc in the quantity <br />;timated below, during the period F-9-7 9 to include <br />~' 9 - ~/ subject to the following Special Provisions: <br />f none this will be so noted hereon) . .SL-ODES ?Z~ Nt Cf t T in/ <br />cSA7/SF At Tapr MA,v.ve /z. Ow.VER /..~/ dESE C-u <br />it of <br />asure <br />c ~/,c2 n <br />Approx. No. <br />of Unite <br />(JAI K/JU~e! <br />Coat <br />Per Unit <br />Tp., ~/ <br />/o ~ <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 />(Signs ure of Seller) <br />chase Order Approved <br />Max L. Rothschild, P.E. <br />Director of Public Works/County Engineer <br />oN ~ <br />s~ al,s~ <br />