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Check One <br />PURCHASE ORDER <br />E1 Paso County <br />DEPARTMENT OF PUBLIC WORKS <br />3170 Century, Colo. Spgs., Colo. 80907 <br />Eller ~(-~wvt~+~~ ~...~!^~ <br />3dress /1/-~~,•vvc,itc; ~ ~~JJ <br />l // .f.~~tLw ~i~-CILCf <br />~Ud7!- <br />!- 3'17- 7}'a~. <br />Gravel, <br />Water <br />Soil [] <br />Other (~ <br />NUMBER ~~~ <br />aaaa 3 <br />Dated ~C~ /~~ 7 19 <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 owmer of the real property wherein / /ice~,r~~ <br />:fists and is located in Township /a. (s), Range l~ W, <br />action ~.a, Quarter S t•V The Department of <br />iblic Works may purchase from me, in the quantity <br />;timated below, during the period /r- ~ 7^'79 to include <br />/n ~7- c't/ subject to the following Special Provisions: <br />:f npne this will be so noted hereon). Slc~ •xe-~Zc t,Gcoa.!/ ~/'/ . G-..,...~, ~e <br />pit of <br />~asure <br />~ u/ <br />uf/1T ^~' <br />Approx. No. <br />of Units <br />?~.."-.~ <br />Cost <br />Per Unit <br />~~ <br />lam""' <br />yments to be made monthly by Warrants issued by E1 Paso County based upon <br />e number of units purchased during prior month. ~~~~ <br />(Signature of Se ler) <br />rchase Order Acquired by, <br />Signature <br />V ~2 <br />Title <br />(Purchasing Agent) <br />~~ ~` <br />rchase Order Approved by /~~~ .-~~,~. :•-f <br />Max~L. Roths hild, P.E. <br />Director of Public Works/County Engineer <br />