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Note: If tenant/landlord split Ie not providod at the dmP of dovery, <br />tenant will be ch ed irk full. <br />NAME, <br /> <br />T L i 7? _ r .C <br />A ESS ' <br />11? <br />N CITY, STA , ZIP 00DE <br />A rXRTILIZER & CIIEMCA <br />L CO Products listed hereon are sold as Is with ell <br />a"ng fAuHa, There ate no warranlWs whictl <br />extend beyond the destxiptton an the face of the <br />product label and eeW makes no war ani, <br />axprees or Implied. as to the merchantelftilly of th. <br />product. Having inspected the saner, customer <br />assumes all risk of loss or liability resulting from <br />use of, or defects In, the products listed and any <br />e'° '`r"misr,ed. <br />N PH NE N ER ? <br />. K rtsqulred by ZEN 172.204 7% is to txrtlfy <br />T <br />CO 80534 <br />Box 606 •Johnstown <br />206 N <br />• P <br />O <br />Parish Ave that the below named materials are property <br /> <br />L <br />A NAME . <br />. <br />, <br />. <br />. <br />Office; (970) 687-6106 64227 dwitied, deserbed, packeged, marked and <br />labeled, and are In proper torrdillon for <br />tothe applicable <br />accordin <br />odation <br />trarut <br />N <br />D ADDRESS Fall: (970' 687-5107 <br />Commerical applicators are IlCeneed b;y , <br />g <br />p <br />regulations of the department of transportation. <br />L CITY, STAT , ZIP ODE t <br />lt <br />C <br />l <br />d <br />D <br />t <br />f A <br />i <br /> <br />0 cu <br />epar <br />o <br />ure. <br />o <br />ora <br />men <br />gr <br />o <br />In case of We-Mency-. all, leak, accident or <br />R <br />D PHONE NUMBER DA <br /> <br />C5 <br /> <br />0,9 O, NO. <br />1 -3 (ire at any hour, call shipper of Infalrac (800-535- <br /> <br /> <br />5D53) (oil free. Isolate any spill, the cargo, and <br />EPA NO.B EXPIRATION DATE RMS LANDLORD SHAHS the vehicle Involovtxi until directions are received. <br />TAX EXEMPTION NO. MERCHANDISE R D K U DELIVER. CASH CHAR E CROP <br />MCFJPTION $here UNIT OF MEAS. QUAOtM PRICE EXTENDED AMOUNT <br />8 <br />2 <br />. <br /> ? t <br /> ` 21 -:? <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />IMPORTANT: IS ILLEGAL TOT 5 T TE111AL MARKOD AS OR K WN TO QE POISON (CLASS A OR B) <br />IN THE SAM9 VEHICLE WITH MATERIAL WHICH IS MARKED AS OR KNOWN TO BE FOODSTUFFS, FEEDS, QR SUB TOTAL a <br />ANY OTHER EDIBLE MATERIAL INTENDED FOR CONSUMPTION BY HUMANS OR ANIMALS. <br />RATE TAX <br />C <br />77 : <br />LOADED BY ERED BY DEUVE ED BY czmd ay <br />X <br />PL>tchesef 6greae to es the [arms and conditions of this sale. NT NAIWE <br />TOTAL <br />This purchase may qualify for a propm( payment discount as shown. <br />Account must be pall In full by 15, ZO to qualify. Tenant b Landlord $ Total Dollars $ <br />MWE - aALANCE Due ON RECEPT OF MILLING 611AIINErrr. A FINANCE CHARGE wnpWed a ¦ penedid We or 1 Ug% per atan I (7 f to per maid m =MorNebrcb tepfnteI wttlah Is en ANNINY. RRCENITAOU <br /> NU6 of 1e% (re% a me of N,re.w ".tondo Will bed V 4 an tM anamt m do hnotoe MRAOq <br />- 30 d.re nom the dale M rmh b, =0 ro mg4hom to hs smucM no - tMd tM BOW. on r VMM to ILIGN. but net tlmtud to acute. duffm tMtem, aid mink uapw M of each tam dm.