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Rote: Ir tenanulandlord split is not provided at the time of delivery, <br />tenant will be charged In full. <br />NAME <br />T c,' t <br />fM 4C <br />E ADDRESS <br />N C1 ¢r?Pnv't. G 0t_.l? <br />A. CITY, STATE, `1P C06} Q? C0 8 0 s 43 <br />N PHONE NUMBER T "t0 7--72-5"7 <br />NAM <br />'S L? Lr? ?- <br />N ADDRESS <br />D Ce den s <br />o CITx, jATf, 2-!P CDC Fo S-L/ 3 <br />R PHON UMBER <br />2 -58? - ?7 S - Z? <br />:PA NO. & DCPIRATION DATE <br />eAsting faults. There are no warraniles which <br />exlend beyond the description og the face of <br /> the product label and seller makes no <br /> warrank express implied. to the <br /> merchantability of the Having <br /> Inspected cted the some. customer assume& <br />umes all <br /> nsk of loss or liability resulting ham use of. or <br />FERTILIZER A CHEMICAL C 0. defects a the products listed and any <br />u ment furnished. <br /> It required by 48 CFR 172.204 - This is to <br />205 N. Parish Ave. • P.O. BOX 606 • Johnstown, CO 80534 certify Mal the below named materials are <br /> <br />Office: (970) 587-5105 property classified, described, packaged, <br />marked and labeled, and are in proper <br />Fax- (970) 587-5107 condition for trartsportalion, according lothe <br />Commerical applicators are licensed <br />by appilC86te regulations of the department of <br /> <br />tr <br />rt <br />ti <br /> <br />Colorado Department of Agriculture. anspo <br />a <br />on <br />DESCRIPTION <br />i <br />T <br />t ?O <br />all 4;?k <br />PRODIrCT CODE I MEAS. ( QUANTITY <br /> <br />IMPORTANT: IT IS ILLEGAL TO TRANSPORT MATERIAL MARKED AS OR KNOWN TO BE POISON (CLASS A 1 <br />1) IN THE SAME VEHICLE WITH MATERIAL WHICH IS MARKED AS OR KNOWN TO BE FOODSTUFFS, FEEDS, <br />ANY OTHER EDIBLE MATERIAL INTENDED F CONSUMPTION BY HUMAN R ANIMALS. <br />OADED BY ORDERED BY DELIVERED SY RFtE1VE BY /1 <br />Purchas r re to I s d dons el this sale. <br />his purchase may quality for a propmt payment discount as shown <br />ocaunl must be paid In rue by 15,20 to quehfy Tenant s <br />In case of "Emergency'. Spill, teak, accident <br />or fire at any hour, call shipper at Infotrac <br />(800-535-5053) toil free Isolals any spill, the <br />cargo, and the vehicle involoved until <br />directions are received. <br />PRICE I EXTENDED AMOUNT ' LANDLOR TAX <br />SHARED I CODE <br />SUB TOTAL <br />RATE TAX LANDLORD <br />TOTAL <br />Landlord S <br />Total Dollars $