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DATE: <br /> PURCHASE <br /> IMPORTANT * 407 03'iTAI110RDER <br /> The PO#and Line Item " * STATE OF COLORADO <br /> Direct*Inquiries To: must appear on all 1876 <br /> invoices, packing slips, P�. # <br /> cartons, and <br /> Phone Number: 3 �((�—3; correspondence. Page# <br /> FEIN `�J tj — /Q/ 7 `{q Invoke In <br /> Tripllate �k I <br /> Vendor Contact: Phone To: <br /> Purchase Requisition#: <br /> V Terms: <br /> E �G�`,UQ 5� tJL�C- <br /> N `J Payment will be made by this agency <br /> D ' d L � �i ( l Ship <br /> INSTRUCTIONS TO VENDOR: <br /> 1.On accepting verbal telephone order,purchase order number must be obtained before <br /> making delivery. F.O.B. <br /> 2.All discounts must be noted on invoice. Delivery/Installation Date: <br /> 3.All chemicals,equipment and materials must conform to the standards required by OSHA Agency Contact: � � -y�� ��n r^ Phone: <br /> 4.NOTE,Additional terms and conditions on reverse side 1 t <br /> SPECIAL INSTRUCTIONS: <br /> LINE COMMODITY/ITEM UNrT OF ITEM CODE MEASURE QUANTITY UNIT COST TOTAL REM COST <br /> THIS PO IS ISSUED IN ACCORDANCE WIDTH STATE AND FEDERAL REGULATIONS. FOR THE STATE OF COLORADO <br /> Form DP-01 (2/94) <br /> 395-53-05-0194 VENDOR Authorized Signature <br />