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0 DATE: ,��;p4 PURCHASE <br /> • IMPORTANT * rr ORDER, <br /> ?he PO#CM Line Item# * * STATE OF COLORADO <br /> Buyer: 1'Yl a , ')(e �o✓-, �� t must appear on all tang'` <br /> Invoices,paddng slips, (� <br /> Phone Number: ? �') MCP LQ -'>' 7 cartons,and, P.O.# I" ------- aye# <br /> Agency Contact: rn v�o r correspondence. <br /> Phone Number: State Award# <br /> FEIN y (Z Phone �76� �� �D"d BID#'� <br /> Vendor Contact: re <br /> Purchase Requisibod M Invoice in <br /> Triplicate <br /> To: <br /> E <br /> N <br /> D <br /> O Payment will be made by this agency <br /> R Ship <br /> INSTRUCTIONSTO To:VENDOR: 5J p S <br /> 1.If for any reason,delivery <br /> th aaoggfethis order is delayed beyond the delivery/installation date TT J <br /> reservedP ir�istarx es whk2► rr►ely d�eiNrery�S not ma left. <br /> de.)(RigM of cancellation is <br /> 2.AN chemicals,equipment and materials must conform to the standards required by OSHA. <br /> Delivery/Installation Date: <br /> 3.NOTE:Additional terms and conditions on reverse side. <br /> �C <br /> F.O.B. <br /> SPECIAL INSTRUCTIONS: ;6 <br /> ASS <br /> /PxS/ <br /> LINE COMMODnYATEM UNR OF UNIT COST TOTAL REM COST <br /> REM CODE MEASURE OLAANTrrY <br /> THIS PO IS ISSUED IN ACCORDANCE WITH STATE AND FEDERAL REGULATIONS. FOR THE STATE OF COLORADO <br /> FORM DP-01 (5195) <br /> 39530-55-0233 VENDOR Authorized Signature <br />