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DATE: °4\co� PURCHASE <br /> IMPORTANT * * ORDER <br /> The PO#and Line Item# <br /> - must appear on all * rays * STATE OF COLO12AD0 <br /> Buyer invoices,packing slips, <br /> Phone Number: _ - r cartons,and P.O.# Page# <br /> correspondence. <br /> Agency Contact: - 5 n 7 ?D K A9 c C 0 C 0 0 0 011 G 1 <br /> Phone Number: '" _f - - -V State Award# <br /> FEIN Phone: BID# <br /> Vendor Coact _ - a;r_.o c 2-- ., <br /> Purchase Requisition#:"-- - _ Invoice in <br /> - - Triplicate <br /> V To: D7; 07 '`T-- - 3 ° C-EO-CGY <br /> E 1 ^13 S :-7 MA': ='TREET, P-00M 215 <br /> N Jr .• ' DENVEo '0 3C2C3 <br /> D <br /> O 0, - " " .,• .; Payment will be made by this agency <br /> R SOT CO 81323 Ship <br /> INSTRUCTIONS TO VENDOR: To: <br /> DESIGNATED JOB SITE , PER SPECS <br /> 1.If for any reason,delivery of this order Is delayed beyond the deliveryAnstallation date <br /> shown,please notify the agency contact named at top left.(Right of cancellation is <br /> reserved In instances in which timely delivery Is not made.)" <br /> 2.All chemicals,equipment and materials must conform to the standards required by OSHA. <br /> 3.NOTE:Additional terms and conditions Date:ons on reverse side. ' <br /> F.O.B. 10-11 -9 <br /> L' TT 'DrTTTm <br /> SPECIAL INSTRUCTIONS: <br /> LINE COMMODRYRTEM UWr OF QUANTITY UNR COST TOTAL REM COST <br /> FEM CODE MEASURE <br /> 001 96273000n0C EAC 23 , 000 . 000 1 . 000000 $23 ,000 . 00 <br /> MID-=''-_';EST'"/CO L BA IN C-81-017 <br /> DUTCH C7EEK FUME EMER ENCY MAINTAIN P J/S RENNER <br /> m <br /> THIS•PO IS ftUED IN ACCORDANCEWITH'STATE`-AND FEDERAL REGULATIONS.-"-" - ' FORTk1E TATE'OSWI-0 ADO,""""'• <br /> t r, <br /> FORM DFM(5/95) <br /> getmu;E�''' VENDOR <br />