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r DATE: CO� PURCHASE. <br /> Me <br /> IMPORTANT * * ORDER <br /> The PO#and Line item# * * STATE OF COLORADO <br /> must appear on all 1876*' <br /> Buyer: invoices,packing slips, <br /> Phone Number: cartons,and P.O. # Page# <br /> Agency Contact: correspondence. <br /> Phone Number: State Award# <br /> FEIN Phone: BID# <br /> Vendor Contact: <br /> Purchase Requisition#: Invoice in <br /> Triplicate <br /> To: <br /> V <br /> E <br /> N <br /> D <br /> O Payment will be made by this agency <br /> R Ship <br /> To: <br /> INSTRUCTIONS TO VENDOR: <br /> 1.If for any reason,delivery of this order is delayed beyond the delivery/installation 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 on reverse side. Delivery/Installation Date: <br /> F.O.B. <br /> SPECIAL INSTRUCTIONS: <br /> LINE COMMODr Y/ITEM UNIT OF QUANTITY UNIT COST TOTAL ITEM COST <br /> ITEM CODE MEASURE <br /> "s <br /> ti <br /> THIS PO IS ISSUED IN ACCORDANCE WITH STATE AND FEDERAL REGULATIONS. FOR THE STATE OF COLORADO <br /> FORM DP-01 (5/95) REQUISITIONING AGENCY <br /> 396-30-55-0159 Authorized Signature <br />