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DATE: ��� � PURCHASE <br /> .�, y as-. I��;TATI\+ORDER <br /> IMPORTANT <br /> TFjA PO#and Line Item' * * "'`', -STATE OFCOIsORADO:.! <br /> Direct Inquiries To: r� / C L C�� must dppear on all *1876 <br /> invoices,packing slips, P.O. # <br /> 7 cartons,and <br /> Phone Number: 562CZ .35la correspondence. Page# <br /> FEIN Invoice In <br /> Tripliate <br /> Vendor Contact: Phone: To: <br /> Purchase Requisition#: <br /> E t7^(—j-3< 3 35 Terms: <br /> N JL04/ Payment will be made by this agency <br /> D Map 1�'- L ACtV ski C�o Ship �s� v��� �G(� s l l� n <br /> O h ado�, (J I To: S N J <br /> R <br /> INSTRUCTIONS TO VENDOR: <br /> I On accepting verbal telephone order,purchase order number must be obtained before O <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:/l 'CI C/Q ✓00 C(r1Phone:(e*3)8tC(0`3S!!7 <br /> 4 NOTE:Additional terms and conditions on reverse side. <br /> SPECIAL INSTRUCTIONS: <br /> LINE COMMODITY11TEM UNIT OF /]UANTITY UNIT COST TOTAL ITEM COST <br /> ITEM CODE MEASURE <br /> -7 `ry 9-M-017 <br /> Ct v�ct Q Ch�LU� ►fit <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 />