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DATE: ��;op'C°ro <br /> �T PURCHASE <br /> ,MPOFMANT ORDER- <br /> Me PO:and Line ftem If `.,.76.` STATE OF COLO--" <br /> "r must appear on an <br /> Phone N r: 30.3 Irr pIces;paddnq slips, <br /> Agency � � G J� correspo and <br /> P.O. # Page it <br /> Phone Number: 6 [ ._ State Award/ <br /> FEIN 8 7 0`�,'S�/ %7?S Phone: g0/ '?'6>3- yya.2 BID i1 <br /> Vendor Contact Gib AQ,� G7y/�Cy, <br /> Purchase RequlsMon R: Im olce in <br /> Triplicate <br /> E Tc <br /> N <br /> D C c,�f�; Gf 7- <br /> R Payment w41 be made by this agency <br /> Ship <br /> INSTRUCTIONS TO VENDOR: To: <br /> 1.If for any reasm aelvery of ttft order Is delayed beyond U„dory*n�tlon date <br /> n�served h wt�ch `anted reined at top Iaf.(Wght of prxeUatfaon Is <br /> iLnely de4: is not made.) <br /> 2 Al chemicals,equlmw t and materials must oordonn b the standards mgAW by OSKk <br /> 3.NOTE Adddlonal terns and conddlons on reverse side. DelNeryAnstallation Date: <br /> F.O.B. <br /> i <br /> SPECIAL INSTRUCTIONS: <br /> LINEE Commoo"YATEM, UNTOF <br /> ME+ COOE MEASURE Ol1AN= trrar COST TOTAL ITEM COST <br /> G oc� ,Bos%h ��J ���al ,8,�✓ <br /> ��� c�GGt vJ'IQv1 Lid <br /> Ae— <br /> fug• � 7D <br /> 95 <br /> THIS PO IS ISSUED IN ACCORDANCE WITH STATE AND FEDERAL REGULATIONS. FOR THE STATE OF COLORADO <br /> FORM DP-01(Sips) <br />