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DATE: _ - - _ ' - it <br /> PURCHASE <br /> ORDER <br /> IMPORTANT The PO#and Line Item# STATE OF COLORADO <br /> must appear on all <br /> Buyer. invoices,packing slips, <br /> Phone Number: - _ `' cartons,and P.0. # 1_ ?`a = _ _ " Page# - <br /> Agency Contact: _Z r Z '.' _ correspondence. - <br /> Phone Number: . : _ - _ = - -- - State Award# <br /> FEIN ^ Phone: - - - BID# <br /> Vendor Contact: J, - = ^ <br /> Purchase Requisition#: Invoice inTriplicate <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 COMMODITYATEM UNIT OF QUANTITY UNIT COST TOTAL ITEM COST <br /> ITEM CODE MEASURE <br /> -- - _ �. V✓ .. - <br /> THIS PO IS ISSUED IN ACCORDANCE WITH STATE AND FEDERAL REGULATIONS. FOR THE STATE OF COLORADO <br /> FORM DP-01 (R 10/97) �r�;�rJO <br /> 395-30-55-0159 Aut onzed Signature 82234010 1 <br />