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DATE: ��°v cOlOp9 PURCHASE w <br /> Ne \° ORDER <br /> IMPORTANT +� <br /> The PO#and Line Item# STATE OF COLORADO <br /> must appear on all 876 <br /> Buyer: invoices,packing slips, <br /> Phone Number: cartons,,and P.O. # Page# <br /> Agency Contact: correspondence. <br /> P State Award# <br /> Phone Number: <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 /> FO.B. <br /> SPECIAL INSTRUCTIONS: <br /> LINE COMMODITY/ITEM UNIT OF QUANTITY UNIT COST TOTAL ITEM COST <br /> ITEM CODE MEASURE <br /> THIS PO IS ISSUED IN ACCORDANCE WITH STATE AND FEDERAL REGULATIONS. FOR THE STATE OF COLORADO <br /> FORM DP-01 (5/95) <br /> 395-30-55-01 59 AGENCY COPY — 1 Authorized Signature <br />