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,r,5 • �v bolo DATE: �°4 �0 PURCHASE <br /> „ JUPI'll C <br /> ORTANT ORDER <br /> The PO#and Line Item# + <br /> / must appear on all `is�e« STATE OF COLORADO <br /> Buyer. Y✓O�`11� 1^�J7/?a�! khpices,pacldng slips. <br /> Phone Number La',3� glon�-3S�f cartons,and P.O.# Page« <br /> Agency Contact 67t e0 r es', correspondence. <br /> Phone Number. 9 yo) -a-*—O 3 31n State Award Ix <br /> FEIN BID#E <br /> Vendor Contact: <br /> Purchase Requisition C Invoice in <br /> Triplicate V ,A / <br /> To: !4 C o/o/'Qd a 5Y'QT� ores� her✓�'cC <br /> E c o �o ry d o <br /> N 5 ��r *� G1hr'�/i'/`5,'t v <br /> D <br /> ° s, Ga Payment will be made by this agency <br /> R 8©�av3 Ship <br /> INSTRUCTIONS TO VENDOR: To: <br /> 1.If for any reason,deYvery of tlrs order is delayed beyond the ,y4%st Nation date �ir/ P/� ✓ <br /> p k ase w agency wr tact named at by left.(R cancellation is <br /> reserved Irstarimwh1ch timely delivery Is not made.) <br /> 2 AN chemicals,ew merit and matedats must conform b the sUndards rewked by OSHA. <br /> 3.NOTE:AdamW terms and oorKrft s on reverse side. Delivery/Installation Date: <br /> F.O.B. - `h 4, 7--1 -D <br /> SPECIAL INSTRUCTIONS: <br /> I <br /> LINE COMMODRYAT M, UNIT OF ITEM UNIT COST M CODE MEASURE TOTAL REM COST <br /> 39a -oo id- Co� T1'Azf,4 <br /> 04/ <br /> N e 0 O G c! 7-)Ia JDI"O J e17 -- <br /> rk S <br /> i <br /> oe3- <br /> THIS PO IS ISSUED IN ACCORDANCE WITH STATE AN FEDERAL REGULATIONS. FOR THE STATE OF COLORADO <br /> FORM DP-01(5/95) <br />