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DATE: ..Co Co�O�b PURCHASE <br /> ° ORDER <br /> Buyer: IMPORTANT *l876 STATE OF COLORADO <br /> Phone Number: The PO#and Line#must <br /> appear on all invoices, P.O. # Page# <br /> Agency Contact: packing slips,cartons, <br /> and correspondence. State Award # <br /> Phone Number <br /> FEIN Phone: BID# <br /> Vendor Contact: <br /> Purchase Requisition#: Invoice in Triplicate <br /> To: <br /> E <br /> N <br /> D <br /> 0 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 shown, <br /> —please notify the agency contact named at the top left.(Right of cancellation is reserved in <br /> instances in which timely delivery is not made.) <br /> 2 All chemicals,equipment and materials must conform to the standards required by OSHA. Delivery/Installation Date: <br /> 3 NOTE. Additional terms and conditions on reverse side. F.O.B. <br /> SPECIAL INSTRUCTIONS: <br /> LINE COMMODITYATEM 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 (R 6/99) <br /> 395-30-55-0159 REQUISITIONING AGENCY <br /> Authorized Signature <br /> CITS#001 <br />