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PURCHASE' <br /> �,.. DATE: � PURCHASE' - <br /> y� ORDER <br /> IMPORTANT ,r <br /> The PO#and Line Item# * * STATE OF COLORADO �- <br /> must appear on all 1a76 <br /> Buyer: invoices,packing slips, <br /> Phone Number: cartons,and P.O. # P4ge# <br /> correspondence. <br /> Agency Contact: <br /> Phone Number: State Award# <br /> FEIN Phone: BID# <br /> Vendor Contact: <br /> Purchase Requisition#: Invoice inTriplicate <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 /> F.O.B. <br /> SPECIAL INSTRUCTIONS: <br /> LINE COMMODITY/ITEM UNIT OF QUANTITY UNIT COST TOTAL ITEM COST <br /> REM CODE MEASURE <br /> i <br /> rr <br /> THIS PO IS ISSUED IN ACCORDANCE WITH STATE AND FEDERAL REGULATIONS. FOR THE STATE OF COLORADO <br /> FORM DP•01 (5/95) AGENCY COPY 1 <br /> 395-WSW-0233 Authorized Signature <br />