HomeMy WebLinkAbout172216 PINNACOL ASSURANCE - PURCHASE ORDER - 7708047City of Fort Collins
Ship To
Date 11/13/07
Purchase Order Number 7708047
PINNACOL ASSURANCE PUBLIC LIBRARY (MAIN)
DEPT 500 201 PETERSON ST
DENVER CO $0281.0500 FORT COLLINS CO 80524-2 0
Delivery Date 11/13/07 Buyer CA Y, DAVID
Purchase Order number must appear on invoices, packing lists, labels, bills of la, g, and all correspondence
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Line Qty/Units D7Srlptlon Extended Price
1 1 Lot �f° A/ - 2,52700
Comp
for Worker's Compensation Quarterly
Policy Premium
Policy Period 12/31/07-04/01/08
Per Invoice# 4118811
Total
$2,527 00
City of Fort C m Director of Purchasing and Risk Management City of Fort Collins
This order is alid over $2000 unless signed by James B O'Neill II, CPPO, FNIGP Accounting Department
City of Fort Collins Purchasing, PO Box 580, Fort Collins, CO 80522-0580 PO Box 580
Fort Collins, CO 80522-0580