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HomeMy WebLinkAbout268613 COLORADO DEPARTMENT OF PUBLIC HEALTH - PURCHASE ORDER - 3303713Date: 06/26/03 City of Fort Collins Page Number: 1 of 1 City of Fort Collins Purchase Order Number: 3303713 Delivery Date: 06/26/03 Buyer: DICK,OPAL Purchase Order number must appear on invoices, packing lists, labels, bills of lading, and all correspondence. Note: Line Qty/Units Description Extended Price Annual Stormwater Discharge Permit Uiry or yori,oiijns Uirector of Purchasing and Risk Management This o der s not valid over $2000 unless signed by James B. O'Neill 11, CPPO, FNIGP City of Fort Collins Purchasing, PO Box 580, Fort Collins, CO 80522-0580 Phone: 970-221-6776 Fax: 970-221-6707 Email: info@ci.fort-collins.co.us 1,499.00 Total 1,499.00 City of Fort Collins Accounting Department PO Box 580 Fort Collins, CO 80522-0580 COLORADO DEPARTMENT OF PUBLIC•HEALTH AND ENVIRONMENT WOCD 2000 700 COR090050 m149900 6%9/2003 700009884 COLORADO DISCHARGE PERMIT SYSTEM INVOICE: 700009884 ATTN: Jim Hibbard PLEASE MAKE ANY ADDRESS Fort Collins, City of, Utilities Dept. CORRECTIONS ON REVERSE 700 Wood Street Fort Collins CO 80522 .. _ - AMOUNT DUE: $1,499.00 DETACH AND RETURN TOP PORTION WITH PAYMENT NOTE: FAILURE TO RETURN TOP PORTION OF INVOICE WITH EXACT PAYMENT MAY RESULT INA POSTING DELAY OR IN THE IMPROPER CREDITING OFYOUR ACCOUNT. STATEMENT OF ANNUAL FEES COLORADO DISCHARGE PERMIT SYSTEM BILLING DATE: 6/9/2003 INVOICE NUMBER: 700009884 BILLING PERIOD: March 14, 2003 to June 30, 2003 DUE DATE: 7/9/2003 FEES CHARGED $1,499.00 PERMIT # COR090050 Type: Storm water municipal >100.000 population / General Permits (07/20) County: Larimer Name of Site: Jim Hibbard Fort Collins, City of Utilities Dept. 700 Wood Street Fort Collins CO 80522 TOTAL CURRENT CHARGES: $1,499.00 COMMENTS: To assure proper credit, please include the permit number on your check and return the top portion of this invoice with your check MAKE CHECK COLORADO DEPARTMENT OF PUBLIC HEALTH &c ENVIRONMENT PAYABLE and 4300 Cherry Creek Drive South RETURN Mail Code ASD-AR-B1 PAYMENT TO > Denver, CO 80246-1530 INQUIRIES (303)692-3616