HomeMy WebLinkAbout172216 PINNACOL ASSURANCE - PURCHASE ORDER - 4400420HN
City of Fort Collins
Page Number: 1
City of Fort Collins
Date: 01/13/04
Purchase Order Number: 4400420
Delivery Date: 01/13/04 Buyer: BONNETTE, ED
Purchase Order number must appear on invoices, packing lists, labels, bills of lading, and all correspondence.
Note:
Line Qty/Units Description Extended Price
1 1 Lot 193,853.00
Workers Comp Premium
POLICY NUMBER 51045
Total
$193,853.00
---, -- - _. .... City Of Fort Collins_ . a _.._ .........._....�..........
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
Phone: 970-221-6775 Fax: 970-221-6707 Email: info@ci.fort-collins.co.us Fort Collins, CO 80522-0580