HomeMy WebLinkAbout172216 PINNACOL ASSURANCE - PURCHASE ORDER - 6601401 (2)Date: 03/02/06
City of Fort Collins
City of Fort Collins
Page Number: 1
Purchase Order Number: 6601401
Delivery Date: 03/02/06 Buyer: BONNETTE, ED
Purchase Order number must appear on invoices, packing lists, labels, bills of lading, and all correspondence.
Note:
Line Qty/Units
1 1 lot
Description
Workers' Compensation Premium
THREE INSTALLMENTS FOR POLICY #51045, AS FOLLOWS:
2/02/2006 PREMIUM INSTALLMENT $64,190.00
3/02/2006 PREMIUM INSTALLMENT $64,190.00
4/02/2006 PREMIUM INSTALLMENT $64,191.00
TOTAL $192,571.00
Extended Price
192,571.00
Total $192,571.00
City of Fo4isa
Director of Purchasing and Risk Management
This orderlid over $2000 unless signed by James B. O'Neill II, CPPO, FNIGP City of Fort Collins
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: purchasing@fcgov.com Fort Collins, CO 80522-0580