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HomeMy WebLinkAboutCORRESPONDENCE - PURCHASE ORDER - 9191070WORK REQUEST
L & P Representative: Date: .
Description and location of work to be performed:
Comments: The individual signing below (or the company represented by the individual) agrees to pay
the cost of the construction described on this work request, based on actual labor, equipment, materials,
contractual, and overhead costs incurred by the utility. Any estimates given are based on the best
information available at the time of the request. Actual costs may vary from the estimate due to
unspecified field conditions encountered during construction.
Bill To:
Company Name:
Attention:
Mail Address:
City & Zip:
Telephone:
Authorized signature
Print name Telephone
Title
Customer purchase order No. (if available)
Terms: Payment in full due 30 days from invoice date.
Dm:wkreq-T&M.doc revised January 27, 2014
Light and Power Utility
700 Wood St. - P.O. Box 580
Ft. Collins, CO 80522-0580
(970) 221-6700
(970) 221-6619 (fax)