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General Code (2) Town of Wappinger 20 MIDDLEBUSH ROAD WAPPINGER FALLS. NY 12590 PURCHASE ORDER & VOUCHER Department: CLAIMANT'S NAMEAND ADDRESS General Code 72 Hinchey Road Rochester, New York 14624-2991 Due on Receipt TERMS Purchase Order No. / I DO NOT WRITE IN THIS BOX Date Voucher Received FUND - APPROPRIATION AMOUNT TOTAL $0 00 ABSTRACT NO. I VENDOR'S REFNO. DATES INV# Quantity DESCRIPTION OF MATERIALS OR SERVICES UNIT PRICE AMOUNT 07/23/2010 002083 1.00 Composition $140 40 $140 40 1 Duplicating $87 76 $87 76 1 Editorial $301 13 $301 13 1 Finishing $73 97 $73 97 1 Shipping & Handling $21 24 $21 24 $0 00 TOTAL $624.50 John C. Masterson 624 50 I, certify that the above account in the amount of $ . is true and correct: that the items, services, and disbursements charged were rendered to or for the municipality on the dates stated; that no part has been paid or satisfied: that taxes, from which the municipaiity is exempted, are not included: and that the amount claimed is actually due Pc{~ SIGNATURE (SPACE BELOW FOR MUNICIPAL USE) 07/29/2010 DATE Town Clerk TITLE DEPARTMENT APPROVAL The above services or materials were rendered or furnished to the municipality on the dates stated and the charges are correct DATE AUTHORIZED OFFICIAL APPROVAL FOR PAYMENT This claim is approved paid from the appropriations indicated above DATE COMPTROLLER G-EN E RAL 72 Hinchey Road ~Ia 10 ~ Rochester, New York 14624-2991 _ _ - - , (800)836-8834' F.x(585)328-8189 Tax ID 20-8015087 Invoice No. Date: Due Date: Terms: Customer No. BILL002083 7/23/2010 8/22/2010 Net 30 W A0691 Bill To: Town of Wappinger Mr. Chris Masterson C/O Clerk's Office 20 Middlebush Road Wappingers Falls, NY 12590 Supplement Project PO No. Supplement No. 20 Quantity 21 Item Billing Amount Tax Total Composition $140.40 $0.00 $140.40 Duplicating $87.76 $0.00 $87.76 Editorial $301.13 $0.00 $301.13 Finishing $73.97 $0.00 $73.97 Shipping & Handling $21.24 $0.00 $21.24 $624.50 $0.00 $624.50 Interest will be charged on all past due accounts at 1.5% monthly. Thank you for choosing General Code. We appreciate your business. Voucher Form (if required) Claimant's Certification I do solemnly declare and certify under penalties of the law that the within bill is correct in all its particulars that the articles have been furnished or services rendered as stated therin that no bonus has been given or received by any persons within knowledge of this claimant in connection with the abovl claim that the amount therein stated is justly due and owing and that the amount charged is a reasonable one V~~~ Accounting Administrator 7/23/2010 Account Charged Payment Record Check# Dated Department Approval Date