General Code (3)
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Town of Wappinger
20 MIDDLEBUSH ROAD
WAPPINGER FALLS, NY 12590
PURCHASE ORDER & VOUCHER
Department:
CLAIMANT'S
NAMEAND
ADDRESS
General Code
72 Hinchey Rd
Rochester, NY 14624-2991
Due on Receipt
TERMS
Purchase
Order No.
-4
DO NOT WRITE IN THIS BOX
Date Voucher Received
FUND - APPROPRIATION AMOUNT
1~IO. QO<t
TOTAL $0 00
ABSTRACT NO. I
VENDOR'S BILL000774
REFNO.
DATES INV# Quantity DESCRIPTION OF MATERIALS OR SERVICES UNIT PRICE AMOUNT
02/17/2010 1.00 Composition $46 80 $46 80
1 Duplicating $13 04 $13 04
1 Editorial $124 61 $124 61
1 Finishing $34 42 $34 42
1 Shipping & Handling $15 00 $15 00
-
RECEIVED
FEB 1 8 20m
ACCOUNTING
TOTAL $233.87
John C. Masterson 233 87
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
municipality is exempted, are not included: and that the amount claimed is actually due
tjLr~lt~,
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(SPACE BELOW FOR MUNICIPAL USE)
02/17/2010
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
APPROVAL FOR PAYMENT
This claim is approved paid from the appropriations indicated above
AUTHORIZED OFFICIAL
DATE
COMPTROLLER
DATE
G ENE RAL 72 Hinchey Road
r<<t]1 10 I Rochester, New York 14624-2991
_ _ (800)836-8834' F8X(585)328-8189
Tax ID 20-8015087
Invoice No.
Date:
Due Date:
Terms:
Customer No.
BILL000774
2/9/2010
3/11/2010
Net 30
WA0691
Bill To:
Town of Wappinger
Mr. Chris Masterson
C/O Clerk's Office
20 Middlebush Road
Wappingers Falls, NY 12590
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Supplement Project
Supplement No. 1 9
Quantity 21
PO No.
Item Billing Amount Tax Total
Composition $46.80 $0.00 $46.80
Duplicating $13.04 $0.00 $13.04
Editorial $124.61 $0.00 $124.61
Finishing $34.42 $0.00 $34.42
Shipping & Handling $15.00 $0.00 $15.00
$233.87 $0.00 $233.87
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 abOVI
claim that the amount therein stated is justly due and owing and that the
amount charged is a reasonable one
VD7L#~~
Accounting Administrator
2/9/201 0
Account Charged
Payment Record Check#
Dated
Department Approval
Date