IQM2 (2)
Town of Wappinger
20 MIDDLEBUSH ROAD
WAPPINGER FALLS, NY 12590
PURCHASE ORDER & VOUCHER
Department:
Purchase
Order No.
CLAIMANT'S
NAMEAND
ADDRESS
1QM2
90-D Raynor Ave
Ronkonkoma, NY 11779
Date Voucher Received
FUND - APPROPRIATION AMOUNT
.
TOTAL $0 00
ABSTRACT NO. I
DO NOT WRITE IN THIS BOX
Due on Receipt
TERMS --
VENDOR'S
REFNO.
DATES INV# Quantity DESCRIPTION OF MATERIALS OR SERVICES UNIT PRICE AMOUNT
I II I 12009 1 Media Traq Annual Maintenance $5,760 00 $5,760 00
January 1, 20l0-December 31,2010
IL/IO .L10ltJ
. /~ r~\'1
.. 'I \
b ~ .'
TOTAL $5,760.00
John C. Masterson 576000
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
lzl Z'"J) Or
DATE
~r~
- 51 ATURE
(SPACE BELOW FOR MUNICIPAL USE)
II
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
This claim is approved paid from the appropriations indicated above
APPROVAL FOR PAYMENT
COMPTROLLER
DATE
AUTHORIZED OFFICIAL
DATE
IQM2
90-0 RAYNOR AVE
RONKONKOMA, NY 11779
Invoice
DATE 11/1/2009
1NV01CE 11 2157
BILL TO
ACCOUNT #
TERMS Net 30
P.O.'
Town of Wappinger, NY
Attn: Chris Masterson
20 Middlebush Road
Wappingers Falls, NY 12590
BALANCE DUE $5,760.00
.
~
Please make checks payable to: IQM2 Inc.
Federal Tax 10: 26-3807522
DESCRIPTION QTY RATE AMOUNT
*****MediaTraq Annual Maintenance January 1, 2010 5,760.00 5,760.00
- December 31, 2010******
RECE\~ IEO
NOV 0 9 ~O09
T()WN C i-ERV
Total $5,760.00
