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John C. Masterson Town ~f Wappinger 20 MIDDLEBUSH ROAD WAPPINGER FALLS, NY 12590 PURCHASE ORDER & VOUCHER Department: CLAIMANT'S NAMEAND ADDRESS John C. Masterson 5106 Princess Circle Wappingers Falls, NY 12590 Due on Receipt TERMS Purchase Order No. DO NOT WRITE IN THIS BOX Date Voucher Received FUND - APPROPRIATION ., AMOUNT petty cash TOTAL $0 00 ABSTRACT NO. I VENDOR'S REF NO. DATES INV# Quantity DESCRIPTION OF MATERIALS OR SERVICES UNIT PRICE AMOUNT 11/18/2009 1 12 Donuts $7 49 $7 49 1 12 Bagels $8 99 $8 99 1 8 oz. Chive CC $2 99 $2 99 1 8 oz. Plain CC $2 99 $2 99 1 5 Munchkins $1 25 $1 25 1 Box Joe Orig Blnd $13 99 $13 99 1 Ht CofLg Orig Blend $1 94 $1 94 1 Tax $1 29 $1 29 $0 00 TOTAL $40.93 John C. Masterson 40.93 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 fer 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 1(1~ SIGNATURE (SPACE BELOW FOR MUNICIPAL USE) ----1{', (( 107 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 frpm the appropriations indicated above COMPTROLLER DATE .. Welcome to Dunkin' Donuts ,. Store #301313 1582 Route 9, Wappingers Falls 11/18/2009 8:51 :27 AM Eat In o rde r Number: 1111536 Register:1 Cashier:Dana V. 1 12 Donuts 1 12 Bage 1 s 1 802 Chive CC 1 802 Plain CC 1 5 Munchkins 1 Bx Joe Orig Blnd 1 Ht Cof LG OrigBlnd Tran Seq No: 1111536 Sub. Total: Tax: Total: Discount Total: 7.49 8.99 2.99 2.99 1.25 13.99 1. 94 $39.64 $1. 29 $40.93 $0.00 Change $0.07 Cash $41.00 **************************************** - Hf~ AHfRICA! WANT A FREE DONUT WHEN YOU PURCHASE A MEDIUM OR LARGER BEVERAGE? Go to TELLDUNKIN.COH within 3 days; tell us about your visit. Enter Validation Code: Visit DunkinDonuts.com for coupon restrictions. Franchisee: Please use PLU #201 Store #301313