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Home Depot Town of Wappinger 20 MIDDLEBUSH ROAD WAPPINGER FALLS, NY 12590 PURCHASE ORDER & VOUCHER Department: CLAIMANT'S NAMEAND ADDRESS Home Depot 1570 Route 9 Wappingers Falls, NY 12590 Due on Receipt TERMS C.r' \J'j l,! Purchase Order No. 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 OS/29/2009 311011 1.00 Measurement for Carpet (Town Clerk) $35 00 $35 00 1 Tax $2 84 $2 84 TOTAL $37.84 John C. Masterson 3784 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 actualiy due OS/29/2009 S}{L (~~ IGNATURE DATE Town Clerk (SPACE BELOW FOR MUNICIPAL USE) 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 COMPTROLLER DATE SPECIAL SERVICES CUSTOMER INVOICE Store 1207 WAPPINGERS FALLS Phone: (845) 298-9200 1570 ROUTE 9 Salesperson: KXG767 WAPPINGERS FALLS, NY 12590 Reviewer: This is only a QUOTE for the merchandise and services printed below. This becomes an Agreement upon payment and an endorsement by a Home Depot register validation. Page 1 of 2 No. 1207-311011 VALIDATION AREA SALE 1207 00017 03990 OS/29/09 72 VRF892 09:59 AM Home Phone CUSTOMER AGREEMENT ~ 311011 f;~ECALL AMOUNT SALES TAX TOTAL XXXXXXXXXXXX6943 HOME DEROT AUTH CODE 029551/6172071 P.O.~/JOB NAME: TOWN CLERK TOWN OF WAPPENGER PARKS! DEROSA JR JOSEPH QUOTE is valid for this date: OS/29/2009 35.00 2.,84 B7.S4 37.84 Name TOWN OF WAPPINGERS REC * * (845) 297-5771 Address 20 MIDDLEBUSH RD Work Phone TA Company Name City WAPPINGERS FALLS State NY Zip 12590 Job Description FOR 311010 County DUTCHESS REF# SKU UM M01 578-468 MEASUREMENT SITE: ADDRESS: 20 MIDDLEBUSH RD STATE: NY ZIP: 12590 COUNTY: DUTCHESS PHONE: 845 297-5771 MEASURE SPECIAL INSTRUCTIONS: DESCRIPTION EXTENSION $35.00 MEASUREMENT #1 MERCHANDISE AND SERVICE SUMMARY :fdr~~~~~~~~~ghltolimittheqUantiti REF # MOl FROM INSTALLATION # 311010-101 TOWN OF WAPPINGERS REC * * CITY: WAPPINGE SALES TAX RATE: $0.00 $35.00 ~~ ~~ \S@~ i\~ ~~ ~@"\S Check your current order status online at www.homedepot.comJorderstatus END OF MEASUREMENT :v ~~~ ~V~ \~ ~ ~ . (". r ~~. ~.~. . ~, (" ",t>~ ." /l". (9801) 0100405125 Page 1 of 2 No. 1207-311011 Customer Copy