General Code (4)
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Town of Wappinger
20 MIDDLEBUSH ROAD
WAPPINGER FALLS, NY 12590
PURCHASE ORDER & VOUCHER
Department:
Purchase
Order No
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CLAIMANT'S
NAMEAND
ADDRESS
General Code
72 Hinchey Road
Rochester, New York 14624-2991
----
DO NOT WRITE IN THIS BOX .......,"...--. ;.1 )
Date Voucher Received ~
FUND - APPROPRIATION AMOUNT
TOTAL $0 00
ABSTRACT NO. I
TERMS Due on Receipt
VENDOR'S
REFNO.
DATES INV# Quantity DESCRIPTION OF MATERIALS OR SERVICES UNIT PRICE AMOUNT
01/23/2009 I 44 Supplement No, 17 $682 77 $682 77
I Composition Work $730 06 $730 06
I Duplication $351 41 $351 41
1 Finishing $114 60 $114 60
1 S&H $52 91 $52 91
TOTAL $1,931.75
1 certify that the above account in the amount of $ 1,931,75
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
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DATE
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SIGNATURE
.~V\ c..bL'/Z.L
TITLE
(SPACE BELOW FOR MUNICIPAL USE)
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
COMPTROLLER
DATE
AUTHORIZED OFFICIAL
DATE
Page:
Sales/Edit:
Customer No:
72 Hinchey Road
Rochester, New York 14624-2991
(800)836-8834 * Fax(585)328-8189
Tax ID 20-8015087
1
BC
WA0691
GENERAL
(1:'] I) ~
Invoice No:
Invoice Date:
Due Date:
Terms:
GOl17852
1/23/2009
2/22/2009
Net 30
Your Order:
SHIP TO:
Town of Wappinger
Mr. Chris Masterson
C/O Clerk's Office
20 Middlebush Road
Wappingers Falls NY
12590
BILL TO:
Town of Wappinger
Mr. Chris Masterson
C/O Clerk's Office
20 Middlebush Road
Wappingers Falls NY
12590
Qty
44
Description
Supplement No.17:
* Editorial Work
* Composition Work
* Duplication
* Finishing
PC/CodeBook Supplement
E-Code Supplement (refer to Website)
Amount
$682.77
$730.06
$351.41
$114.60
Interest will be charged on all past due
accounts at 1.5% monthly.
Subtotal
S&H Charges
Tax EXEMPT
Pmt Rec'd
Total Due
$1,878.84
$52.91
$0.00
$0.00
$1,931.75
Thank you for choosing General Code. We appreciate your business.
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Voucher Form (if reauired)
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 above
claim; that the amount therein stated is justly due and owing; and that the
amount charged is a reasonable one.
U~---=~
Accounting Administrator
1/23/2009
Account Charged
Payment Record: Check #
Dated
Department Approval
Date