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Green, Jack M.
"~ -~ ,- '" -.. '.~- T;~"'--:~"':7~~~-;""r",~,~'7~'11-:~?'L.~~t,~\;i,:~~f!~:~~'t~~tG~?~~:T~_i~?Yr::~;~r; " TOWN O' W.PIIING..., NY P.O. Box 324, Middlebulh Road Wappingers Falls. N.V. 12590 ..lititchQe ~NIl. DO NOT WltlTEIN THIS BOX r .,....,.- o-.liclulNr IlellIIYed PURCHASE ORDER & VOUCHER AMOUNT CLAIMANT'S NAME AND ADDRESS L )" TEAMS ~s ".NO. OATES QUANTITY D5SCRlPTlON 0' MATERW.I QlIt ~s ,'.. ','''.'' .. - .. , '.. "" _.. _,_ _;.. ..: '(".:_:.'__\~:::'_': _,,",_":' 'J:'> UNIT PAICE AMOUNT 11- tL '/i " ;.' I _ .. ,..l~:t\- I D/.. { /I " " I TOTAL " "I' (/.... tj tl---'/ ' .. ~ I. . ' , ___ lilt "'.., ICCiGIIlllln '" -'II 01 S IIlruI_ CCIMCl: Ihellhe .... ...... _ ~ ~ WIlt ~ lit. fCW "lll!!i T............: lIlIli no.,.... been _ or AlIIllIct. Ihel...... '""" whiclIlhe rnunlc:illIIllY II IXempted. .. Nll includecI: lIlICIlIIa1 .... IlMIlIlIIl ~ inOI"'" M . . ~ .." . ' . \." .',,.,,,.f', "'~' , f( dil __~_","__':', ~i;l' ,',," DATE TITLE t:'?_'-,-:.:'-,:':\'.-::-, '. ',',' ,:,,:.... _,,:' ~ (SPACE _QW~~ USE) DEPART.....'I'~~~~L , The above servic.s or""tIri.~ ""8l'4l~reciot .. . . ..... .: ' furnished to the mlJnielpiltity Ol'\tne d__.acta"" thll charges are corre.ct ~....OVALFOR PAYMENT 'Thit _m it ~ p8idfrorn the IPPI'OPMtlonl il'ldicated Hove /1;/1 t Ie ~ DAT~ ...' ., . ~~ ~ :-- ", ,',. :.::.... .' ,< .~'"':A;,~ . .... ..:....:...:..:. ',' .', ':", .....,'.....:.'.'...t.::,..:..:.._._.... DATE COMPTRou.~