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Landry, Sandra + r TOWN 0' WA........ NY' P.O. Box 324. Mlddlebush 'Floid W,pplngers Falls. N.Y. 12590 :rtqM '.' AMOUNT Cl.AIMANT'S NAMI AND ADDReSS ~o '('.:~ r (k. . LfA v,d f ~., ;:) ~.~f l~ ~::V\ Cl_t 1:>V''1e., L L,.J~ (\;Jfi\'0c\.ef5. f~..\(51~J~\J. .............................. '\ v \ ~. 5('>,0 ,\ .... TERMS OATES QUANTITY DESCRffIIT\C)fJf OFw.""w.a~i~1 illi':; los C III C + ';)1\ 17\""\'~ Grt'r+c,\("'" UNtTPFtlCe AMOUNT 136 00 10-24-05 Cla.. .5 ~.' , 'I J ,,' TOTAl 141.00 I. .'. .... '. '. . . . ................-.nirl..."'*'"'ofS is IrueIllllCDrNCl: lhIl... --. .....IlIlIMulMlllellla-. ..,.,..,10...... ~iII.ihlift......... Nt_,*, IIRtlHft.. .1IIItlIId: Nt...... fIom wllich Ihe I'IlUIIlclpeIIlIl uempIId. .,. nol included: IlIlIlhIl...1IIlOUIlt cIIiIMO illlIaIIIIItlr due . . . it \ \ '(;'OS" DATE ,"-' 0 .. " "~;i b i .' -+-, . 1\ ~ k', ,',' (,4...~ J""'" \.....~...^.. tv'" '- ". t,.,. ,',' ."y\ '~;' .."." '_ ~'\ ....) " TITLE " DePMTMENT APPROVAL The above services or materi81s were rendered or furnished to the municipality on the date. stated and the charges are correct . APPROVAL FQftPAVUENT . ThiI~ la~paidffom_.~~'bolle /1,1/&,/(15 DATE CC)MPtROl.L~Ft