Merritt, Virginia
TOWN 0' wa.......". NY
P.O. Box 324. MIddJebush Road
Wapplngera Falla. N.Y, 12590
.,~
,~NO.
DO NOT wRITE IN THIS 80X
PURCHASE ORDER & VOUCHER
AMOUNT
r Nt G 1\ J{, 1"7', Y I 1..1!r) rti;&
CLAIMANT'S I 1 . ''\'. .,... ~ J "d.....
::: U'.l1t!:J' 6' '( (^' . . ~... . '\J .'.
L \./J 0.,. 1) (1\ f\ .:J[I 1..fJ.......l..t S....J
I~ S9li
TOTAL
TERMS
~CTNO.
~..
OATES
QUANTITY
DESCRIPTION OF MATERIALS OR;tIavtc&S
UNIT PRICE
AMOUNT
/ f (.
5,'
'-...~~
1
136 00
<
10-24-05 Class
5 00
",.......
TOTAl..
141,,00
1/ /', rt.~, 0 ~
I ,-- (..-,/ !.- . ,./"V
DATE
'.. ~"""III Ileemount Of'
,~..... ....,: .......... ..... lIMn pIIld or .......: \llet --. '"'"' wIIICh \he
/..\ i
t.f# ;;:,.l~
(SPACE IELOW~CII; UtcIPAl., use~
DEPARTMENT APPROVA\.
The above servicftsormateriats wert~eredQr
furnished to the muniC~tity on the date. sUitedancUhe
charges are correct
APPROVAL FOR PAYMENT
'TtQ _M Is IPIll'OVed peid ftam 1I'Ie ~.lnclicatecl.bOve
1/.//t,/t5
DATE
. DATE