Russell, Newell
TOWN OF WAPPINGIR. NY
P.O. Box 324, Middlebush Road
Wappingers Falls, N.Y. 12590
Purchllle
Order No.
DO NOT WRITE IN THIS BOX
PURCHASE ORDER & VOUCHER
D~le Voucher Received
FUND. APPROPRIATION AMOUNT
TOTAL
ABSTRACT NO. I
CLAIMANT'S
NAME AND
ADDRESS
r/lI;[tUk)J /~ RussEll-. J~~
/o8R.ool(s/.D.E" PIC,
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L ;f/,lPJ Yb,f/(I/%'?O ..J
TERMS
VENDOR'S
REFNO
DATES , QUANTITY DESCRIF'T10N OF MATERIALS OR SERVICES UNIT F'RICE AMOUNT
//8-oS Elee t: JOlt ;J::;,Sfeet;or.- ,5:3011,$- I ;;,,:.!O f?17(--1;3{) r:? /J1 , ~-
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2J
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TOTAL
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I. certify !NIt thll .bove .ccount in the .mounl 01 $
is IN. and coned: Ih.t the it.ms. servicas. .nd disbursemenls ch.rged "'.re rendered to or lor the municipality on the d.tes st.ted: th.1 no part hes been paid or satislled: that t..... lrom which the
municipality is ..empted. .re not included: .nd th.llhe .mount cl.imed is .ctu.ny due
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/ DAfE
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SIGNATURE
~~.
(SF'ACE BELOW FOR MUNICIF'AL USE)
DEPARTMENT APPROVAL
The above services or materials were rendered or
furnished to the municipality on the dates stated and the
charges are correct
11
APPROVAL FOR PAYMENT
This claim is approved paid from the appropriations indicated above
DATE
AUTHORIZED OFFICIAL
DATE
COMPTROLLER