Semp, Henry
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TOWN 0' WAJIPI....R. NY
P.O. Box 324, Mlddlebulh Road
Wappingers Fall., N.Y. 12590
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F'N' OJI.fittAT1OM' AMOUNT
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PURCHASE ORDER & VOUCH_
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CI.AIMANT'S
NAME AND It) ('
ADDRESS
TERMS
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..NO.
OATES
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QUANTITY
DESCRIPTION OF MATEAW.S QIl SlRVtCI$ .
UNIT PRICE
AMOUNT
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TOTAL
142.95
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it "'" IIId --'; IIIat 1M ..... MMcH. end diItIUI'H_. cht'IJlIIS ""'" .........,.01' ...."-'1.... CI!t'" ........: IIlIt no pill "" lIMn ,., Of tIlltlIlKI: IIIat tant. IIaI'Il which 1M
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, DATE TITLE
.~E_~~~,~tl~U$Et
DEPA~T.INTAP....o~1-
The above services O{rMt..,.ts~"'r.enderect. or
furnished to tnemunicipatltY on the det...stated.nd~n.
charges are correct
APPROVAl-FOR fllA:YM.ENT
This ClIiIn'ls,llPI)I'OVeCi'" 'lOT ~ ~~..abOVe
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DATE
COMPTROLLER