Smith, Constance :~7':"', '(,'"":.';: c;~"':-::',':'~.'!'~~''r'~ .,. '. " ",,'~:"~ ,'i:.,~;;> TOWN O'Wa"IN..., NY P,O. Box 324, MlddlebuthAold Wappinger. Falll. N.Y. 12590 , PurGhIIe ~No, bONOr,WltITeIN THIS 8,OX "'",l."_:.,.- r,., // "Ie' , (. ;,v"" I r .i CLAIMANT'S .~ NAME AND 1:363 A-T . ADDRESS . I I.- ~' {/~jlj/ /1/ l r .., JA4/ 3/6 f /11#-; Ivy....J /~S7tJ ~7 , r/ ",_"~"'~.'f1ON AMOUNT . '.,' '. ". k .", .',. TOtA" ,. . . ~TNO. I ; PURCHASE ORDER & vOUCHeR TERMS ~ REF,NO. OATES QUANTITY UNIT PRICE AMOUNT i\ i'V' - (,,1 ';, ,'y I ' /"'" I - .\ TotAl 1'6.00 ~.-< i /""" ,,",:;:~-':"'_:.'-_.,::i':,:-:""", 1.'/ '.,' . .... .", . .'<.. ,., .' ,.' .......,.....'...\...,.,....~)Cl;OIlIIlln...~.,s it lruulld ClllINCl: lhIIl\he "-, ...... IIld di~""'llI~.... .......I!t~ flit Il!it ~1llli.J~r......... ~ "* 110 _l\IiI~ lMIiCIor ........: Ihet lallet. Iram wIllc:h \he _.~j..._.......--._..l f ยท i l,r....' ~" .:,c J I / C 0 6 "'it':<'", I DATi: (SPACE"OW FOR~ USE) " . Z ;1 C; r-~"'''',. ' '~. ',~., ,.' 4'-"&'~.f l'~~"'''' '_/ ~" t,,', 'i''''' . ...r( ~ "., .,' , ,---... Tn'- ' ,.:. ' / DEPARTMENT' APPROVAL The above servl~.orm......s werere,ndereQC)I' furnished to 'trnt mynlQ{paflty on thed8tes stated andt~ charges are correct ' APPROVAL FOR PAYMENT , 'thia ct.im ia llIlI)fOVed paid fftlI'ft \tie ....,... lncllclltlld ebove 1/ //t-./t .f;r OATE 1,' DATE COMPTROLLER .".~....l~...c.~';:;,:.~,:~""'.....~.;....~ "