Steagher, Jacquelyn
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TOWN 0' W.........,NY
P,O.Box 324, MlddIebu.hRoad '.
Wapplngers Fall., N.Y. 12590
,,'tl:.
, ,',,,. 'l!!
00 NOTWR'T2IN THIS 80X
PURCHASE ORDER & VOUCHER'"
:f' if;
AMOUNT
r, "
~l}.~ ~JLf ( I I
CI.AIMANT'S
NAMIAND
~I$S
110:ll;((
.,
l1 I'
/.'. I ..- ..
"
L
TOTAL
/)
~No,
VINOOQ ,
, flIF.HO.
TERMS
OATES
QUANTITY
II i If') {
DESCRIPTION OF MATEAtAl.$OA SIAVIces
UNIT PRICE
AMOUNT
t",'l
l
i
: ..;}
I
i 1/ fr
.1,/
Ii //
,
II 7/c' ,p'';
!' I, C'
"I '
~ ""
)
R, .
i
/
'~
'1
J
TOTAL
1'0.88
I, . .' . ' "., . . .,.. ',' ",~,,""'.....~ln"'''''!OUlllot$
illIue lIlId CIIfl'KI: Ihet the 1lImI. HMca, IIlll ~ ~ ............>Ioor fOrllil.~ ...........: ",,*1IO.PIIl lilt... _ or ....hd:lhet 1aHt. flllII'I which the
munIc:ipeIIIy .....,...,.,. noI included: lIlId lhetthe IIllO\Iftt ....illIoIIIItIv M . ,.' " ", '
ii,
;t. '.1
TITLE
(SPACE 8ILf)Wti'Q.. MUNiCIPAL USE)
DEPAR1'MItf'rAPPftOVAl.
The above, services'orm~ 'were,."derect or
furnished to the rnuniQipatityOl'l thad"'stJftedand thft
charges are correct
APPROVAL FOR PAYMENT
Thil Nim II ~ PIld ff'Oln"~ Indicated aboYlt
/(/Ib /I'S'
, DATE
,C::OMP~Ol.LE~