Taylor, Donna
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TOWN O. WAPPtIl..... .......
P.O. Box 324, MlcIdlebullh Road
Wappingers Fa"., N.V. 12590
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PUItlIiIe
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00 NOT WRITE IN THIS lOX
CLAIMANT'S
NAME AND
ADDRESS
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AMOUNT
PURCHASE ORDER. VOUCH.SR
r
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L
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TOTAL
TERMS
~I.
MF.NO.
OATES
QUANTITY
OISCRIPTION OF MATERIALS OR HtMCIiS
UNIT p~e
i\/i,j
C\ \~ \J ". ,'t\
i
I
j
,-- ';::..~....:./
i
,
TOTAL
145.55
I.
it IM"'~: \IIIl1lle '*"'.......IM -........~.... ........, fI!t-'
munlcipIlIly .....,... _llClllncluded: IMlhal '"' ~~.~...' ..
__.....-unIlnlllt elnDllIllol S
........: lhal no '*'.. bMlI_ or ....tIed; \IIIllalW. '-' wIlich IlIe
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f '!'~'"
DATE
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\ TITLE
DEPARTMENT APPROVAL
The above services or materials were renderec:t or .
furnished to the municipality on the dates stated and the
charges are correct .
(~"OW'OA MUNICIPAl. use)
APPR.OVAl-FOR PAYMENT
ThiI cI.lm Is ~!)IId from the ~llonl indlcatlCl.bove
11~{,lt:5
,/ DATe
DATE
C~U..EA