Staples (6)
TOWN OF WAPPINGER. NY
P.O. Box 324, Middlebush Road
Wappingers Fails, N. Y. 12590
Purchase
Order No
DO NOT WRITE IN THIS BO)(
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"I
Dole Voucher Received
FUND. APPROPRIATION AMOUNT
TOTAL
ABSTRACT NO. I
PURCHASE ORDER & VOUCHER
CLAIMANT'S
NAME AND
ADDRESS
STAPLES
L
..J
TERMS
VENDOR'S
REFNO
DATES QUANTITY DESCRIPTION OF MATERIALS OR SERVICES UNIT PRICE AMOUNT
Pg. 626 1 381015 HP LaserJet 2100-2200 Series Printer 139. 92 139 92
I
TOTAL
I. certify thai the above account in Ihe amount of $
is true and conec!: that the items. services. and disbursements charged .,are rendered to or lor the municipality on lhe dales stated: Ihat no part has been paid or satisfied: that laxes. from which the
municipality is exempted. ere not included: and that the amount claimed is aclually due
!J= c.~
NATURE
TOWN CLERI
TITLE
DATE
AUTHORIZED OFFICIAL
(SPACE BELOW FOR MUNICIPAL USE)
r APPROVAL FOR PAYMENT
I Th.s claim IS approved paid from the appropnatlons Indicated above
I
I
I
DEPARTMENT APPROVAL
The above services or materials were rendered. or
furnished to the municipality on the dates stated and the
charges are correct
DATE
COMPTROLLER