General Code (2)
Town of Wappinger
20 MIDDLEBUSH ROAD
WAPPINGER FALLS, NY 12590
PURCHASE ORDER & VOUCHER
Department:
CLAIMANT'S
NAMEAND
ADDRESS
General Code
72 Hinchey Road
Rochester, New York 14624
Due on Receipt
TERMS
Purchase
Order No.
DO NOT WRITE IN THIS BOX
Date Voucher Received
FUND - APPROPRIATION AMOUNT
TOTAL $0 00
ABSTRACT NO. I
VENDOR'S
REFNQ.
DATES INV# Quantity DESCRIPTION OF MATERIALS OR SERVICES UNIT PRICE AMOUNT
8/2712008 1.00 Laserfiche Change Order See attached Invoice #GOI 14238 $6,287 00 $6,287 00
TOTAL $6,287.00
John C. Masterson 6 287 00
1 certify that the above account in the amount of $ , .
IS true and correct; that the ilems, services. and disbursements charged were rendered to or for the municipality on the dates stated; that no part has been paid or satisfied; that taxes. from which the
municipality is exempted, are not included: and that the amount claimed is actually due
08/27/2008
DATE
Town Clerk
SIGNATURE
TITLE
(SPACE BELOW FOR MUNICIPAL USE)
APPROVAL FOR PAYMENT
DEPARTMENT APPROVAL
The above services or materials were rendered or
furnished to the municipality on the dates stated and the
charges are correct
DATE
AUTHORIZED OFFICIAL
This claim is approved paid from the appropriations indicated above
COMPTROLLER
DATE
..GENERAL
rite] IJ ~
Page:
Sales/Edit:
Customer No:
72 Hinchey Road
Rochester, New Yark 14624-2991
(800)836-8834 * Fax(585)328-8189
Tax ID 20-8015087
1
BC
WA0691
Invoice No:
Invoice Date:
Due Date:
Terms:
GOl14238
8/15/2008
9/14/2008
Net 30
Your Order:
BILL TO:
Town of Wappinger
Mr. Chris Masterson
C/O Clerk's Office
20 Middlebush Road
Wappingers Falls NY
SHIP TO:
Town of Wappinger
Mr. Chris Masterson
C/O Clerk's Office
20 Middlebush Road
Wappingers Falls NY
12590
12590
Qty
Description
Laserfiche Change Order for Additional Product:
50% invoiced on receipt of signed change order
Amount
$6,287.00
REC;i=fVED
AUG 2 ? 2008
Tnl Ii I"'. r::'RK
r! "! \.'(_L:,
Interest will be charged on all past due
accounts at 1.5% monthly.
Subtotal
S&H Charges
Tax
Pmt Rec'd
Total Due
$6,287.00
$0.00
$0.00
$0.00
$6,287.00
Thank you for choosing General Code. We appreciate your business.
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Claimant's Certification
Voucher Form (if required)
I do solemnly declare and certify under penalties of the law that the within
biJI is correct in all its partie/Jars; that the articles have been furnished
or services rendered as stated theris; that no bonus has been given or received
by any persons within knowledge of this claimant in connection with the above
claim; that the amount therein stated is justly due and owing; and that the
amount charged is a reasonable one.
~D7-t._N'= '~
Accounting Administrator
8/15/2008
Account Charged
Payment Record: Check #
Dated
Oeptartment Approval
Date