Signal Graphics
Town of Wappinger
20 MIDDLEBUSH ROAD
WAPPINGER FALLS, NY 12590
PURCHASE ORDER & VOUCHER
Department:
CLAIMANT'S
NAMEAND
ADDRESS
Signal Graphics
1299 Route 9, Suite 105
Wappingers Falls, NY 12590
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
REFNO.
DATES INV# Quantity DESCRIPTION OF MATERIALS OR SERVICES UNIT PRICE AMOUNT
8/] 4/2008 1.00 Town Clerk Certification Forms 4 Pads/50 ea $17 02 $17 02
TOTAL $17.02
John C. Masterson 17 02
I certify that the above account in the amount of $ .
is true and correct; that the items, 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
municipaiity is exempted. are not included: and that the amount claimed is actually due
August 14,2008
DATE
Town Clerk
TITLE
(SPACE BELOW FOR MUNICIPAL USE)
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
APPROVAL FOR PAYMENT
This claim is approved paid from the appropriations indicated above
DATE
COMPTROLLER
I Signal Graphics@
o PAID IN FUll
Cash Check#
AMEX
DISC I
Salesperson
I VISA I MC
o Customer Called
o Artwork Filed
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