Safeguard
Town of Wappinger
20 MIDDLEBUSH ROAD
WAPPINGER FALLS, NY 12590
PURCHASE ORDER & VOUCHER
Department:
CLAIMANT'S
NAMEAND
ADDRESS
Safeguard
15 Manchester Road
Poughkeepsie, New York 12603
Due on Receipt
TERMS
Purchase
Order No.
DO NOT WRITE IN THIS BOX
Date Voucher Received
FUND - APPROPRIATION AMOUNT
IL{/o. VOC).,
TOTAL $0 00
ABSTRACT NO. I
VENDOR'S
REFNO.
DATES INV# Quantity DESCRIPTION OF MATERIALS OR SERVICES UNIT PRICE AMOUNT
11/01/2011 1 500 Sheets Safety Paper $50 00 $50 00
1 Shipping & Handling $10 00 $10 00
TOTAL $60.00
Christine Fulton 60 00
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 municipaiity on the dates stated; that no part has been paid or satisfied; that taxes. from which the
:~:~:~I~m'M ..oo,~_.,".."..._m~2~.,LU~ Ooputy Town Clock
DATE SIGNATURE 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
/1 '1//( .~y(,~ t?
DATE
AUTHORIZED
APPROVAL FOR PAYMENT
This claim is approved paid from the appropriations indicated above
DATE
COMPTROLLER
~SAr-EGUARD.
INVOICE
Page 1
_~ 027344579
1 0/26/207111 rOO~K9~OO.wh"I:la:rHV2'MCOla:-
CUSTOMER P.O.
\ 330272990
TAX CODE
JEROME MARTIN
15 MANCHESTER ROAD
POUGHKEEPSIE NY 12603
CUSTOMER NUMBER
220808
For Inquires Call: (845) 471-4466
INVOICE TERMS: Payable Upon Receipt
LATE CHARGE: 1-1/2% per Month or Maximum Allowable Rate
Minimum of $.50 Per Month
FED. TAX 10: 23-1689322
B
I
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TOWN OF WAPPINGER, NY
20 MIDDLEBUSH RD
WAPPINGERS FALLS NY 12590-4004
1,,111,,111111111111111,1111,,1111111111111,,1111.111111111111
S
H TOWN OF WAPPINGER
~ ANGIE
20 MIDDLEBUSH RD
~ WAPPINGERS FALLS NY 12590
QUANTITY I PRODUCT NAME I DESCRIPTION I FORMS AMT. I DISCOUNT I % AMOUNT DUE
T
o
500 CUSTMISC
OPBMISC
50.00
50.00
SAFETY PAPER NO BORDER
-0 PAY BY CREDIT CARD, SIMPLY CALL YOUR BUSINESS SPECIALIST
TOTAL PRODUCT
DISCOUNT
PREPAYMENT
SHIPPING/HANDLING
SALES TAX
50.00
.00
.00
10.00
.00
iAFEGUARD MESSAGE:
(845) 471-4466 JEROME MARTIN PLEASE PAy.... 6000
THIS AMOUNT""- .
K-------------------------------------------------------------------------
TOWN OF WAPPINGER, NY
~SAr-EGUARD. PLEASE INDICATE CHANGE OF ADDRESS AND/OR PHONE NUMBER:
INVOICE DATE
INVOICE
10/26/2011 027344579
INVOICE NUMBER
., ""11] \'J 1:1 :.~ I' It'J I:i =-: I]"". :ll :ill UJ:.ll [I
220808
00K9-00
II:~ 1):::1 :.\.' II h'J I :12:
HV2MCO
E-MAIL ADDRESS:
AMOUNT DUE
~ 60.00
TO INSURE PROPER CREDIT RETURN THIS STUB
WITH YOUR REMITTANCE.
10/26/2011 7:00 XXXX
R
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SAFEGUARD BUSINESS SYSTEMS
PO BOX 88043
CHICAGO IL 60680-1043
11111111111111111,,11111111,,1111111111111111111,,11111111.111
220808 27344579 000006000 5
295018821100
