General Code (2)
..-
Town of Wappinger
20 MIDDLEBUSH ROAD
WAPPINGER FALLS, NY 12590
PURCHASE ORDER & VOUCHER
Department:
CLAIMAN,..S
NAMEAND
ADDRESS
General Code
781 Elmgrove Road
Rochester, New York 14624
Due on Receipt
TERMS
Purchase
Order No.
5/
DO NOT WRITE IN THIS BOX
Date Voucher Received
FUND - APPROPRIATION AMOUNT
I'1Jn .Ljnz.
TOTAL $0 00
ABSTRACT NO. I
VENDOR'S
REFNO.
DATES INV# Quantity DESCRIPTION OF MATERIALS OR SERVICES UNIT PRICE AMOUNT
08/01/2011 1.00 Composition $95 47 $95 47
1 Duplicating $93 09 $93 09
1 Editorial $342 63 $342 63
1 Finishing $76 11 $76 11
1 Shipping $ Handling $15 00 $15 00
TOTAL $622.30
John C. Masterson 622 30
\, 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
:;;,;::-::- -"'~"~'~"'''-''-Zfle~ Town CI"k
DATE IGNATURE 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
APPROVAL FOR PAYMENT
This claim is approved paid from the appropriations indicated above
AUTHORIZED OFFICIAL
DATE
COMPTROLLER
DATE
.-
G ENE RA L 781 Elmgrove Road
61ili1iI;---- ---- --', Rochester, New York 14624-2991
,'_ _,1,. i (800)836-8834 * Fax(585)328-8189
" ..... ,... -,. Tax 10 20-8015087
Information made civil
Invoice No.
Date:
Due Date:
Terms:
Customer No.
BILL005367
7/27/2011
8/26/2011
Net 30
WA0691
Bill To:
Town of Wappinger
Mr. Chris Masterson
C/O Clerk's Office
20 Middlebush Road
Wappingers Falls, NY 12590
[Rj ~ ~ ~ rl~'l ~ [D)
Supplement Project
Supplement No. 22
Quantity 22
AUG 01 2011
TOWN OF \i\'l\PPINGER
PO No. TOWN CLERK
Item Billing Amount Tax Total
Composition $95.47 $0.00 $95.47
Duplicating $93.09 $0.00 $93.09
Editorial $342.63 $0.00 $342.63
Finishing $76.11 $0.00 $76.11
Shipping & Handling $15.00 $0.00 $15.00
$622.30 $0.00 $622.30
Interest will be charged on all past due accounts at 1.5% monthly.
Total Due
$622.30
This order is subject to General Code's Terms and Conditions which are
available at www.generalcode.com/TCdocs
Voucher Form (if required)
Claimant's Certification
I do solemnly declare and certify under penalties of the law that the within
bill is correct in all its particulars that the articles have been furnished
or services rendered as stated therin 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
~~.
Accounting Administrator
7/27/2011
Account Charged
Department Approval
Payment Record Check#
nated
Date
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