Affadavits- Poughkeepsie Journal
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Wappingers Falls, N. Y. 12590
DO NOT WRITE IN THIS BOX
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.,
D~le Voucher Received
FUND - APPROPRIATION AMOUNT
TOTAL
ABSTRACT NO. I
TERMS
VENDOR'S
REF.NO.
PURCHASE ORDER & VOUCHER
CLAIMANT'S
NAME AND
ADDRESS
Poughkeepsie 'Journal
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DATES QUANTITY DESCRIPTION OF MATERIALS OR SERVICES UNIT PRICE AMOUNT
I
ad # 3347723- legal 7723- 4/30/2012 /147.92
request for proposals for Engineering Services fo I
the Challenger Little League field
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I I
TOTAL
I
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I, Ri ta Lombardi
is ltue and correct; lhallho ~ems. services. and disbursemenls charged
municipality is exempled. are not included; and Ihalthe amounl cia
5/1/2012
DATE
certify Ihallhe above accounl in the amounl 01.$
re rendered to or lor the municipalily on the dates slaled; Ihal no part has been paid or sa/isfied; Ihallaxes. from Which the
-.'"~ '
SIGNATURE
Pri:aGipal Cl.,rk
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
AUTHORIZED OFFICIAL
II
I
I
I
APPROVAL FOR PAYMENT
This claim is app;oved paid from the appropriations indicated above
DATE
DATE
COMPTROLLER
IUUI lummunny. your newspaper.
CLASSIFIED
ADVER"flSING
INVOICE
~ P.O. BOX 1231
85 CIVIC CENTER PLAZA
POUGHKEEPSIE. NY 12602
BUSINESS OffiCE: (845) 437-4704
Pou.ghkeepsie Journal
pough keepsiejourna Leo m
:.:. ..'7BJU.~<'. ........
04/30/12
TOWN OF WAPPINGER SUPERVISOR'S
ATTN: CHRISTOPHER COLSEY
20 MIDDLEBUSH RD
WAPPINGERS FALLS NY 12590-4004
TO PLACE A CLASSIAED AD
PLEASE CALL (845) 471-7355
103347723
103347723
103347723
000 REQUEST FOR PROPOSAL
000 REQUEST FOR PROPOSAL
AFFIDAVIT CHARGE
04/30/12
04/30/12
04/30/12
246
246
1
1
127.92
20.00
82
147.92
TERMS: PAYABLE UPON RECEIPT
) ASSURE PROPER CREDIT, DETPCH AND RETURN THIS PORTION WITH REMITTANCE *
~ payable to: THE POUGHKEEPSIE JOURNAL 0 Visa 0 Masterca-d
--1
147.92 0103347723 04/30/12
Signature
D PLEASE CHANGE MY ADDRESS AS INDICATED ON REVERSE
INVOICE
t:xpUllllOn Montn I Year
0103347723000147920
11111111111111111111111111111111111111"11, Jlllllrll rI.I.I" II
TOWN OF WAPPINGER SUPERVISORIS
ATTN: CHRISTOPHER COLSEY
20 MIDDLEBUSH RD
WAPPINGERS FALLS NY 12590-4004
Pou~hkeep.sie Journal
PO BOX 1629
BINGHAMTON, NY 13902-1629
845-297-2744
82
1)...n."........ft............ft '1.....___1
P.O. BOX 1231
85 CIVIC CENlER PlAZA
POUGHKRF.PSIF NY 1?^m
Poughkeepsie Journal
Poughkeepsie, N. Y.
AFFIDAVIT OF PUBLICATION
State of New York
County of Dutchess
City of Poughkeepsie
Rita Lombardi.
of the City of Poughkeepsie,
Dutchess County, New York, being duly sworn, says
that at the several times hereinafter mentioned he/she
was and still is the Principle Clerk of the Poughkeepsie
Newspapers Division of Gannett Satellite Information
Network, Inc., publisher of the Poughkeepsie Journal, a
newspaper published every day in the year 2012 in the
city of Poughkeepsie, Dutchess County, New York, and
that the annexed Notice was duly published in the said
newspaper for
one insertion
successively, in each week, commencing on the 30th
day of Apr il in the year of 2012 and
on the following dates thereafter, namely on:
day of
, both days inclusive.
\
In
/~
day
My commission expires
ROSE ANN SIMPSON
Notary Public, State of New York
No. 01516215893
Qualified in Dutchess County
Commission Expires January 4, 2014