Platts County Village
.
Town of Wappinger
20 MIDDLEBUSH ROAD
WAPPINGER FALLS, NY 12590
PURCHASE ORDER & VOUCHER
Department:
CLAIMANl'S
NAMEAND
ADDRESS
Platt's Country VdIc:Ig,
Locksmith! Inc.
196 Old 'Route 9
- - .-. ...
, -..
E S Due on Receipt
T RM
Purchase
Order No,
3
DO NOT WRITE IN THIS BOX
Dele Voucher Received
FUND - APPROPRIATION AMOUNT
A I '110 .Ol.../o~
TOTAL $0 00
ABSTRACT NO. I
VENDOR'S
REFNO.
DATES INV# Quantity DESCRIPTION OF MATERIALS OR SiRVICES UNIT PRICE AMOUNT
1/5//~ SJ,q:J.3 5e.rv.Le.~ 5ltf~/ Comb<, ~ / +r-i.p 180
6~
TOTAL 1> J~ 10 -s&.ee
t, 1) J r1 c.. C.-/ 0....1"\ e... - PI ill certify the! the above account in the amount of $ -:::fl::tl6" :$ I ~ 0 . 0 0
is true and correct; that the ~ems, services, and disbursemants charged were rendered to or for the municipality on the dates stated; that no part has been paid or satisfied; thatl8xes, from which the
municipality is exempted, are not Included: and that the amount claimed is actually due
.J0Jl . 5, :J. 61 d..
DATE
8? /Ylc ~- PUett
SIGNATURE
DPf'L:csc. f7l~r.
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 ~
11m i~z C AUT" ~ OFFICiAl
APPROVAL FOR PAYMENT
This claim is approved paid from the appropriations indicated above
DATE
COMPTROLLER
,.
Platt's Country Village Locksmith
196 Old Rt.9
FishkiII, NY
845297-8220
12524
845897-8220
r'-
" ..)
LOCATION BUS. PHONE
RES. PHONE
GE
8,.'::, ·
'*
.0
Se.r\lKL 5d'e....
Sa.;.f~.-CQlX)_bocJ~l~J'
'/rfiiiiiilCe-ailJiion:S1Jil"jjefmonth"(lffKl-penmnum)
. be Idded to unpiIid'llilIIInces.
CUSTOMER'S X
SIGNATURE
AUTHORIZATION FOR SECURITY/EMERGENCY SERVICES
I hereby certify that I have the authority to order the lock, key or security work
designated above_ Further, I agree to absolve the locksmith who bears this
authorization from any and all claims arising from the performanCe of such work_
SIGNATURE DATE
ADDRESS
YEAR MAKE
'''AUTO
LICENSE/SERIAL NUMBER
B PRODUCT 619
S 2923
,,,.,./ To Aeorder:
800-225-8380 or nebs.com
J...;
TOTAL
MATERIALS
TOTAL
LABOR
o SERVICE CHG.
'9-TRIP CHG.
SUBTOTAL
TAX
:sore
TOTAL I <3 6 i 00
~ER