General Code (4)Town of Wappinger
20 MIDDLEBUSH ROAD
WAPPINGER FALLS, NY 12590
PURCHASE ORDER & VOUCHER
Department:
General Code
CLAIMANT'S
NAMEAND 781 Ehrigrove Road
ADDRESS Rochester, NY 14624-2991
Purchase
Order No
DO NOT WRITE IN THIS BOX
Date Voucher Received
FUND -APPROPRIATION AMOUNT
$3,271 00
TOTAL $3,271 00
ABSTRACT NO.
Due on Receipt VENDOR'S
TERMS REFNO.
DATES INV# Quantity DESCRIPTION OF MATERIALS OR SERVICES UNIT PRICE AMOUNT
1.00 Laserfiche SW Assurance Plan $3,271 00 $3,271 00
$0 00
$0 00
$0 00
TOTAL $3,2 71.00
Christine Fulton 3 271.00
I certlfy that the above account in the amount of $ '
is true and correct; that the items, services, end disbursements charged were rendered to ortor the municipality on the dates stated; that no part has been paid or satisfied; that taxes, from which the
municipality is exempted, are not included: and that the amount ctaimed Is actually due
08/13/2012
DATE
Town Clerk
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
DATE AUTHORIZED OFFICIAL
APPROVAL FOR PAYMENT
This claim is approved paid from the appropriations indicated above
DATE COMPTROLLER
781 Elmgrove Road
Rochester, New York 14624-2991
(800)836-8834 * Fax(585)328-8189
Tax ID 20-8015087
Invoice No: 00009016
Invoice Date: 8/9/2012
Due Date: 9/8/2012
Terms: Net 30
P0:
Town of Wappinger Customer No: WA0691
Christine Fulton Maintenance Period Ends: 10/19/2013
C/O Clerk's Office
20 Middlebush Road
Wappingers Falls NY 12590
Qty Description Laserfiche SW Assurance Plan Amount
1 Weblink Basic LSAP $1,749.00
4 Full, Email & Snapshot basic L $660.00
5 Retrieval & E-mail basic LSAP $330.00
1 LF Team Server LSAP $495.00
1 LF QF-ScanConnect LSAP $37.00
Interest will be charged on all past due Subtotal $3,271.00
accounts at 1.5~ monthly. S&H Charges $0.00
Tax EXEMPT $ 0 . 0 0
Payment/Credit:
Total Due $3,271.00
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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 therein; that no bonus has been given or received
by any persons within knowledge of this claimant in connection with the above claim; that the ~rnount therein stated is
justly due and owing; and that the amount charged is a reasonable one.
~'~
Accounting Administrator 8/9/2012
Account Charged Payment Record: Check # Dated
Department Approval Date,