General Code (5)Town of Wappinger
20 MIDDLEBUSH ROAD
WAPPINGER FALLS, Nl' 12590
PURCHASE ORDER & VOUCHER
Department:
General Code
CU\IMANT'S
NAMEAND 781 Elmgrove Rd
ADDRESS Rochester, NY 14624-8189
Purchase ~ / j ~
OMerNo. ~5~.(,..(
DO NOT WRITE IN TH/S BOX
Date Voucher Receivetl
FUND-APPROPRIATION AMOUNT
TOTAL $0 00
ABSTRACT NO.
Due on Receipt VENDOR'S
TERMS REFNO.
DATES INV# Quantity DESCRIPTION OF MATERIALS OR SERVICES' ~ UNIT PRICE AMOUNT
08282012 1.00 Supplement 24 $1,816 80 $1,816 80
TOTAL $1,81 6.80
Christine Fulton 1,816.80
1, 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 muniGpallty on the dates stated; that no part has been paid or satisfied; that taxes, from which the
muniGpatlty is exempted, are not inGuded: and that the amount Geimed is actually due
08/31/2012
DATE SIGNATURE
Town Clerk
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
I
GENERAL 781 Elmgrove Road
~li~ Rochester, New York 14624-2991
(800)836-8834 ` Fax(585)328-8189
' Tax ID 20-8015087
Information made civil.
G°~L~C~L~~MC~D
Bill To:
Town of Wappinger
Christine Fulton
C/O Clerk's Office
20 Middlebush Road
Wappingers Falls, NY 12590
Supplement Project
Supplement No. 24 Quantity 22
AUG- 31 2012
TOWN OF WAPPINGER
TOWN CLERK
PO No.
Invoice No. BILL008911
Date: 8/28/2012
Due Date: 9/27/2012
Terms: Net 30
Customer No. WA0691
Item Billing Amount Tax Total
Code Analysis $1,107.14 $0.00 $1,107.14
Composition $474.72 $0.00 $474.72
Duplication, Finish & Handling $215.16 $0.00 $215.16
Shipping & Handling $19.78 $0.00 $19.78
$1,816.80 $0.00 $1,816.80
Payment applied: $o.oo
Interest will be charged on all past due accounts at 1.5% monthly. TOt<11 Balance Due $1,816.80
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 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 amount therein stated is justly due and owing, and that the
amount charged is a reasonable one.
Accounting Administrator 8/28/2012
Account Charged
Department Approval
Payment Record Check# dated
rlala
Thank you for choosing General Code. We appreciate your business.