Per B. JensenTown of Wappinger
20 MIDDLEBUSH ROAD
WAPPINGER FALLS, NY 12590
PURCHASE ORDER & VOUCHER
Department:
CLAIMANT'S /~ ~~ ~ + G~~,
NAMEAND ~..> T v
ADDRESS
-~,~~ i ~~ ~ l 2-33
Purchase
Order No.
DO NOT WRITE /N THIS BOX
Date Voucher Received
FUND -APPROPRIATION AMOUNT
TOTAL $0 00
ABSTRACT NO.
Due on Receipt EF OR'S
TERMS
DATES INV# Quantity DESCRIPTION OF MATERIALS OR SERVICES UNIT PRICE AMOUNT
g(~, Ll p~~~ --~c~~-~s
~ ~~C~-/~G~, ~d -- ~o
TOTAL ~n
I ~~ // ~ `'~ ~ <<~r ~ " certify that the above account in the amount of S ~~ ~`-' " ~ y
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
municipality is exempted, are not included: and that the amount claimed is actually due
DATE SI NATURE
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
~~ ~~la-
DATE AUTHORIZED OFFICIAL
APPROVAL FOR PAYMENT
This claim is approved paid from the appropriations indicated above
DATE
COMPTROLLER