Wells Fargo Financial Leasingh
Town of Wappinger
20 MIDDLEBUSH ROAD
WAPPINGER FALLS, NY 12590
PURCHASE ORDER & VOUCHER
Department:
Wells Fargo Financial Leasing
cLAIMANrs
NAMEAND P•O. Box 6434
ADDRESS Carol Stream, IL 60197
Purchase
Order No.
DO NOT WRITE /N THIS BOX
Date Voucher Received
FUND -APPROPRIATION AMOUN T
A1410.404 $1,195 00
TOTAL $1,195 00
ABSTRACT NO.
TERMS Due on Receipt VENDOR'S
REFNO.
DATES INV# Quantity DESCRIPTION OF MATERIALS OR SERVICES UNIT PRICE AMOUNT
O 1 /02/2013 1.00 General Code Annual Maintenance $1,195 00 $1,195 00
TOTAL $1,19 5.00
i Christine Fulton 1,195.00
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 municipality on the dates stated; that no part has been paid or satisfied; that taxes, from which the
municipality is exempted, are not included: antl that the amount Gaimed is actually due
O 1 /02/2013 _ _ Town Clerk
DATE 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
APPROVAL FOR PAYMENT
This claim is approved paid from the appropriations indicated above
DATE
AUTHORIZED OFFICIAL
DATE
COMPTROLLER
ENTERAL
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Information made civil.
781 Elmgrove Road
Rochester, New York 14624-2991
(800)836-8834 * Fax(585)328-8189
Tax ID 20-8015087
Invoice No:
Invoice Date:
Due Date:
Terms:
PO:
C0010111
1/1/2013
1/31/2013
Net 30
Town of Wappinger Customer No: WA0691
Christine Fulton
C/O Clerks Office Maintenance Period Ends:
20 Middlebush Road
Wappingers Fa11s NY 12590
Qty Description eCode360 Annual Maintenance
1 eCode360 Annual Maintenance Fe
Interest will be charged on all past due
accounts at 1.5~ monthly.
Subtotal
S&H Charges
Tax EXEMPT
Payment/Credit:
Total Due
12/31/2013
Amount
$1,195.00
$1,195.00
$0.00
$0.00
$1,195.00
___Thank you for choosing General Code. We appreciate your business.
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.
~Oa1.-or~t- ~-c_~
Accounting Administrator 1/1/2013
Account Charged Payment Record: Check # Dated
Department Approval Date