General Code (3)Town of Wappinger
20 MIDDLEBUSH ROAD
WAPPINGER FALLS, NY 12590
PURCHASE ORDER & VOUCHER
Department:
General Code
CLAIMANT'S
NAMEAND 781 Elmgrove Road
ADDRESS Rochester, NY 14624
~,r~ha8e
Order No.
DO NOT WR/TE IN TH/S BOX
Date Voucher Received
FUND-APPROPRIATION
A1410.404 AMOUN
$3,271 T
00
TOTAL $3,271 00
TERMS Due on Receipt vENDOIrs
REFNO.
t V V V.,...,. ~ uywll certity that the above account in the amount of $ 3,271.00
is true and correct; that the items, services, and disbursements charged were rendered to or for the munici y n the dales stated; that no pert has been paitl or satisfied; that taxes, from which the
municipality is exempted, are not inclutled: end that the amount Gaimed is actually tlue
08/l 5/2013 ~` _
Deputy Town Clerk
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
DATE
AUTHORIZED OFFICIAL
APPROVAL FOR PAYMENT
This claim is approved paid from the appropriations indicated above
DATE COMPTROLLER
GETVERAL
~- ~*~
:,~L
h formation maa'~ 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:
00012113
8/1/2013
8/31/2013
Net 30
Town of Wappinger
Christine Fulton
C/O Clerk's Office
20 Middlebush Road
Wappingers Falls NY
12590
Customer No: WA0691
Maintenance Period Ends: 10/19/2014
Qty Description Laserfiche SW Assurance Plan
1 Weblink Basic LSAP
4 Full, Email & Snapshot basic L
5 Retrieval & E-mail basic LSAP
1 LF Team Server LSAP
1 LF QF-ScanConnect LSAP _ ~-- °~ "'
~ ,
AUG 0 5 2013
TOWN ~~ ~~PPINGER
Interest will be charged on all past due
accounts at 1.5o monthly.
Subtotal
S&H Charges
Tax EXEMPT
Payment/Credit:
Total Due
Amount
$1,749.00
$660.00
$330.00
$495.00
$37.00
$3,271.00
$0.00
$0.00
$3,271.00
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. ~L
8/1/2013 Accounting Administrator
Account Charged Payment Record: Check # Dated
Department Approval Date