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Approved by State Board of Accounts PURCHASE ORDER -PAYMENT VOUCHER <br />PAID BY Chec No. <br />Lb <br />AMOUNT <br />Date ,209� <br />• PURCHASED OF <br />ADDRESS <br />DELIVER TO <br />SEND INVOICE TO <br />EXTRA -CURRICULAR ACTIVITIES REPORT <br />RILEY HIGH <br />ONE V413C <br />1902 S. FULO% <br />RI 42488 <br />Date 202Z <br />TO THE TREASURER: The following expense is incurred, payable from they 4UU ir0"J'A% /(G Account.o(,Ip <br />NO payment is to be made unless this form is on file with the Treasurer, properly approved and items or service have been received. <br />QUANTITY <br />DESCRIPTION <br />UNIT <br />PRICE <br />TOTAL <br />• <br />TAX EXEMPT 740281-03 <br />The Sou <br />by the F <br />SIGNED <br />Items priced <br />DATE <br />of the State of Indiana, and is, therefore, not subject to any excise taxes imposed <br />CLAIMANTS <br />SIGNATURE <br />DATE <br />20 TITLE <br />Form No. SA-1 B <br />VENDOR PURCHASE ORDER NOT AUTHORIZED UNLESS SIGNED AS PRESCRIBED ABOVE. <br />