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1995, 08-20 Permit: 95006576 Refund
v# Dept .4CE VENDOR --J+2NACE L FUEL, INC N 122 HELENA WA 992;;2 Vendor Cordact/Tel LGFS PAYMENT DOCUMENT SPOKANE COUNTY AUDITOR SHIP TO: Confirming Order BDJL TO: MVG82430009 Change Order # Bid ID Blanket# RC# vI# FOB: ACCTG. PERIOD: :"3i9`' COMMENTS COMM LN# DESCRIPTION PO DATE: DELIVERY DATE: ENTERED BY: BLDG/ROOM: WAREHOUSE: SUPER • C •: ► 1 •: COMMODITY NO REF ACCT LINE QUANTITY UNIT UNIT PRICE TOTAL PRICE .95006341-3011 3 BOWDISN RC - DUPLICATE PERMIT TO #95006576-100% REFUND $40.00 X 100% = $40.00 SYSTEM VOID PAGE TOTAL: DISCOUNT TOTAL: FREIGHT TOTAL: GALES TAX TOTAL: PURCHASE ORDER VALUE: USE TAX TOTAL: 40.0© 0.00 0.00 0.00 40.00 0.00 LLINE NO. FUND I AGCY I ORG SB ORG I ACT OB] SB OBJ REV SRC SB REV 1 RPT CAT BS ACCT JOB NO. PAY THIS AMOUNT PIF RECEIVING CERTIFICATION Materials noted in quantity J have been received in good condition or contracted for. is SIGNED 1 I TITLE ACCT H 3 8/25/95 DATE PAYMENT CERTIFICATION I, the undersigned do hereby certify under penalty of perjury that sufficient funds have been budgeted for this claim, the materials have been furnished, services rendered or labor performed as described herein or contracted for, that the claim is a just, due and unpaid obligation against Spokane County or fund agency indicated above, that I am authorized to authenticate and certify to said claim. SIGNED DATE TITLE OFFICE ADMINISTRATOR /95 DEPARTMENT 2 TRAVEL CERTIFICATION 1 hereby certify under penalty of perjury that this is a true and correct claim for necessary expenses incurred by me and that no payment has been received by me on account thereof. SIGNED TITLE DATE PAGE anner FURNACE & FUEL, INC. N. 122 HELENA, SPOKANE, WASHINGTON 99202, TELEPHONE 535-1711 FAX (509) 535-8712 Aug 21, 1995 Spokane County Department of Buildings 1026 West Broadway Spokane, WA 99260-0050 Re: Cancellation of Permits Please cancel the following permits and credit our company, customers have cancelled jobs. Rick Neal 3011 South Bowdish Road Spokane, WA Permit #: 95006341 Sincerely Cherie Greenwood Clerk