1994, 12-02 Permit: 94006207 RefundRZFJfND
2 - 4+
Dept 030 - CGDc--- NF:0RCr-
R
CASTLEWOOD HOMES
i'2702 E. VO2A 113
w
SPOKANE, WA 992?•
Vend" comb*Tel
am
LGFS PAYMENT DOCUMENT
SPOKANE COUNTY AUDITOR
Coafha I g Order
Change Otaw #
Bid ID
Bknkat#
RC.#
VI#
FOB: PO DATE: BLDG/ROOM: BUYER
ACCTC. PERIOD: ', DELIVERY DATE: WAREHOUSE:
JilEW DONALD L. LABRECQU
LN# DESCRIPTION
COMMODITY NO REF ACCT LINE OUANT17Y UNIT UNIT PRICE TOTAL, PRICE
;: } , •7
-*1 - N.
5011 SUNNYVALE �. PROJECT NOT REQUIRED - 100% REFUND
00000000
-*2 - N.
5010 SMOCK - PROJECT NOT REQUIRED - 100% REFUND
0.000000
0.000000
9400o2,:j6
-*3 - N.
N. 5019 SHAMROCK - PROJECT NOT REQUIRED - 100% REFUND
0.000000
- 3
a;
0e 0000'00
vi-2Vvh�
—N.
* 4 - N.
4810 SUNNYVALE - PROJECT NOT REQUIRED - 100% REFUND0.000000
PAGE TOTAL:
k ION PAYMENT CERTIFICATION
shave been 1, o bereby rtify under penalty of perjury that sufficient funds have been budgeted for this claim, the
contracted for. mate ' Is have services rendered or labor performed as described herein or contacted for, that the claim is
Just, and unpa tion against Spokane County or fund agency indicated above, that I am authorized to authenticate
■ rtify said m
SIGNED _ TIT1E
DATE
TRAVEL CERTIFICATION
I 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 tbereof.
10.00
10.00
40.00
40.00
10.00
10.00
120.00
SIGNED TITI E
DATE PAGE
P
PV# M V i'J
j
Dept 0
VENDOR
CASTLEwo0j;
12702 E.
5 P 0 K A N 9- 1
Vendor Coz%lwVT9j
FOB:
ACCTC. PERIOD:
LGFS PAMENT DOCUMENT
SPOKANE COUNTY AUDITOR
SES M. Blum.
Confinning Order
PO DATE:
DELIVERY DATE:
VPITIP01— — jj F w
BLDG/ROOM:
WAREHOUSE:
Change Order #
Bid ID
Bknkot#
RC#.
VI#
1RCHASINr,DTRF.rTOR- IJUNALU Le LABRE-CQUE
—*4
OOJOOOOO
40*00
—*5 — N.
5010 SUNNYVALE — PROJECT NOT REQUIRED
— 1001% REFUND
@
0*000000
40*00
3- 4
—*5
04000000
10400
?4:"'J_-
21
00000000
40*00
1,9"+. j C) J,
—*6 N.
5014 SUNNYVALE — PROJECT NOT REQUIRED
— 100% REFUND
@
0*000000
40,00
0*000000
10000
PAGE TOTAL:
180*00
GRAND TOTAL:
300900
01
ACCYS
401 j'.)
I QRQ SB
C-11001)
OR Q SBO M. SRC
B REV RPT CAT
I IQB 0
N PAY THIS AMOUNT
02
33
4JG ri G
0 0
1
- 41
42210
0 2
40*00
C 4
401 4
4,',', 6,
01
?41
100010
4
G 3
G, ? t
40*00
0S
iJJ
'Y
10 a 0"
40*05
07
3GO
10000
40*00
CE7RTIFItATION
PA ENT TION
n q
ived
:ived conditi
nd..
. c
. b..,
b n
e' for.
COntracte for.
d
'd
b c
0 certifyu
unde �do be certify under penalty of perjury that sufficient funds have been budgeted for this claim, the
ma Is have bee d,
TRAVEL CERTIFICATION
I hereby certify under penalty or that this
ma
just, and unpa
-4 a
ae_7� re
services rendered or labor performed as described heroin or contracted for, that the claim is
on, . ane "
ligation against Spokane County or fund agency indicated
perjury
is a true and correct claim for necessary expenses
?CERTIFI
nd oerti to said
above,
i
that I am authorized to authenticate
incurred by me and that no payment bas been received
LE
by me on account thereof.
SIGNED
Trnx
SIGNED TITLE
DATE
DATE
1FAGZ
•
Pvf� MV12201:s4JN
Dept OJ0 — 7: ,'NF0u;
vsmak
CASTLEWOOD HOM= S
12702 E. NIRA 41.
SPOKANE, WA 99214'.
Vendor Coand/Te1
LGFS PAYMENT DOCUMENT
SPOKANE COUNTY AUDITOR
SHIP TO:
Cordhadop Order
IOU TO:
chane Order #
Bid D
Blanket#
VI#
FOB: 1'/34
ACCTG. PERIOD:
CpMMENTS•
PO DATE:
DELIVERY DATE:
ENTFRF.f) RY•
JOEW
BLDG/ROOM:
WAREHOUSE:
:.' COMM LN1T
DESCRIPTION
BUYER
P[IRCHASfNC�IRECTCTR•DONALD L. LABRECQUE
COMMODITY NO 1 REF ACCT LINE
QUANTITY
UNIT
UNIT PRICE
TOTAL PRICE
LINE NO.
08
09
10
11
12
F / '.
401
406
401
406
AGCY
03J
43c
ORG
.000:3
0000
0001
0O0'r
SB ORG
ACT
OBI
SB OBI
REV SRC
SB REV
221C 02
4241
2211.: 02
42411n�
2210 02
RPT CAT
BS ACCT
TOB NO.
PAY THIS AMOUNT
P/P
10.00
40.03
10.00
40.00
10.00
GRAND TOTAL: 300.00
RECEIVING CERTIFICATION PAYMENT CERTIFICATION TRAVEL CERTIFICATION
Materials . tity have been 1, the undersigned do hereby certify under penalty of perjury that sufficient funds have been budgeted for this claim, the I hereby certify under penalty of perjury that this
received in J . contracted for. ma ria s en furnished, services rendered or Tabor performed as described herein or contracted for, that the claim is is a true and correct claim for necessary expenses
a • ue and obli • tion against gains[ Spokane County or fund agency indicated above, that ! am authorized to authenticate incurred by me and that no payment has been received
SIGNED ce , • to said t. by me on account thereof.
17TLE
DATE
SIGNED
DATE
TITLE
SIGNED TITLE
DATE PAGE
3
NUMBER
CONTRACTOR
SUBDIVISION
LOT & BLOCK
RV
CK
94S 726
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114 i ( ,per t t G. �C; t-^«
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94S 727
14 rl I el 6-c. l I G Te C r -c,
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4S 728
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94
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94s 730
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130 5;n-��o
y5152.CIZ2-I
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94S 731
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94S 732
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94S '7147
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94S 736
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94S 737
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y6-�68.405 ..
II'
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94S 738
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4636, . q O52.
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94S 73
f� SQ �t� •�hM't>•C�.1�„
94S 740
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94S 741''
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31 303 , 14),j
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