1996, 06-17 Permit 96000006 RefundREFUND
Pv#
Dept 030 — cony ENFORCE
moat
WELLS, CORY E BEVERLY
205 S PARK RD :.94
SPOKANE WA 99212
Vendor Con:ad/Tel
MV061460010
SHIP TO:
LGFS PAYMENT DOCUMENT
SPOKANE COUNTY AUDITOR
Cordtrndty Order
BILL TO:
PV MV061460010
Change On #
Bid ID
Blanket#
RC#
VI#
FOE:
ACCTC. PERIOD: U6/96
DESCRIPTION
COMMODITY NO
PO DATE: BLDC/ROOM:
DELIVERY DATE: MARCIA MCGARRIGLt HOUSE:
F.NTFREr) BY
REF ACCT LINE
80% 732.8 E 1ST 960006
PROJECT CANCELLED
QUANTITY'
UNIT
BUYER
PIIRCHASINCI DIRECTOR DONALD L. LABRECQUE
UNIT PRICE
PAGE TOTAL:
DISCOUNT TOTAL:
FREIGHT TOTAL:
SALES TAX TOTAL:
PURCHASE ORDER VALUE:
USE TAX TOTAL:
GRAND TOTAL•
TOTAL PRICE
48.80
4.50
53.30.
0.00
0.00.
0.00
53.30
0.00
• 77. 3D •
• " LINE NO,
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01 496 030 0008 id en „
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RECEIVING CERTIFICATION
Materials noted in quantity I have been
received in g
SIGNED
TITLE
DATE
for.
OA 4
6/17/96
PAYM
fe
.4tty
SIGNED 17a_
DATE
CERTIFICATION
reigned • o hereby cerii
n fished, services
':- tion against
6/17/96
rider penalty of perjury that suffident funds have been budgeted for this claim, the
Bred or labor performed a described herein or contorted for, that the claim is
okana County or fund agency Indicated above, that I am authorized to authenticate
TITLE
OFFICE ADMINISTRATOR
ACCOUNTS PAYABLE
3700
TOTAL TO VENDOR:
TRAVEL CERTIFICATION
1 hereby aNry under penalty of perjury that this
is a true and correa claim for necessary0;1011 s
incurred by me and Wet no payment has been received
by me on account thereof
SIGNED TITLE •
DATE
53.30