Resolutions - Jersey City

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CHECK NO,
CHECK DATE
VOUCHER NO.
VENDOR INV.#
VENDOR INFORMATION
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HAMILTON SERVICES.
P.O. BOX 1153
DENVILLENJ 07834
LAFAYETTE POOL COMPLEX
PROJECT NO. 2006,(18 . .
COMPLETION CONTRACT
FENCE WORK, ESTIMATE 222
CITY OF JERSEY CITY
1 JOURNAL SQUARE PLA
JERSEY CITY NJ 07306
PURCHASE ORDER & VOUCHER
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DELIVER TO
REQUISITlN #0154671
BUYER EMERGRESO
ARCHITECTURE
575 ROUTE 440
JERSEY CITY NJ 07305 I
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TAX EXEMPTION NO. 22-6002013 PO Total 18,450.00
CLAIMANT'S CERTIFICATION AND DECLARATION OFFICER'S OR EMPLOYEE'S CERTIFICATION
I do solemnly decare and cert under the penalties of the law that the wihin bil is correct in all ns
particulars; that the artcles have been furnished or .services rendered as stated therein; that no
bonus has been given or recved.by any persons wihin the knowledge of this claimant in
connecton wih the above clim; that the amount therein stated is justly due and owing; and that
the amount charge is. a reone.
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VENDOR SIGN HERE
OFFICIA POsm DATE
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FOR PAYMENT, VENDOR MUST SIGN ATX
Having knowledge of the facts in the course of regular proceures, I certif that the
materials and supplies have been received or the services rendered; said certcation is
based on delivery slips acknowledged by à principal offcial or employee or other
reasonable procedures. ~/.A
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TILE OR POSITION DATE
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DATE
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ON THIS VOUCHER AND RETURN TO THE DELIVER TO ADDRESS
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