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"ATTACH BILLS TO THE BACK" <br />FINANCIAL VOUCHER <br />WASHINGTON COUNTY, COLORADO <br />DATE: 1v2 ' 19 20 <br />TO: Jqg�f,Aq Q46 <br />ADDRESS: <br />D <br />Amount Warrant No. <br />PAID DUN 0 2096 <br />Date Paid <br />131 <br />Vendor No. <br />Have all bills itemized, OK'd and acknowledged before filing with Financial Department. <br />Attach invoice if applicable. <br />The undersigned, under penalty of perjury, states that the above account is true and just: that the <br />articles or services rendered have been furnished or performed and that the charges made therefor are <br />true and correct after allowing all credits. <br />Approved f ayme <br />Department Head �_-- Claimant <br />Chairman Board of County Commissioners Date <br />Conxnissloner <br />Commissioner <br />