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LAPP,- 7-9B TUE 2:40 PM <br />TE OF COLORADO ) <br />) <br />COUNTY OF SEDGWICK ) <br />SEDGWICK COUNTY FAX N0. 9704740954 III IIIIIIIIIIIIIIII <br />• • sss <br />TO ~1Vlst6l~1 of I'IrNCRRL4 B 7EOLOr ~ <br />ADDRESS j3/3 Sf1fR~7fJA/ Sr^ ~oo.., ~~5 <br />DATE ~/3p/,C ~ /yys CITY89TATE ~JfNL~ER CD 8Ga,O4 <br />I V. NQ. AS PER ffEMIZED BILL ATTACHED TOTAL <br />~y/~5 GIRAf/' ~ m/7 //d FC;R UI. 8875 O <br /> RFlU r t - ~ Gq ~ Pr~d~J- <br /> .5V o -I1 I- -'N -4G,- u~ -t.~~ <br /> tvvTN Q rGK •T eaG <br /> <br /> <br /> <br />MERCHANDISE ORDERED. RECENED <br />NT B 0 <br />i <br />- <br /> <br />-- <br />Y: <br />AND APPROVED r-0R PAYME - ~) ~~~~ <br />~,~~ NET AMOUNT OF WARRAN 5 0 O <br /> <br />THIS VOUCHER MUST 6E FILED VVRH THE COU HE MONTH <br />STATE OF COLORADO ) <br />ss. <br />COUNTY OF SEDGWICK ) <br />Subscribed and sworn fo belore me this <br />day of , 19 <br />('County Clerk <br />( Deputy <br />( Notary Public <br />• StMke offices not your own <br /> <br />I, the undersigned, do solemnly swear that the above account is legal, <br />just and true, that the services or supplies therein charged for have been <br />aealally end neoeeeariy famished and rendered b and for said County <br />end that the same has not been paid, nor any paR thereof. <br />~pGWrC1C .NTY I~ngai a ~eIDG~ <br />BY <br />IMPORTANT: All vouchers must be signed by the firm or person In whose <br />favor they are drawn. <br />~~~= <br />~ ~ ~~oo <br /> <br /> <br />