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`u"L'PURCHASEORDER—INVOICE- OUCHER\ <br /> . <br /> DATE OFOBDEA AGER NO <br /> 09/24/86 AWP 1 96037 <br /> RYNT NAME AIO ADAIESS a SELLER(NpmNe.Street.CM.and State)• <br /> vSan Joaquin Local Health District <br /> E P• O, Box 2009 <br /> E C nf•ktt�n_ CA 95907 <br /> fIApILyt SIPPlES OR SERVICESTO!Name ndadereuJ i <br /> Sacramento AFS <br /> 9624 Kiefer Boulevard <br /> SUPPLIES OR SERVCES DUANOTY WT PRCE AMANT <br /> C0untY and state f <br /> stora <br /> Stockton RTR Sto <br /> and Stockton ATCT. <br /> 7� i��V Fi 7 inQ Ff.c - � t•__. <br /> atate q, <br /> 0 <br /> 1 <br /> AGENCY NAME AND ga1MG gDDRESS• <br /> Federal Aviation Administration TOTAL <br /> A P.O. Box 92007, Worldway Postal Center, AWP-26 ---_oAvs <br /> aLos Angeles, CA 90009 DATE MVDICE RECENED <br /> ORDERED BY(Sgnatum and tale) <br /> MICHELLE J. SOIKf�.IRS CAr APR <br /> PURPOSE AND ALCQUN1lW;DATq <br /> 601.0/211/48440/2591 <br /> County and State filing fees for underground <br /> tank Permits at SCK RTR, SCK ASR and SCK ATCT <br /> I PURCHASER — Toslgnbso bfo -tn <br /> p` lall of items <br /> t <br /> RECEIVED BY <br /> AUDREY B. <br /> TITLE <br /> SELLER — Please lead Enstfuc Ions on copy 2 <br /> ❑PAYMENT PAYMERT <br /> RECEIVED $------------------ ❑REQUESTED $ <br /> ---------- <br /> NO FURTHER INVOICE NEED BE SUBMITTED <br /> SELLER DATE <br /> eY_______________________ <br /> lSipnarurol <br /> INSTRUCTIONS TO SELLER <br /> After satisfactory identification of the Government representative Presenting this <br /> purchase order, verify the Itemization, including quantity, unit Price, amount, <br /> total and discount sectio.. <br /> This form Is an designed that Copy 1 may be used u a cash Payment receipt or <br /> as your invoice by completing. As aDProDriate. either the Payment Received or <br /> Payment Pe eset blocks and signing the Seller Raztion. <br /> If you would rather submit your own Invoice,DO NOT SIGN COPY 1. but attach <br /> it unsigned to your iavoiee to expedite verification and processing f-. payment. <br /> 2. SELLER'S COPY OF ORDER <br />