Laserfiche WebLink
U <br />QUANTITY <br />([.as. o0z' <br />GAL i,I L; I <br />DESCRIPTION (COLOR, SIZE, PART NO., ETC) <br />PRESS HARD WHEN HANDWR.1"I'M <br />AL <br />STRUCTIONS ON BACK OF LAST <br />CWY <br />STATE OF CALIFORNIA <br />SUE -PURCHASE ORDER <br />Calibration <br />Ir <br />J <br />!AD 4(,A (REV. 484) <br />NOTICE TO VENDFR <br />I. FURNISH DATA FOR ALL ITEMS <br />— ---------------- <br />MAR 2 21989 <br />OUTLINED IN HEAVY RULE IF NOT <br />AASF (large <br />purrip servicing 2 ea 20,000 gal underground <br />ALREADY COMPLETED BY AGENCY. <br />X <br />2- ALL SHIPMENTS 10 BE PREPAID F.O.B. <br />storage tanks for JF -4). NTE 2 hr3 @ $34-00 per hour <br />,jj,'_NLAT I C- N UNLESS OTHERWISE <br />SHIP <br />T. <br />S."ECIFIED. <br />3. SEE ADDITIONAL INSTRUCTIONS ON <br />AASF <br />BAC,", Of LAST COPY. <br />Calif National Guard <br />wi!l you will separately? (If (CHECK ONE) <br />yes, hiAintriplicate; If no, <br />2000 Stirnpson Road <br />cf.rlilitctionond return ❑ <br />�nstfucticins) YES NO <br />Stockton, CA <br />X <br />per <br />(200 982�0395 <br />REFER TO THIS ORDER BY <br />SUB -PURCHASE ORDER NUMBER <br />SUB -PURCHASE ORDER NUMBER <br />5103 ' 7 <br />DATE <br />19 Jan 88 <br />VENDOR'S INVOICE NO. (IF ANY) <br />CERTIFICATION: <br />I hereby ceriify that this is a true and just bill and payment <br />has not b­n;­ci,ed <br />_VCN66R7S IG'4ATURE <br />sp <br />TITLE (OWNER, MGP., CLERK, ETC,) <br />*- , ci T <br />r— I CHARGE TO: <br />i liestern Meter <br />1551 East Eight Mile Road t1ILITARY LEPiIRT.1,10,11T <br />Lodi, 'Q <br />CA 95242 '2A1'E OE C,,1LIi_,10RNIA <br />I <br />P.O. BOX 214�05 <br />9 <br />i /209) 911+8-6104. Q1, I 9�Q�yl <br />Inst; wpnaH? <br />25 Jay) 88 VFNDnR MOM THIS IS A, SELF INVOICING FORM—NO SEPARATE INVOICE NEEDED. <br />Rn,7nn <br />QUANTITY <br />([.as. o0z' <br />GAL i,I L; I <br />DESCRIPTION (COLOR, SIZE, PART NO., ETC) <br />UNHI <br />PRICEAMOUNT <br />X <br />RA <br />Calibration <br />check and service of one each fuel pump, at <br />— ---------------- <br />AASF (large <br />purrip servicing 2 ea 20,000 gal underground <br />storage tanks for JF -4). NTE 2 hr3 @ $34-00 per hour <br />$Y;.. o0 <br />$68;00 <br />4 <br />7 <br />Small <br />5 <br />$6,8: W <br />f- FZ AiYEAR Z&41 RAET&STATE PRICE I hereby ceritly, on personal knowledge that this order for <br />SCHEDULE NUMBER <br />purchasing the items specified above is issued in accordance <br />5U3 TOTAL <br />i�AI,AOF FUND <br />AND ALI.-orMENT (COMPLETION OPTIONAL) with the procedure prescribed by law governing the purcha,,c <br />t_ <br />Of SLICII items for the StaU, of California; that al su('1h <br />legal <br />r <br />NONE <br />requiremorils, have en fully cot plied with. <br />AUTH10571lZi6N G <br />$68:00 <br />SUB TOTAL <br />­!�LO A Cdi) <br />TIT L 'TC <br />H. T. HODGWN <br />SALES TAX <br />No e, <br />Area II Coordinator <br />,VU6iTF0­NAL UXPFNDITUFIE CODING <br />I hereby certify that the above goods and/or services were <br />00 <br />received by me and are necessary for the State of <br />California <br />TOTAL <br />$68. <br />and that quantity and up. !S- s in icated. <br />SIGNATURE OF RECEIVE� <br />&I <br />CASH <br />DAYS <br />AMOUNT <br />DATE A[' EIV ACHASED UNDER <br />;DISCOUNT <br />A, E, <br />S.A.M. 3571.1(2) <br />Rn,7nn <br />