121-18 Attachment.pdf

TOWNSHIP OF WEST ORANGE PURCHASE ORDER TOWNSHIP HALL 66 MAIN STREET WEST ORANGE, N.J. 07052 VOUCHER MUST BE RETURNED FOR PAYMENT 4 Ship to: TOWNSHIP OF WEST ORANGE ENGINEERING DEPARTMENT 25 LAKESIDE AVE Vendor: T & M ASSOCIATES WEST ORANGE, NJ 07052 11 TINDELL ROAD FOB DESTINATION FREIGHT PREPAID & CHARGED BACK MIDDLETOWN, NJ 07748 Account Various - see below - Vendor Code 1001403 Date of Order 01/11/18 Quantity Uni p ater : itPri Extended. 1.0000 RES 26-18 SITE REMEDIATION FH 4 66,500.000 66,500.00 52220.00 03-2450-15-0050-030 UST SITE REMEDIATION - UST SITE REMEDIATION 14280.00 03-2507-17-0600-010 UNDERGROUND FACILITI - UST REMOVAL/REMEDIAT Purchase Order Total: 66,500.00 THIS ORDER IS TAX EXEMPT PER NJSA 54:32B-9(a)(1) TAX EXEMPT ID NO. 22-6002396 JRO SOLEMNLY DECLARE AND OCRTIFY WNOER THE PENALTIES OF THE { 4} LAO TURT THE WITHIN ILL IS CORRECT NALL ITS PARTICULARS, THAI PROCEDURES, | CARTIPY THAT THE HATERIA'S AND SUPPLIES TAB ARTCLE ISHED ONS Dene! | TIRED Ivisesn THAT NO SOMUS HASBEEN ClVaN Gr HecENED™ HAVE BEEN RECIEVED OR THE SERVICES RENDERED; SAID By ANY PERSON OR PERSONS WITHTHE KNOWLEDGE OF THS CLAWANT | CERTIFICATION IS BASED ON DELIVERY SLIPS ACKNOWLEDGED STATED IS ARTLY DUE AN OWN OWING: ANG THA Te AMOUNT THERIN. BY A MUNICIPAL OFFICIAL OR EMPLOYEE OR OTHER REASONABLE, DEPARTMENT IB AREASONAGLE PROCEDURES. us) 4 ORDERED BY — i VENDOR SIGN HERE a va OFFICIAL POSITION DATE SIGN AND RETURN ONLY THIS ORIGINAL FOR PAYMENT.