ABCDEFG
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WESTWOOD REGIONAL BOARD OF EDUCATION
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701 RIDGEWOOD ROAD
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TOWNSHIP OF WASHINGTON, N. J. 07676
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TEL 201-664-0880
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FAX 201-664-7642
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PAY TO:
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VENDOR #TERMS
PURCHASE ORDER #
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THE DECLARATION AT THE BOTTOM MUST BE COMPLETED
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QUANTITYUNITDESCRIPTION OF GOODS/SERVICES RENDEREDUNIT PRICETOTAL
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CLAIMANTS CERTIFICATION AND DECLARATION
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I do solemnly declare and certify under penalties of the law that the within bill is correct in all its particulars; that the articles have been
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furnished and services rendered as stated therein; that no bonus has been given or received by any persons with the knowledge of this claimant
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in connection with the above claim; the amount therein stated is justly due and owing; and that the amount charged is a reasonable one.
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By:
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ORGANIZATION
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Official PositionDate
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Director/PrincipalDate
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APPROPRIATION ACCOUNT CHARGED
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Superintendent ApprovalDate
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Payment Authorized
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The above claim was ordered paid at the meeting of the Board of Education held on
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Business AdministratorDate
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