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FOR FINANCE USE ONLY PAYMENT REQUISITION <br /> VENDOR # VOUCHER # ORANGE COUNTY FINANCE OFFICE <br /> new <br /> PREPARED BY DATE July 21 , 1987 <br /> This is to request that a check be drawn for the following valid and necessary expenditures of <br /> this department. <br /> Pay to the order of: North Central Piedmont <br /> 306D Revere Road <br /> Hillsborough, NC <br /> P.O. # Partial Full city state zip <br /> FOR FINANCE USE ONLY <br /> INVOICE DATE AMOUNT <br /> # invoice disc. pay gross disc, net <br /> L <br /> Account No. Description Amount <br /> 10-410-27 Annual Contribution 350.00 <br /> A- <br /> 10-590-37 Tax <br /> fse 2 „47. ..ArAdir <br /> yep; en ea. <br /> (Finance Director) <br />