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FOR FINANCE USE ONLY PAYMENT REQUISITION <br /> ORANGE COUNTY FINANCE OFFICE <br /> VENDOR # l I VOUCHER # <br /> new <br /> PREPARED BY DATE July 31 , 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: Maxway <br /> North Hills hopping Center <br /> H i 1 1 chnrnitoh <br /> N.C. 27278 <br /> P.O.# Partial Full city state zip <br /> FOR FINANCE USE ONLY <br /> INVOICE DATE AMOUNT <br /> # <br /> invoice disc. pay gross disc. net <br /> Account No. Description Amount <br /> 10-410-33 See attached invoice $ 33.26 <br /> 10-590-37 Tax $ 1 .66 <br /> (Department Read) (Finance Director) <br />