Fire Damage
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Prepare separate requisitions for
each fund and for each vendor.
PURCHASE HEOUISITION
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CITY OF SALINA, KANSAS
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DO NOT WRITE IN TillS !lOX
Vendor No.
--------------.----
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Dept. ._.. ..
Account Numhers
DCpL No.__
Amount
Please Issue Purchase Order To
$
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Total $ ..__________.___..u
TillS TOTAL IS TO EQUAL TOT.\!'
BELOW
QUANTITY
DESCRIPTION
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TOTAL
Above Articles to be Used For:
SHIP TO
DEPT.
Address
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SALINA, KANSAS 67401
Ap]lJ'()\'cc! By_________.
White Original To CIty Clerk s Ofrin-
=:; ADAMS BUSINESS FORMS