Laserfiche WebLink
I EQUIPMENT PURCHASED OR RENTAL/LEASE <br />VENDOR CHECK/ <br />VENDOR INVOICED TRANSACTION TRANSACTION CIIECK PAYMENT TYPE PROOF OF PAYMENT AMOUNT <br />INVOICE fl INVOICE DESCRIPTION OF EQUIPMENT PURCHASED VENDOR NAME VOUCHER <br />DATE AMOUNT NUMBER DATE NUMBER AMOUNT USED PROVIDED CLAIMED <br />1 Total Equipment Charges S <br />MISCELLANEOUS/OTHER EXPENSES <br />AMOUNT <br />CLAIMED <br />es <br />PROOF OF PAYMENT <br />PROVIDED <br />Total Other Charges. <br />1 <br />r <br />ri 1 <br />im <br />r <br />CIIECK <br />AMOUNT. <br />CIIECK/ <br />VOUCl1ER <br />NUMBER <br />TRANSACTION <br />DATE <br />TRANSACTION <br />NUMBER <br />0 <br />U <br />0 O <br />m <br />i <br />z <br />C <br />O <br />0 <br />7_ <br />W <br />> <br />DESCRIPTION OF GOODS/SERVICES <br />PURCHASED <br />INVOICE <br />DATE <br />41 <br />U <br />O <br />7_ <br />Exhibit C Payment Request Summary Form -CZ219 <br />