Permit 2
1
�: 3t1? a 002,3 ; � j , ,z2x=v 5
1 r �y r 5 5 j ���\. CITY OF TIGARD e
U �/ (��.Q F PE14D IURE REQUEST S :���
..This form is a multi -use form. Appropriate receipts must be attached. Documentation
! lraportant for all purposes. Staple documentation to form.
VENDOR NO.: /1 /DD! ' DAZE: .! �.v‘ . g t996
■
p yAB TO: Ke- roCae. \■%Acs 1 Mtn c- . REQUESTED BY:
P.0. ( e ?
W \5 \xe �0�. 91010 D (o"] * Approved request e Wednesday
10:00 AM to A/P for checks by
'e. r- t 5 I Z: 0 ;4.91... - 0001 : Friday.
Date Description, Invoice No., etc. Account No. Amount
C_ t v - t TO Rt.F u hrb .� 5
j °0 SFUNb .. , oV a �o. - \c' og \--\\.e_ I D - Z2(�o0 $ 3
assura Posed 1 . Q • 4 3 4 Z -
S e\ OV•e.,At,■ q a rvmt\- -9Z
(EWA 92- 0o11 • t- c * 92_ -
Z -Z4331 c.A-cck 3 - lo- 92. .
l
t C.IT• KEEP Frenn Acs - *tic -ZZc
To Fv1A411v 2 o0000445mr03" z5
g ActDurvV 1ctaNSC -sR ,., o� . o �
((^` ``\\ '2Volrsa■d
O} 'CV.e V.SSV1raV\Ce. ` k - b pZ e
[ ■LIC.9■\ red ree ■V\ - kleA 3
og \kv■at.ercyou.v.c\,:NA. (oze_e: '.
N
It7rAL $ 99 9-1 00
Mileage $0.255.
APPROPRIATl BALANCE: AS OF: SIGNATURE:
(Up to $25.00) Section Manager Purch. Agent
($25.01- 2,500.00) Division Manager
($2,500.01-7,500.00) Dept. Head (J1 l� n
. �c.c- +..- -y
($7,500.01 - 15,000.00) City Administer
($15,000.01- ?) Local Contract Review Board
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