I P—8-7-40-5OM · COMMONWEALTH OF KENTUCKY I!
· I ·     Your Invoice No .........................................
· . IE, ¤IVISi<>¤ ¤r ‘I;· ~ ; T I,n ‘ Dat ..,_. Jil".   .... *5;..*, ,..
DEPARTMENT _TTT___.,.____, ?I}I_}}ri_駥§ _________.__,.,_________.. Institution .............TE 1 €.‘.+El?.2¥t€E¥Y ................ - ................ “°'°° ° *¥ "·· * *I
L t_ t Wh_ h Purchase Order,
¤¢¤ Wn ° IC I . ,., ,. Confirming Order or
Delivered ....................... . .........   E..,...............,...... . ,........ . .................... . .........».......................T. Contract N0_ ___________   _________
Copy from Purchase Order or Contract
Name and Address of Vendor ....... IILIZQlT}1£j1`l2j.§.iIIéAl.HBQQ[Yi.>.§$]I}.‘.iZf...Q€?.n .....................»o..............T....... Account No-   U
Copy from Purchase Order or Contract
bamhemz, Kv.
``‘‘‘‘’‘‘‘`'`'‘‘`’```‘‘`‘‘`‘'``'`’’‘`‘‘```‘‘`````‘‘`‘``````‘``‘‘`‘` ` ''`'`` ” ``‘`‘'‘`'`‘‘`````‘`````'``'`‘````'‘‘`‘````‘‘‘‘‘‘```‘``''’'````'`‘ ‘ ‘``‘```````‘````'`‘`‘'``'''' Terms ____.____,_,____,,.__._.,__,,_,__........_,...............
—---·-··——···-·--—————·-——-----·—··—·--·-»-——-··-···--»--------—·----··--TEEE-·----·--·—~—-··-·--·-··---·---·----·-·-—·--·-·-——··-—---—---~-·-~-—-·--·-·-··-·-··-·-···»--- VENDOR LEAVE BLANK
SEND THIS INVOICE IN DUPLICATE DIRECTLY To:   Voucher No >___   _____
DIVISION or ACCOUNTS AND CONTROL, C°°I° Am°¤"* C°°*° Am°¤“* Amount of
DEPARTMENT OF FINANCE, Encumbranc,3
STATE CAPITOLI ________ ,___E__; Liquidation $ ..........................................
EI=zANI;w;,;Im’;y
at CU.1;`G<%I‘l rxr}, Kmzxifsmzlzgy, l1,,§=O1"t‘.':l.Zl.Cl'l the ‘
1:IuIt;.v i;<>,_;e:1;h¤».1· x iL‘I;h the s’sO1·;z€;e Of
Eitoxe, @.:.5:1*41 Rui; }’C){i“CS   iz;c;·iI—ém;zIl
x2;Ii:;:1J·iel, in :I<:<:·17.‘:ln1Ic:ea ·T.j,‘ch zI,;x··.e1.eIz;I*b
, for tim _iIL.lI§.I)d A;>:?:i.P. ZL, 1941, to I`Iis:;~<:h
I .5]., lil-TEM, $12.00
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TOTAL AMOUNT .
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VENDOR LEAVE BLANK
VENDOR’s CERTIFICATION
Discount ......................... . ..............................................................
I hereby certify that the commodities specified above have been
furnished to the Commonwealth of Kentucky; that the quality and prices Net Amount ________________________________________________________________________________
IT · t -
conforrn to t e proposal and purchase order or contract, and hat pay Checked with Purchase
me,nt, lh whole or In part, has not been received. Order, or Contract   '__·___   _________________
Checked with
Signed .......... lzIt.¤I.;I;EIf@.L.e2;.,IIL..éiezyezsig;;2._.QosaI~;I2eE;.Iy .......... “°°°"""¤ "‘°*’°'* N° ·---·---·-·~---·-··--·····--------···-···---·---···-·---····-··-·
By _.   Extensions and Additions Checked ......................... E .............
..o1·l;:s tLll(lj.T,O1‘.
VENDOR’S COPY SEE INSTRUCTIONS ON REVERSE SIDE