| INVOICE PAYMENT REQUEST
For
a printable form, click below:
Invoice
Payment Request Form
TO: Cathy LaRue,
Section Administrator
(757) 363-1760 Telephone
Virginia Section AWWA
(757) 363-1720 FAX
P. O. Box 55420
Virginia Beach , VA 23471-9420
DATE:
_________________________
SUBJECT: Request for Payment of
Invoice
Attached is an invoice as described below. My dated signature
on the invoice signifies my approval for payment.
Name of Payee
______________________________________
Amount
$______________________________________
Payment Due Date ______________________________________
Committee Name
______________________________________
Activity Description ______________________________________
Budgeted Committee Expense Item? ___yes
___no
What budget code and category should invoice be charged to? (Refer
to budget)
Code
____________________
Category _____________________
If not budgeted, explain (check one):
___Special trustee action
___Other
(please explain)_______________________________________
___________________________________________________________________________
___________________________________________________________________________
Other comments:_____________________________________________________________
___________________________________________________________________________
Respectfully Submitted: _______________________________
__________________
Committee Chair Signature (Required)
Telephone No.
__________________________________________________
Other
Committee Member Signature (Optional)
|
