DISTRIBUTION (CHECK BOX(S)): SUPPLIER NO.

SUPPLIER NAME
ADDRESS
CITY STATE ZIP
06/16/14
AGENCY / DEPARTMENT DATE REQUESTOR PHONE NO.
(REQUIRED)
1
2
3
4
5
6
7
8
INVOICE TOTAL 0.00 0.00 0.00
DETAILED DESCRIPTION
FMA 02/08 ORIGINAL INVOICE(S) MUST BE ATTACHED
Amount PO # Release Line
CA BOE
Sales Tax
Invoice Amount
L
i
n
e

#
Invoice Number
Invoice Date
MM/DD/YY
TOTAL INVOICE
AMOUNT
AMOUNT TOTAL
Description (45 Characters Maximum Includes
Customer Or Account Number)
I HEREBY CERTIFY THE ARTICLES OR SERVICES DESCRIBED BY THE INVOICE(S) ATTACHED AND LISTED BELOW WERE NECESSARY FOR USE BY THIS AGENCY / DEPARTMENT AND HAVE BEEN DELIVERED OR PERFORMED AND THAT NO PRIOR CLAIM HAS BEEN
PRESENTED FOR SAID ARTICLES OR SERVICE
IF DISPUTED INVOICE, ENTER X IN THE BOX TO
THE RIGHT.
HOLD FOR PICKUP
ATTACHMENT
INPUT / AUDITED BY:
Date Invoice
Received
MM/DD/YY
Customer Or Account
Number
If SUPPLIER IS SUBJECT TO PROMPT
PAYMENT, ENTER X IN THE BOX TO THE RIGHT.
ENCUMBRANCE LIQUIDATION
PAYMENT REQUEST PREPARED BY:
(REQUIRED)
MAIL
BATCH NO.
City of Oakland
AUTHORIZATION SIGNATURE AND DATE (REQUIRED)
BATCH DATE
0.00
DISTRIBUTION (CHECK BOX(S)): SUPPLIER NO.
SUPPLIER NAME
ADDRESS
X CITY STATE ZIP
06/16/14 (510) 238-6976
AGENCY / DEPARTMENT DATE REQUESTOR PHONE NO.
(REQUIRED)
1
05/05/09 INV6779-02052 04/23/09 13,425.00
OAKLANDP
D
200911028 1 13,425.00
2
3
4
5
6
7
8
INVOICE TOTAL 13,425.00 13,425.00 0.00
DETAILED DESCRIPTION
FMA 02/08 ORIGINAL INVOICE(S) MUST BE ATTACHED
City of Oakland
AUTHORIZATION SIGNATURE AND DATE (REQUIRED)
BATCH DATE
13,425.00
HARRIS CORPORATION
PO BOX 9800, M/S R5-11A
If SUPPLIER IS SUBJECT TO PROMPT
PAYMENT, ENTER X IN THE BOX TO THE RIGHT.
ENCUMBRANCE LIQUIDATION
PAYMENT REQUEST PREPARED BY:
(REQUIRED)
DOROTHY G. REYNOSO
MELBOURNE, FL 32902-9800 MAIL
49343
I HEREBY CERTIFY THE ARTICLES OR SERVICES DESCRIBED BY THE INVOICE(S) ATTACHED AND LISTED BELOW WERE NECESSARY FOR USE BY THIS AGENCY / DEPARTMENT AND HAVE BEEN DELIVERED OR PERFORMED AND THAT NO PRIOR CLAIM HAS BEEN
PRESENTED FOR SAID ARTICLES OR SERVICE
BATCH NO.
INPUT / AUDITED BY:
Invoice Amount
L
i
n
e

#
Invoice Number
Invoice Date
MM/DD/YY
TOTAL INVOICE
AMOUNT
Line
Date Invoice
Received
MM/DD/YY
Customer Or Account
Number
Release
IF DISPUTED INVOICE, ENTER X IN THE BOX TO
THE RIGHT.
HOLD FOR PICKUP
ATTACHMENT
OPD - FISCAL SERVICES
AMOUNT TOTAL
Description (45 Characters Maximum Includes
Customer Or Account Number)
Maintenance Services for
StingRay04
PO #
CA BOE
Sales Tax
Amount
DISTRIBUTION (CHECK BOX(S)): SUPPLIER NO.
SUPPLIER NAME
ADDRESS
CITY STATE ZIP
06/16/14
AGENCY / DEPARTMENT DATE REQUESTOR PHONE NO.
(REQUIRED)
1
2
3
a 1 01/01/00 A A 12345678901 9 1 9.00
4
a 1 01/01/00 A A 1 9 1 9,999.00
5
a 1 01/01/00 A A 1 9 1 999,999.00
6
a 1 01/01/00 A A 1 9 1 9,999.00
7
a 1 01/01/00 A A 1 9 1 99.00
8
a a 01/01/00 A A 1 9 1 99.00
INVOICE TOTAL 0.00 1,020,204.00 0.00
DETAILED DESCRIPTION
FMA 02/08 ORIGINAL INVOICE(S) MUST BE ATTACHED
City of Oakland
AUTHORIZATION SIGNATURE AND DATE (REQUIRED)
BATCH DATE
0.00
If SUPPLIER IS SUBJECT TO PROMPT
PAYMENT, ENTER X IN THE BOX TO THE RIGHT.
ENCUMBRANCE LIQUIDATION
PAYMENT REQUEST PREPARED BY:
(REQUIRED)
MAIL
I HEREBY CERTIFY THE ARTICLES OR SERVICES DESCRIBED BY THE INVOICE(S) ATTACHED AND LISTED BELOW WERE NECESSARY FOR USE BY THIS AGENCY / DEPARTMENT AND HAVE BEEN DELIVERED OR PERFORMED AND THAT NO PRIOR CLAIM HAS BEEN
PRESENTED FOR SAID ARTICLES OR SERVICE
BATCH NO.
INPUT / AUDITED BY:
Invoice Amount
L
i
n
e

#
Invoice Number
Invoice Date
MM/DD/YY
TOTAL INVOICE
AMOUNT
Line
Date Invoice
Received
MM/DD/YY
Customer Or Account
Number
Release
IF DISPUTED INVOICE, ENTER X IN THE BOX TO
THE RIGHT.
HOLD FOR PICKUP
ATTACHMENT
AMOUNT TOTAL
ABCDEFGJOL;;,,SMNOPQ
RSTUVWASXXXXXXXXXX
XXXXXXXXXXXXXXXXXX
Description (45 Characters Maximum Includes
Customer Or Account Number)
ABCDEFGJOL;;,,SMNOPQ
RSTUVWASXXXXXXXXXX
XXXXXXXXXXXXXXXXXX
PO #
ABCDEFGJOL;;,,SMNOPQ
RSTUVWASXXXXXXXXXX
XXXXXXXXXXXXXXXXXX
CA BOE
Sales Tax
ABCDEFGJOL;;,,SMNOPQ
RSTUVWASXXXXXXXXXX
XXXXXXXXXXXXXXXXXX
ABCDEFGJOL;;,,SMNOPQ
RSTUVWASXXXXXXXXXX
XXXXXXXXXXXXXXXXXX
ABCDEFGJOL;;,,SMNOPQ
RSTUVWASXXXXXXXXXX
XXXXXXXXXXXXXXXXXX
Amount