Dept. Form No. 5. (Approved by the Comptroller of the Treasury May 28, 1914.) U. S. DEPARTMENT OF AGRICULTURE. (Bureau, Division, or Office.) PUBLIC VOUCHER FOR PURCHASES, AND SERVICES OTHER THAN PERSONAL. Bureau No. Appropriation: symbol: The United States, to W. L. Swayze, Dr. Address, Washington, D. C. (The submission of accounts on this form without consulting instructions on the back hereof may delay payment.) E. 5761 1004-4 1056 Aug. 8, Aug. 10 Baskets, wire, less 120 1 $0.625 67 50 I certify that the above bill is correct and just, and that payment therefor has not been received. (Do not sign in duplicate.) (Bill must be completely filled in by payee before certification, and there must not be any erasure or other alteration whatever.) (Payee sign here) IV. L. Swayze. Per. (Title). I certify that the above articles have been received by me in good condition and in the quality and quantity specified, or the services performed as stated; that they were necessary for the public service and in accordance with the orders therefor; that the prices charged are just, reasonable, and in accordance with the agreement, or that they were secured in accordance with No... of the method of advertising and under the form of agreement lettered as shown on the reverse hereof. (Any notations made in spaces provided therefor on the back of this voucher become a part of this certificate.) (Signature) C. B. Lower, Chief, Supply Div. (Title of certifying officer.) 191.., on the Treasurer of the United States, in favor of payee named above. Bureau No. Dept. Form No. 5. (Approved by the Comptroller of the Treasury May 28, 1914.) U. S. DEPARTMENT OF AGRICULTURE. (Bureau, Division, or Office.) PUBLIC VOUCHER FOR PURCHASES, AND SERVICES OTHER THAN PERSONAL. Appropriation: Symbol: The United States, to T. C. Savage & Co., Dr. Address, Elko, Nev. [The submission of accounts on this form without consulting instructions on the back hereof may delay payment.] I certify that the above bill is correct and just, and that payment therefor has not been received. (Do not sign in duplicate.) (Payee sign here) T. C. Savage & Co., (Bill must be completely filled in by payee before certification, and there must not be any erasure or other alteration whatever.) Per E. M. Lowe, (Title.) Cashier. I certify that the above articles have been received by me in good condition and in the quality and quantity specified, or the services performed as stated; that they were necessary for the public service and in accordance with the orders therefor; that the prices charged are just, reasonable, and in accordance with the agreement, or that they were secured in accordance with No.. and under the form of agreement lettered (Any notations made in spaces provided therefor on the back of this voucher become a part of this certificate.) of the method of advertising as shown on the reverse hereof. (Signature) James W. Connor, In charge Field Party. (Title of certifying officer.) Paid by Check No. dated 191.., on the Treasurer of the United States, in favor of payee named above. |