Fillable CLAIM STATEMENT 2017 Ua CC Claim Statement

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CLAIM STATEMENT 2017 Ua CC Claim Statement

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_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________
_____________________________________________
CLAIM STATEMENT
CERRITOS COMMUNITY COLLEGE DISTRICT
11110 Alondra Blvd.
Norwalk, CA 90650
Payee: ____________________________________Date: ________________________
Acct. No: _________________________________________________
District’s REQ/PO#: ________________________________________
For the following goods or services furnished to the District:
Description:
Amount $______________________
Manager
Payee
CS2017egfsvs
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CLAIM STATEMENT 2017 Ua CC Claim Statement

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Completed 29 February 2020

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