[Adopted 3-14-1949 (Ch. 5, Art. II of the 1971 Code)]
In accordance with the City Charter and § 103 of the Town Law of the State of New York, vouchers may be audited, allowed and paid if they shall have been certified to be true and correct in a statement signed by or on behalf of the claimant upon the following form. (Law requires verification or certification of all claims. No claim can be paid unless the following is filled in completely.)
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(AFFIX SECURELY TO CLAIM)
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State of New York
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______________________________ County
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certifies that the articles, materials or services
charged in the annexed bill or account were actually sold, delivered
or furnished to the City of Middletown, on the order of _____________________________________
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at the dates and for the prices therein named,
which were fair, just and reasonable prices for the same; that the
labor and services therein charged were actually rendered and performed
on the like order, and the prices charged therein are fair and reasonable
prices for such services; that said bill is just and true; that there
is due thereon $_____________ and no part of the same has been paid;
and there is no setoff or counterclaim against the same.
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