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Payment Request
PAYEE SRISAN, BOBBY
EXPENSE CATEGORY CLAIMS-GENERAL LIABILITY
DEPARTMENT LAW
FUND LIABILITY RESERVE FUND
PROGRAM MISCELLANEOUS
ACTIVITY MISCELLANEOUS
PAYMENT REQUEST GAX 5700 22091610647

Total:$375.00

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PURCHASE ORDER CONTRACT DESCRIPTION REF. LINE CHECK DATE CHECK STATUS  AMOUNT
n/a Claims-general liability 101 09/29/2022 Paid $375.00
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