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COMMONWEALTH OF PENNSYLVANIA**~ S~** **AEV,12~8S** ".;.::xt;:,·'"
. 4500445684 lOiD7

INVOIC£NO, 

### PUBUCATIONS:AUTHORIZATION AND INVOICE 

# 154593.

'TO.: (NAME'AND_ADDRESS OF NEWSPAPER)



### Philadelphia Daily News 

### P.O. Box 8263 Philadelphia, PA 19101 Attn'.: Maryann Logan Legal
HEREWITH 15 ENCL.'OSED COPY FCR pueUCAT1CN 'OF ADVEf'I;TISEMENT FO/'{ PR'Of'OSAL.S TC TYPE 'OF AD 

# o EMPL'OY 

# o PURCHASE 

# o CONTRACT 

# o SEL.L 

# o CLASSIF!ED 

## I!J LEGAL N'OTlCE pUI3USH AOVERTISEMENT (NO, '01" TIMES) MAXIMUM NC. 'OF LINES DATE 'ORDER NO. 

## I September 17, 2009 OATES 'OF INSERTICN 

### Sept. 18, 2009, Friday edition You, as vendor, are authorized to publish this advertisement in your newspaper, subject to the terms of this order, as**f0110w~:** Advertis8Ijlent to**be.j:wplis~e.d** i!1**heg~lar~qv~rtising** columns, n,?positi?n s!?ecified; caption of two lines and**~ignature** to be In capitals and subject matter and title 

### of officer. to be set'soltd i'tqype regularlY;U'sed**by~y'our** newsRaRedor '[>ublic (Illgal) notice advertising; charge to be made at the rate charged to and paid by commercial advertisers for matter similarly set and occupying similar space; advertisement to be run in the editions specified above. Vendor agrees that, in the performance of any contract awarded to it hereunder, said vendor will not discriminate against any employe or other persons on account of race, color, sex, religious creed, ancestry, age or national origin and that the Commonwealth, upon receipt of satisfactory evidence of such discrimination, shall have the rightto cancel said contract. Return this copy at once ifyou will not acceptthis advertisement underthe terms set forth. Proof ofadvertising inthe form of atearsheet must be included on Parts 

### 1,2& 

### 3. Return original and two copies (signed by the editor or publisher) to Agency listed above. Part 1 must be notarized. Part 4 is yours. . Commonwealth to be billed only for actual number of printed lines published.

LOG 'ORG

ACTUAL NO. 'OF PRINTEO UNES COST PER LINE TCTAL AMOUNT 

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. Before me, the subscriber, a Notary Public in

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## ..)."7""". \: that the advertisement, of which tearsheet is attached,hereto, was published in the regular advertising columns of said neyvspaper, in the editions of said newspaper, in all respects. as ordered and invoiced above; and that the C()mmonwealth**.i$nOt~barged-.,.** therefor at a rate higher than is charged any ordinary commercial advertiser for a similar amount of inatt!,r occupying**slmiiar'spice'~** and set in a similar manner, in said newspaper. . "
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# ~~~7A~. SIGNATURE 'OF AFFIANT My commission

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# .3 *This affidavit must be made by.the Owner, Publisher, or the designated agent of the owner or publisher. COMPTROLLER

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