COUNTY CLAIM FORM-SAMPLE BALLOT REIMB-SIGNED 09012020.PDF
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Claim for Reimbursement County Sample Ballots == KATIE “a 2020 Primary Maricopa Cauity: 6/31/2020 $776,858.75 Date: Amount Requested: Rey Valenzuela/Scott Jarrett Elections Director Name: Richard Greene County Contact Name (For Questions About Reimbursement): 602-506-2471 rgreene@risc.maricopa.gov County Contact Phone No. & Email: Maricopa County Recorder's Office Payment Address: 111 S. 3rd Ave., Ste. 102 Phoenix, AZ 85003 By signing this County Claim for 2020 Primary Sample Ballot Reimbursement, I certify that: e This isa valid claim for reimbursement of charges incurred for the actual cost of printing, labeling and postage of the 2020 primary sample ballot in compliance with A.R.S. § 16-461. e My office has provided documentation to the Secretary of State’s office, in the form of invoices and receipts, to backup this claim. e My office will retain financial records including, but not limited to: receipts, purchase orders, invoices, and detailed financial reports that backup this claim in case of an audit or other inquiry into the 9/1 |ow County Board of Designee Signature Date ia ey