SAMPLE BALLOT CLAIM FOR REIMBURSEMENT - GENERAL - SIGNED12112020.PDF

County Claim for Reimbursement
Sample Ballots
2020 General
Maricopa Count
County:
12/11/2020 $248,485.76
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 General Sample Ballot Reimbursement, I certify that:
• This is a valid claim for reimbursement of charges incurred for the actual cost of printing, labeling
and postage of the 2020 General Sample Ballot in compliance with A.R.S. § 16-461.
• My office has provided documentation to the Secretary of State’s office, in the form of invoices and
receipts, to confirm this claim.
• My office will retain financial records including, but not limited to: receipts, purchase orders,
invoices, and detailed financial reports that confirm this claim in case of an audit or other inquiry
into the validity of this claim.
Digitally DN: cn=Reynaldo signed by Valenzuela Reynaldo Valenzuela Jr., o=Maricopa Jr. County, ou=Elections
Department, Date: 2020.12.11 email=rvalenzuela@risc.maricopa.gov, 16:17:14 -07'00' c=US
County Board of Supervisor or Designee Signature Date