172x Filetype XLSX File size 0.02 MB Source: www.doa.la.gov
HVI INVOICE TRACKER CONTRACT TITLE: INVOICE #: CONTRACTOR: LAGOV PO #: REPORTING PERIOD: EXPENDITURE INCURRED BY NAME BUSINESS ENTERPRISE LED (check appropriate box) (check appropriate box) CERTIFICATION $ AMOUNT (If Subcontractor) NUMBER CONTRACTOR SUBCONTRACTOR LAVET HUDSON TOTAL INVOICE $0.00 *This form must be submitted with all invoices for contracts where RFP points were earned for the use of LaVet and/or SE-HI.* I certify that a good faith effort has been made to obtain LaVet and/or Hudson Initiative vendor participation for the reporting period reflected above: SIGNATURE DATE AGENCY PERSONNEL: Submit this form to the Office of State Procurement via e-mail - OSP.Reports@la.gov - with "HVI" in the subject line. HVI INVOICE TRACKER This information will be used to calculate your department's total expenditures towards the annual HVI program goal.
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