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Voucher <br />Kittitas County, Washington <br />Claimant: C3790 - HOYT, RICHARD <br />PO BOX 814 <br />SOUTH CLE ELUM, WA 98943 <br />FDate I Invoice # Description <br />6/14/2017 2017-2555 SPECIAL EVENT <br />APPLICATION REFUND <br />Warrant #: <br />Run Date: 6/19/2017 <br />Voucher Total: $200.00 <br />Budget Code Amount Invoice <br />Total <br />001-1632171 $200.00 $200.00 <br />Comments: <br />THIS IS REIMBURSEMENT FOR THE FALL SPORTING CLASSIC SPECIAL EVENT APPLICATION <br />I, the undersigned, do hereby certify under penalty of perjury, that the materials have been fumished, the services <br />rendered, or the labor performed as described herein, and that the claim is a just due and unpaid obligation <br />against Kittitas County and that I am authorized to authenticate and certify to said claim. <br />Prepared by: Mandy Buchholz, DEPUTY CLERK II. 06/14/2017 9:42 AM <br />Copy: 2 <br />