Implementation: This program will allow localities to request reimbursement of funds used to purchase electronic pollbooks for the locality’s polling places. ONLY laptops Which laptops are eligible for reimbursement under this replacement program? purchased under the GFE program will be eligible. Models are: Dell 600, 610, 620, and 630. The request can be made by the General Registrar or Electoral Board Who can make the request? member. How do I request grant funding for the laptop (EPB) purchase? Fill out the Request for Reimbursement of Electronic Pollbooks form Department of Elections-626 EPB. Please provide all necessary information. the name of the locality applying for reimbursement. Locality Name: the date you submitted your request. Date of request: Description of Equipment Purchased: Include the make, model, vendor, specs, etc. Indicate the cost of each piece of equipment, including accessories. Per Item Cost: Number of pieces of equipment. Quantity: Cost of each item times the quantity ordered. Item Total: The sum to the items listed in the Item Total column. Total Purchase Cost: Indicate the total amount you are requesting for Total amount of reimbursement requested: reimbursement based on the reimbursement limits of this program. You must certify that the laptops purchased will be used as EPB Certification of Purchase: and that the laptops purchased meet the minimum performance requirements specified by Department of Elections. You must further agree to maintain the records, receipts and other documents as directed by the Department of Elections for a period of 5 years and make them available to the Department of Elections or State or Federal auditors when requested. Indicate your position title, your name and sign where Authorized Locality Representative: indicated. Indicate the number of precincts in your locality. Number of precincts: What else do I need to submit with the Request for Reimbursement of Electronic Pollbooks In order to receive reimbursement you must also submit a copy of the for the Form? invoice equipment purchased by your locality What is the Department of Elections Only portion? Please do not write in this area as it is reserved for Department of Elections staff. Who at Department of Elections should receive the form? You will send your completed form to Eugene Burton, Voting Equipment Coordinator. You may fax the form to 804.786.2045 or attach the request and send to Eugene’s email address .
Implementation: This program will allow localities to request reimbursement of funds used to purchase electronic pollbooks for the locality’s polling places. Which laptops are eligible for reimbursement under this replacement program? ONLY laptops purchased under the GFE program will be eligible. Models are: Dell 600, 610, 620, and 630. Who can make the request? The request can be made by the General Registrar or Electoral Board member. How do I request grant funding for the laptop (EPB) purchase? Fill out the Request for Reimbursement of Electronic Pollbooks form Department of Elections-626 EPB. Please provide all necessary information. Locality Name: the name of the locality applying for reimbursement. Date of request: the date you submitted your request. Description of Equipment Purchased: Include the make, model, vendor, specs, etc. Per Item Cost: Indicate the cost of each piece of equipment, including accessories. Quantity: Number of pieces of equipment. Item Total: Cost of each item times the quantity ordered. Total Purchase Cost: The sum to the items listed in the Item Total column. Total amount of reimbursement requested: Indicate the total amount you are requesting for reimbursement based on the reimbursement limits of this program. Certification of Purchase: You must certify that the laptops purchased will be used as EPB and that the laptops purchased meet the minimum performance requirements specified by Department of Elections. You must further agree to maintain the records, receipts and other documents as directed by the Department of Elections for a period of 5 years and make them available to the Department of Elections or State or Federal auditors when requested. Authorized Locality Representative: Indicate your position title, your name and sign where indicated. Number of precincts: Indicate the number of precincts in your locality. What else do I need to submit with the Request for Reimbursement of Electronic Pollbooks Form? In order to receive reimbursement you must also submit a copy of the invoice for the equipment purchased by your locality What is the Department of Elections Only portion? Please do not write in this area as it is reserved for Department of Elections staff. Who at Department of Elections should receive the form? You will send your completed form to Eugene Burton, Voting Equipment Coordinator. You may fax the form to 804.786.2045 or attach the request and send to Eugene’s email address .
FAQs%20EPB%20Reimbursement.docx