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Commonwealth <br />of Massachusetts <br />Form CPF R1: Itemization of Reimbursements <br />Municipal Form <br />Office of Campaign and Political Finance <br />File with: <br />City or Town Clerk or Election Commission <br />Eileen Jay <br />1/3/2016 <br />Individual Being Reimbursed <br />Bill Hurley for School Committee <br />Committee Name <br />$157.42 <br />Amount of Reimbursement <br />4/28/2015 <br />Signed under the penalties of perjury: <br />� d,„ 'f"1 <br />CaniYdn atels /Treascarer urer's signature (in ink) <br />Date of Reimbursement <br />Date Vendor Name and Address <br />2/25/2015 Brookhaven Refreshments <br />Waltham Street <br />Lexington, MA 02420 <br />Amount Purpose <br />WW-1 ire <br />Date <br />$27.20 Food Service <br />1/28/2015 Hmart $23.00 Food For Coffee <br />Middlesex Turnpike Meeting <br />Burlington, MA 01805 <br />1/26/2015 Staples Inc <br />297 Great Road <br />Bedford, MA 01730 <br />1/26/2015 Staples Inc <br />297 Great Road <br />Bedford, MA 01730 <br />$5.49 Envelopes <br />$12.27 Copies <br />2/23/2015 United States Post Office $26.46 Postage <br />Massachusetts Ave <br />Lexington, MA 02420 <br />