2016 COLORADO MUNICIPAL
ELECTION SUPPLY ORDER FORM
MINIMUM ORDER OF $25.00 REQUIRED
Please open shipment immediately
upon receipt; discrepancies must
be reported within 15 business
days.
Acct #__________________________ *Customer Purchase Order # ______________________________________ *Date _____________________________________
*Contact Name_______________________________________ *Pho #______________________________Ext___________*Fax #_____________________________
*Bill to Entity __________________________________________________ *Ship to Entity ________________________________________________________________
*Mailing Address ___________________________________________ *Ship To Physical Address _____________________________________________________
*City __________________________________ *Zip _____________________ *City __________________________________________ *Zip _____________________
*eMail Address __________________________________________________________ *Need By Date_________________________________
*Information
Qty
Required to insure proper processing of order
Unit
Item #
ea
ea
ea
ea
17A822
17A962
17A965
17A929AV
ea
17A969AV/MB
ea
17A1123MB
ea
17A972MBMUN
ea
ea
ea
ea
ea
ea
ea
ea
17A929A
17A933
17A973
17A993
17A994PB
17A995
17A1109
17A910
ea
ea
ea
pd/100
ea
ea
ea
ea
ea
ea
ea
pd/50
ea
ea
ea
ea
ea
ea
ea
ea
ea
ea
17A249
17A1105
17A1172
17A800
17A823
17A824
17A827
17A909
17A930PC
17A932CT
17A934
17A998
17A1103
17A1110
17A1111
17A1118
17A1124
17A1126
17A1128
17A1133
17A1135
17A1136
ea
roll
ea
ea
ea
ea
172434
179536
172003
172004
17A981
email for info
Description
ABSENT VOTER / MAIL BALLOT SUPPLIES
Spoiled Ballot Envelope
Record Book of Voters Applying for Absent Voter Ballot
Envelope to Deliver AV Ballots to Election Judge
Absent Voter Polling Place Sign
Suggested Qty
Price
As Needed
1/Election
1/Election
1/Election
1.65 ea
13.20 ea
3.30 ea
3.85 ea
Mail Ballot Carrier Envelope
Mail Ballot Return Envelope w/Self-Affirmation MUST Specify With or Without Pull Tab (PT) to cover voter signature
Secrecy Sleeve for Mail Ballot - *CUSTOM ONLY EMAIL FOR PRICING
Historical Data
Historical Data
.70 ea
.45 ea No/PT
.60 ea With PT
*
2/Precinct
1/Election (Min)
2/Precinct
As Needed
2/Election
2/Precinct
1/Precinct
As Needed
3.85 ea
1.10 ea
.85 ea
5.00 ea
1.10 ea
.85 ea
.95 ea
.85 ea
As Needed
As Needed
1/Elected Official
As Needed
1/Precinct
1/Precinct
1/Officer
As Needed
1/Election
2/Precinct
2/Election
1 Pad
1/Poll Worker
3/Election
2/Election
1/Precinct
2/Election
2/Election
1/Precinct
2/Election
1/Appointed Official
4/Election
.85 ea
8.55 ea
.85 ea
3.85 pd
3.30 ea
3.30 ea
.75 ea
.75 ea
1.75 ea
11.00 ea
.55 ea
16.50 pd
.55 ea
.55 ea
1.10 ea
.75 ea
.75 ea
.75 ea
.75 ea
.75 ea
.55 ea
.75 ea
As Needed
As Needed
As Needed
Min Order: 2
1/Precinct
.50 ea
19.35 rl
16.55 ea
27.50 ea
17.50 ea
CUSTOM ORDER
EMAIL
SIGNS
Polling Place Sign for Posting - Municipalities with Precincts
Notice of Election for Posting
100 Foot Prohibition of Electioneering Sign
Laminated Double-Sided Polling Place Directional Arrows
Voter Instruction Card for Posting Paper Ballot
No Smoking Sign
Abstract of Votes Cast for Posting
Notice of Voter Assistance
FORMS
Election Expense Bill (in duplicate)
Nomination Petition
Certificate of Election
Voter Signature Form (1 Pad = 100 forms)
Large Supply Judge Envelope (Supplies to Precinct)
Small Supply Judge Envelope (Return of Supplies to Clerk)
Oath of Office
Voter Assistance / Disabled Voter Self Affirmation (Rev 8/02)
Clerk's Receipt for Ballot Box, etc. (in Duplicate)
Poll and Tally Book
Adhesive Label for Ballots
Adhesive Election Seals (Crack-N-Peel)
Certificate of Appointment of Election Judge
Certificate of Appointment of Watcher
Certificate of Sealing Election Returns
Certificate of Registration List by Clerk
Certified List of Appointed Watchers
Affidavit of Appointment of Substitute Watcher
Receipt for Registration Records / Ballot Box/ Election Material
Certificate of Sealing Ballot Box
Certificate of Appointment
Statement / Certification of Determination
MISCELLANEOUS SUPPLIES
* RED * Wire Seals, Plastic, Numbered, To Seal Voting Machines
I Voted Stickers (1 roll of 1,000 stickers)
Tabletop Voting Booth - White Corrugated Cardboard
Standing Voting Booth - White Corrugated Cardboard
Provisional Ballot Stamp - Red Ink - Self-Inking Stamp
Aluminum Ballot Box w/Lock and Two Keys
Minimum $15.00 Shipping & Handling Per Order
Prices are subject to change without notice.
Order by E-Mail
ElectionSupplies@hartic.com
REV: 11/17/2015
Order by Fax
800.437.3532
Questions? Call us
800.223.HART (4278) Opt 3