Vendor Claim Forms
VENDOR CLAIM FORMS
Claim vouchers/invoices should be mailed to the Nassau County department that has received the goods or services. A step-by-step guide to completing each claim voucher is found on the back of each document.
Fillable PDF Claim Forms
Printable PDF Claim Forms
THE CLAIMANT’S CERTIFICATION
If you do not have a contract with Nassau County that requires the use of a claim voucher, and wish to use your own invoice/voucher, the following ‘Claimant’s Certification’ disclosure statement must be included in your invoice or claim for payment.
Insert or attach the certification statement below to your invoice. [Claimant's Certification is available here as a PDF.]
I hereby certify that this claim voucher is just, true, and correct; that the amount claimed is actually due and owing and has not been previously claimed; that no taxes from which the County is exempt are included; and that any amounts claimed for disbursements have actually and necessarily been made. I further certify that all items and/or services were delivered or rendered as set forth in this claim, and for all items and/or services delivered or rendered in accordance with a purchase order or contract that the prices charged are in accordance with the reference purchase order or contract. For all claims made as reimbursement for employee expenses, I further certify that the amounts set forth were actually and necessarily expended for the benefit of Nassau County, and that the monies expended have not been reimbursed nor do I expect to be reimbursed from any other source.
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