HVI INVOICE TRACKER
               CONTRACT TITLE:                                                                                                                              INVOICE #:
               CONTRACTOR:                                                                                                                                LAGOV PO #:
               REPORTING PERIOD:
                    EXPENDITURE INCURRED BY                                       NAME                           BUSINESS ENTERPRISE                        LED 
                           (check appropriate box)                                                                  (check appropriate box)         CERTIFICATION                   $ AMOUNT
                                                                           (If Subcontractor)                                                           NUMBER
                  CONTRACTOR            SUBCONTRACTOR                                                              LAVET            HUDSON
                 TOTAL INVOICE                                                                                                                                                                        $0.00 
               *This form must be submitted with all invoices for contracts where RFP points were earned for the use of LaVet and/or SE-HI.*
               I certify that a good faith effort has been made to obtain LaVet and/or Hudson Initiative vendor participation for the reporting period reflected above:
                                               SIGNATURE                                                                     DATE
               AGENCY PERSONNEL:  Submit this form to the Office of State Procurement via e-mail - OSP.Reports@la.gov - with "HVI" in the subject line.
                                       HVI INVOICE TRACKER
       This information will be used to calculate your department's total expenditures towards the annual HVI program goal.