| Name | Misty Dawn Vickers |
|---|---|
| Date | 03/05/2024 |
| Address – Must match your W-9 | 4480 Banbury Lane APT L Roanoke, VA 24018, VA 24018 United States Map It |
| Phone | 15402307706 |
| Email hidden; Javascript is required. | |
| Date(s) services were, or are to be, provided (can be a date range or period) | Art Pop event at Taubman 3/1/2024 |
| Amount of invoice ($) | 100 |
| Services provided (Project Title / Short Description) | Mandala Table |
| Services provided (details of agreement) | Flowers and materials set up for participants to make collaborative mandalas individually and collectively. |
| Invoice number (Required: This is the number the you assign for tracking.) It should correspond with your bookkeeping system.) | M202402 |
| Add PDF of Vendor’s Invoice Here (Optional. Use this if you have an invoice already generated from your system. Please use this field to upload a breakdown of costs if relevant.) | ARTS-CONNECT-CATALOG-Invoice-2.docx |
| By typing your name, you attest to the accuracy of information submitted and agree to provide the stated services or affirm that you have provided the services described. | Misty Dawn Vickers |
| STAFF USE ONLY – Processing Notes | DCJ: Okay to pay through Arts Connect Neighbors Grant, 35-310-8348-2010, |
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