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<br />," ;::..) C/' e}' <br />J.-.,j <br /> <br />CITY OF LA PORTE <br />TRAVEL EXPENSE FORM <br />(PRINT THIS FORM ON PINK PAPER) <br /> <br />DEPARTMENT: <br /> <br />Council <br /> <br />DEPARTURE DATE: <br />TIME: <br />RETURN DATE: <br />TIME: <br /> <br />10.27.2010 <br />am <br />10.29.2010 <br />pm <br /> <br />EMPLOYEE NAME: <br /> <br />Jay Martin <br /> <br />DIVISION: 6069 <br />PurposelDestination of Travel: <br /> <br />Texas Municipal League 98th Annual Conference <br />Corpus Christi, Texas <br /> <br />A. <br /> <br />TRANSPORTATION <br />1 Air Travel <br />2 Gasoline <br />3 Taxi <br />4 Car Rental <br /> <br />Check if item was prepaid/P-Card, list amount and deduct at the bottom of the page. <br />D <br /> <br />(For City Auto Only) D <br />D <br />D <br /> <br />Totals <br /> <br />Miles <br /> <br />187.78 <br />Total <br /> <br />I <br /> <br />5 <br /> <br />Mileage (For Private Auto Only) <br /> <br />375.56 <br /> <br />6 <br /> <br />Parking <br /> <br />@ <br /> <br />Days <br /> <br />Rate <br /> <br />Total <br /> <br />B. <br /> <br />LODGING <br /> <br />(All Hotel charges require an itemized bill) <br /> <br />2 <br /> <br />@ <br /> <br />155.25 <br /> <br />310.50 <br /> <br />\' <br /> <br />Days Rate Total <br />[] Check here if lodging was prepaid/P-Card, list amount and deduct at the bottom of page. <br />I <br />C. MEALS (MONEY RECEIVED AT PER DIEM RATE DOES NOT REQUIRE RECEIPTS) J <br />(Did not receive any funds prior) Amount Received on Request 153.00 <br />NOTE: Meals should not be charged on P-Cards Total <br /> <br />270.00 <br /> <br />Total <br /> <br />[] Check here if registration was prepaid/P-Card, list amount and deduct at the bottom of page. <br /> <br />J <br /> <br />D. <br /> <br />REGISTRATION <br /> <br />E. OTHERS Phone Calls <br /> <br />(Personal phone calls are limited to $5.00 per day) <br />All others - Must itemize and attach receipts <br /> <br />Total <br /> <br />Total <br /> <br />,./ <br />Gross Total: 921.28 k <br />Less amount charged to City P-Card 31 0.50 ../ <br />Less amount prepaid items 270.00 v <br />Less amount of Cash Advance 340.78 / <br />Balance due Employee if (Credit) 0.00 <br />Balance due City of La Porte if Debit 0.00, J <br /> <br />~~~V~~PE~~~~~~S~~;::'RUE AND ACTU;~;;~~~~~~~;~:;~ TH:~~~~/ <br /> <br />DATE: . // - // .. ,/ ,I / .I) 1),-//"-" <br /> <br />Revised 01/06 Mileage Rate DIRECTOR SIGNATURE //~c;r>'\\ <br />I <br />j' <br />J <br /> <br /> <br /> <br />, <br />fi\t..,." <br />