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<br />PER DIEM OAl.CULArION:
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<br />lltd . NOt lfjl tbf..IftI~.
<br />aN
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<br />'THE; TOTAL. SHCI,lLP aAl.ANClE WITH ~eAL$ (PER DIEM) LISTEO AeQve.
<br />
<br />__MlQUllI
<br />
<br />.pL.&Ase NOTE: Mea' money received" the Per Olem rate Will not requite r.Ipl$ to be returned.
<br />(ALL O"l'WfiRIT&MSREQUIRI ASCliIPTS)
<br />
<br />II
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<br />I have read en~ ynderstanc:i the fra\fel Policy. I wijl complete the Travel (bpense form within fIVe working days
<br />Qf mv ;~tu*'".attacm' allreqWivedr re4eiptsand$u.mlt it tQthEt Director of Finance. I wiN also. refund to thl!l City,
<br />the amount remainit\S. if any. of the adVenoEt '.ived.
<br />If thi$ repOi'lI$ l'IQt StIJf'tllttH as required, this authorIZes the City to deduct the full amCJunt of this
<br />Tr.vcrd Advance ftom my payche$k.
<br />
<br />Date:
<br />
<br />Employee Signature:
<br />
<br />APPROVAL:
<br />
<br />City Mlnager (lftequltid)
<br />
<br />.' -. .......... ".-"""
<br />Department OltclctOr
<br />
<br />REVISED 1.00
<br />
<br />Budgeted fl,lnds avallablEt:
<br />Plea~e~ElQl<appr()p~a!~ '?ox.
<br />
<br />
<br />yes
<br />NO
<br />
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