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Home My WebLink AboutAgenda Report - January 5, 1994 (36)OF CITY OF LODI COUNCIL COMMUNICATION AGENDA TITLE: Travel and Business Expense Policy and Procedures MEETING DATE: January 5, 1993 1994 PREPARED BY: Finance Director RECOMMENDED ACTION: By motion approve and adopt the attached Travel and Business Expense Policy and Procedures. BACKGROUND INFORMATION: During the 1993-94 Budget Hearings the City Council requested staff to prepare a Travel and Business Expense Policy for Council review in response to concerns expressed by the local press and citizens as to staff and Council business and travel expenses. Accordingly, the following goals were established by the City Council for use by staff in preparing a "travel and business expense" policy: * Employees and City officials should be fairly and equitably compensated for the cost of official travel and business expenses at meetings, conferences or activities which require overnight travel, day trips or other business activities. * That the recommended policies should control and limit City costs to those expenses necessary and essential for the conduct of City business based on the purpose, nature and circumstances of the travel, business meeting or activity. * That when employees and City officials authorize, travel or incur business expenses in accordance with these policies, they should feel comfortable that their expenses can be scrutinized closely by the City Council, the press and other concerned persons without fear of personal criticism. * That the City's travel and business expense policies should be documented and available for review by staff, the City Council, the press and other interested persons. Staff also considered the following criteria in preparing this policy: use of per diem as a cost control measure; the need to establish individual accountability and responsibility for cost of travel; Internal Revenue Service policies and regulations; practices of other cities and agencies; and, ease of administration. APPROVED: THOMAS A. PETERSON xruea caws ` City Manager cc -1 Ttie recommended policy was presented to the City Council at a "Shirt Sleeve" on November 2 for review and comment, subsequently revised based on Council comments and suggestions and is now presented for approval and adoption. FUNDING: None. One objective of this policy is to reduce the City's cost of travel and business expenses. Dixon Flynn Finance Director Attachment CITY OF LODI TRAVEL AND BUSINESS EXPENSE POLICY AND PROCEDURES TRAVEL AND BUSINESS EXPENSE POLICY AND PROCEDURES Jack A. Sieglock, Mayor Stephen J. Mann, Mayor Pro Tempore Ray G. Davenport, Council Member Phillip A. Pennino, Council Member John R. (Randy) Snider, Council Member Thomas A. Peterson, City Manager Prepared by the Department of Finance H. Dixon Flynn, Finance Director CITY OF LODI, CALIFORNIA January 1994 TABLE OF CONTENTS SECTION DESCRIPTION PAGE I GENERAL 8 Overview 1 Definitions 2 General Policies 2 Basic Policy 10 Employee and Supervisor's Responsibility 10 Authorization Required 10 Authorizing Officials 10 Authorizing Officials Responsibilities 10 Basic Expense Standard 11 Personal Expenses Business Expense Report and Claim Voucher Spouses Transportation Business Meals City Manager's Authority Proof of Expenses Reimbursement from Other Agencies and Persons Per Diem Mileage Rate Auto Allowance City Council Budget II ADVANCES AND DIRECT PAYMENTS Advances 7 Direct Payments 7 III OVERNIGHT TRAVEL AND MEETING EXPENSES General 8 Summary of Allowances 8 Business Expense Report and Claim Voucher 8 TABLE - Summary of Allowances 9 IV LOCAL TRAVEL AND BUSINESS MEALS General 10 Summary of Allowances 10 Credit Card Charges, Petty Cash and Cash Advances 10 Transportation of Material 10 Business Expense Report and Claim Voucher 10 TABLE - Summary of Allowances 11 TABLE OF CONTENTS ` V REPRESENTATION EXPENSES General 12 Summary of Allowances 12 Authorization and Approval 12 Substantiation 12 TABLE - Summary of Allowances 13 VI ACCOUNTING FOR EXPENSES General 14 Tax Withholding 14 VII BUSINESS EXPENSE REPORT'AND CLAIM VOUCHER Authorization 16 Claim 17 VIII SAMPLE VOUCHERS 19 r") CITY OF LODI Travel and Business Expense Policy Section I General A. Overview This Policy and Procedure Manual has been developed to provide overall policy and procedural guidance for payment and/or reimbursement of travel and business expenses incurred by city employees, board members, commissioners, official representatives, and City Council Members when conducting official city business. Accordingly. the City Council established the following goals on which these policies and procedures were developP.c I Employees and city officials should be fairly and equitably compensated for the cost of official travel and business expenses at meetings. conferences or activities which require overnight travel, day trips or other business activities. 2 That the recommended policies should control and limit city costs to those expenses necessary and essential for the conduct of city business based on the purpose. nature and circumstances of the travel. business meeting or activity. That when employees and city officials authorize, travel or incur business expenses in accordance with these policies. they should feel comfortable that their expenses can be scrutinized closely by the City Council. the press and other concerned persons without fear of personal criticism. 4. That the City's travel and business expense policies should be documented and available for review by staffs the City Council, the press and other interested persons. In developing these policies and procedures. the City also considered the following criteria to guide_in their preparation: use of per diem as a cost control measure: the need to identify individual accountability and responsibility: Internal Revenue Service policies and regulations: practices of other cities and agencies: and ease of administration. After several reviews and changes. this document represents the collective thoughts of City staff. management and concerns expressed by the public. The end result of these policies is to assure the public that the City is a good steward of the City's resources. B. Definitions For the purposes of this policy the following definitions will be used: 1. Business Expense - expenses incurred by employees for transportation, meals, lodging, incidental expenses and registration expenses at conferences, training and meetings in the conduct of official City business. 2. Employee - includes permanent, part-time, seasonal, temporary and contract employees, members of the City Council, commissioners and board members. 3. Official Eepresentatives - includes persons under contract or designated by the City Council to represent the City when in the best interest of the City. 4. Official Guest - a person designated by either the Mayor, City Manager or Department Head as an "official guest" for whom City funds may be charged to offset their expenses when conducting official City business. 5. Honorarium - a payment, reimbursement or gift to honor or recognize services of a person(s). 6. Business Meal - a meal expense incurred by a City employee in the conduct of official City business. Normally, this is a lunch expense but could be a breakfast or dinner expense for the employee and official guest. 7. Day Travel - travel within and around the City of Lodi within a distance not greater than 200 odometer miles from Lodi. 8. Business Meeting - generic name used in this Manual to describe a meeting, conference, training seminar and business lunch within a distance not greater than 200 odometer miles in one day. 9. Per Diem - a daily rate paid for overnight travel calculated not to exceed ordinary and necessary expenses for meals and incidental expenses which is reduced by one-quarter of the daily per diem rate for pre -paid meals included in the transpgrtation cost or registration cost. C. General Policies Basic Policy The City will pre -pay, advance funds and/or reimburse employees for all reasonable travel and business expenses when conducting official City business in accordance with these policies to include per diem, transportation, lodging, registration fees, business meals, incidental expenses, and representation expenses. Employee and Supervisor's Responsibility Every employee and official who travels on city business or who supervises others who do, is responsible for knowing these policies and procedures. 2 a Authorization Required Attendance is considered to be in the best interest of the City and is authorized by the Mayor, City Manager, Department Head or in the case of the Library Board, the President of the Board or in the case of Councilmembers. the Councilmember prior to incurring the expense. Authorization may be verbal or in writing. The "Authorization" section of the Business Expense Report and Claim Voucher should be completed prior to travel or incurring business expenses to protect the interests of both the City and the employee. However, the Finance Department is not authorized to pre -pay business expenses or advance monies for travel without an approved Business Expense Report and Claim Voucher. Authorizing Officials The Mayor, Councilmembers. the City Manager, Department Heads or in the case of the Library Board the President of the Board have the authority to authorize employees and City officials to travel and incur business expenses on behalf of the City of Lodi. Only the Mayor, Councilmembers and City Manager may authorize City funds to be used for "representation expenses", and/or reimbursement of official representatives or guests for travel and business expenses incurred on behalf of the City of Lodi. Authorizing Official's Responsibilities Officials who authorize travel and business expenses are responsible for determining that the cost is reasonable and justified. They should be certain that: a) The purpose of the meeting cannot be accomplished by mail or telephone. b) The minimum number of people needed are going c) The itinerary ensures effective accomplishment of the purpose at the lowest reasonable cost. d) The employee understands and follows these policies and procedures e) There is enough money in t'ae budget to cover the costs. Basic Expense Standard Attendance is limited to the minimum number of employees required to represent the City, obtain information and/or maintain skills and professional qualifications. These policies are not to be construed to require employees to obtain the cheapest possible accommodations, transportation or meals when conducting official business. Employees are expected to exercise good judgement and incur only those expenses which would be incurred by a "reasonable person" in the conduct of business at their own expense. Personal Expenses Personal business expenses should not be mixed with official business expenses. Accordingly, the City will not reimburse employees for those expenses which are of a personal nature unless specifically authorized in this policy. The following expenses are normally considered to be personal expenses: expenses incurred by a spouse, family member or adult guest; pay TV; room bar; meals in room; valet service; entertainment; bar tabs; repairs to a personal car, and exvenses incurred to carry on a business enterprise Business Expense Report and Claim Voucher a) Cash advances or pre -paid expenses will not be made by the Finance Department without an approved Business Expense Report and Claim Voucher. b) On completion of travel and/or after incurring a business expense, employees will complete a Business Expense Report and Claim Voucher to report their expenses whether prepaid, paid or to be reimbursed. Spouse Employees will not be reimbursed for the expenses incurred on behalf of a spouse, family member or adult guest except on those occasions when an invitation expressly includes spouses and attendance is approved by the Mayor or City Manager as necessary and appropriate. It is not the intent of this policy to preclude spouses, family members and adult guests from accompanying an employee to a business meeting at their own expense. Transportation a) Employees are expected to use commercial air common carrier as the preferred means of transportation to and from meetings which are greater than 200 miles (one way) from Lodi unless travel by city vehicle, private automobile or other means of transportation is authorized. Normally employees will not be reimbursed for transportation expenses greater than the cost of commercial air common carrier to and from their destination plus taxi fares. b) When local travel is necessary to conduct official business, employees are expected to use a city car as the preferred means of transportation unless travel by commercial carrier or private automobile is authorized. Employees will be reimbursed odometer mileage for travel by private automobile at mileage rates published by the Internal Revenue Service for business miles. c) Travel should be by the most direct, usually travelled route. Travel by city or private automobile should be coordinated and shared when more than one employee is travelling to the same meeting. 4 d) When driving a privately owned vehicle on city business, employees must meet the following conditions: 1) Have a valid California driver's license 2) Understand that any damage to the car, needed service or repair occurring on the trip will be the employees responsibility with no reimbursement from the City as a travel and/or business expcnse. This does not preclude the emVlovee from filing a claim for damages inj_ury or other costs through the City's "risk management" program. Comply with California statutoryrequirements for vehicle insurance. Business Meals Employees, officials and business guests may be reimbursed for the cost plus tip of a business meal when approved by their Department Head as necessary in the conduct of City business. The City will purchase meals when necessary to maintain an "arm's length" relationship with developers, contractors and vendors. A list of guests must be attached to the Business Expense Report and Claim Voucher indicating all guests for whom their meal was purchased by the City. City Manager's Authority From time to time, the City Manager is authorized to change and/or modify the policies and procedures in this document which are ministerial and do not substantively change the intens of theseIpo icier to ensure compliance with Federal and State tax regulations and to ensure employees are reimbursed for reasonable expenses incurred in the conduct of official city business. Proof of Expenses Employees will be required to provide receipts for all expenses greater than $15.00. On those occasions when it is impractical to provide a receipt or when the receipt is lost, a memo signed by the employee and approved by the Department Head must be attached to the Business Expense Report and Claim Voucher. Reimbursements from Other Agencies and Persons Any amount paid by others to reimburse the City for the cost of travel, business expense or representation expense will be reported on the Business Expense Report and Claim Voucher if the revenue is directly tied to the expen-ses reported. The name and address of the agency to be billed must be shown. Typically, the City receives reimbursement from POST for POST sponsored training of police. Per Diem Per diem is paid only to employees who require overnight accommodations. Per diem is $50.00 per day for meals and incidental expenses and will be paid in increments of $12.50 mr quarter day or 6 hours beginning at 12:01 am and ending at 12:00 pm for time when travel begins to time travel ends as shown on the "Business Expense Report and Claim Voucher". 5 Employees and officials will be paid $500 Kr -ft for meals and incidental expenses when away from Lodi greater than 10 hours and required to obtain overnight accommodations. Per Diem will be paid from time of departure to time of return in increments of $12.50 pgr quarter day (6 hours) beginning at 12:01 am and ending at 12:00 pm. The per diem allowance may be reduced by the Department Head up to $12.50 per meal to offset the cost of meals purchased by the City on behalf of the employee. This normally occurs when meals are purchased as part of the registration fees. Mileage Rate Employees and officials will be paid the mileage rate set by the Internal Revenue Service (IRS) for business miles when authorized to use a personal automobile to conduct City business, The current rate will be published annually by the Finance Department. Auto Allowance Employees entitled to an auto allowance will not be reimbursed mileage for use of a private automobile except for travel greater than 200 odometer miles in one round trip. City Council Budget The City Council bud.-et for travel and business expenses will be allocated tQ each Councilmember. Within each allocation. the Councilmember will have discretionary authority to incur travel and business expenses. For amounts greater than the initial allocation for�Mial meetings, conferences or activities, a s ial appropriation must be made by the City Council. R Section II Advances and Direct Payments A. Advances Employees may (1) pay their travel and business expenses with personal funds and be reimbursed after the fact or (2) request monies in advance. A cash advance is a lump sum payment made to an employee before travel begins based on estimated costs. Cash advances are to be used for expenses of travel, lodging, per diem and meetings in the conduct of official city business. Cash advances are not to be used to pay personal living expenses. Cash advances must be reviewed by the authorizing official to ensure the advance is reasonable. On return to Lodi, employees have 30 days to file a "Business Expense Report and Claim Voucher" to account for their expenses. Any unused advance will be returned to the Finance Department. The employee will be reimbursed the difference if actual, authorized expenses exceed the amount advanced. The amount which may be requested in advance can be determined by referring to the "Summary of Allowances". B. Direct Payments Employees may request the Finance Department to make direct payment to vendors for lodging, conference fees and/or commercial transportation. Direct payments to vendors will be paid on a standard "Claim Voucher" and not a "Business Expense Report and Claim Voucher". All direct payments will be reported on the Business Expense Report and Claim Voucher under "Total Cost" and a copy of the standard "Claim Vouchers" will be attached as proof of expenses. OI Section III Overnight Travel and Meeting Expenses A. General The City will reimburse, advance by cash and/or prepay the expenses of employees when conducting official city business away from Lodi for periods greater than 10 hours which require overnight accommodations. B. Summary of Allowances See Summary of Allowances - Overnight Travel and Business Expenses C. Business Expense Report and Claim Voucher 1. Travel advances will be paid on the Business Expense Report and Claim Voucher. 2. Pre -paid expenses for lodging, commercial carrier, meetings and conferences will be paid on a standard "Claim Voucher" and later attached to the Business Expense Report and Claim Voucher when the final report is submitted to the Finance Department. 3. Within 30 days of completing travel, each employee is required to submit an individual Business Expense Report and Claim Voucher reporting total cost of travel and business expenses, whether pre -paid, advanced or to be reimbursed. Receipts and standard "Claim Vouchers" showing prepaid expenses will be attached to the Business Expense Report and Claim Voucher. 8 Summary of Allowances Overnight Travel and Business Expenses 1. COMMERCIAL TRANSPORTATION] Airplanes, buses, trains, public transit, rental vehicle to and from destination, etc 2. LODGING Room at motels, hotels, bed and breakfast, etc Valet, maid service, room bar, pay television, personal telephone calls, tips and meals in room 3. MILEAGE Reimbursed for use of private automobile 4. PER DIEM Meals, personal telephone calls, tips, etc Cost, receipts required for individual expenses greater than $15.00 per purchase Cost, receipts required Not reimbursed Reimbursed at mileage rate published by IRS to owner/operator. Passenger(s) not reimbursed. Employees with an auto allowance will not be reimbursed for mileage. $50.00 per day and/or $12.50 pgr_ quarter day S. INCIDENTAL TRANSPORTATION EXPENSE Airport limousines, buses, taxi's, tolls, parking fees Cost, receipts required for individual expenses tips, etc greater than $15.00 per purchase. 6. CONFERENCE—EXPENSE Registration fees; purchase of printed material, tapes and other training material directly linked to program or conference; meals and activities for banquets and activities directly linked to program or conference. 7. OTHER EXPENSES Official telephone calls and other expenses 0 Cost, receipts required Cost, receipt required for individual expenses greater than $15 per purchase Section IV Day Travel and Business Meals A. General The City will reimburse, advance by cash or credit card or prepay the expenses of employees and official guests when conducting city business in and around Lodi. For purposes of this section,local travel is considered to be travel which does not require overnight accommodations and is within a 200 mile radius of Lodi when authorized by a Department Head: The City will pay the expenses of city employees when attending meetings or conferences held locally which do not include overnight accommodations.. When there meetings include meals or other expenses, the City will reimburse the employee for their meal expense plus tip. B. Summary of Allowances See Summary of Allowances - Local Travel and Business Meals C. Credit Card Charges, Petty Cash and Cash Advances Credit card changes, use of petty cash and cash advances will be reported on the "Business Expense Report and Claim Voucher" when submitted. Credit card charges (City credit cards) will be considered advances to the Department Head or employee named on the Credit Card. D. Transportation of Material The cost of transporting material by private or City auto in lieu of using commercial carriers may be reimbursed to employees as follows: 1. City Automobile - not reimbursed except for the p:trchase of gas/oil and emergency repairs. 2. Incidental Transportation Expenses - actual cost of tolls and fees. 3. Private Automobile - mileage rate authorized by the Internal Revenue Service for odometer miles for vehicle owner. 4. Employees entitled to an "automobile allowance" - not reimbursed mileage E. Business Expense Report and Claim Voucher The Business Expense Report and Claim Voucher must be completed for all expenses charged to local travel and business meals. For business meals paid by credit card, the Bank Statement from the City's bank will be attached to the Business Expense Report and Claim Voucher with the required receipts. Summary of Allowances Day Travel and Business Meals 1. COMMERCIAL TRANSPORTATION Buses, public transit, rental vehicle to and from destination, etc 2. MILEAGE Reimbursed for use of private automobile 3. INCIDENTAL TRANSPORTATION EXPENSE Tolls, parking fees 4. CONFERENCE/REGISTRATION EXPENSE Registration fees; purchase of printed material, tapes and other training material directly linked to program or conference; meats and activities for banquets and activities directly linked to program or conference. 5. BUSINESS MEALS Meals of employees and official guests 6. OTHER EXPENSES Official telephone calls and other expenses Cost, receipts required for individual expenses greater than $15 per purchase. Reimbursed at mileage rate published by IRS to owner/operator. Passenger(s) not reimbursed. Employees with auto allowance will not be reimbursed for mileage. Cost, receipts required for individual expenses greater than $15.00 per purchase. Cost, receipts required Cost plus tip, receipts and list of guests required Cost, receipt required for individual expenses greater than $15 per purchase. • Section V Representation Expenses A. General City officials, employees, guests or designated individuals are occasionally asked to represent the City or participate in events, celebrations, or special meetings to promote the interests and traditions of the City. Such events and activities normally celebrate National, State or local holidays. However, they may include promotional events, celebrations recognizing individuals for service to the City and/or participation in activities of organizations with a State-wide or regional goal to represent, promote or advocate good government and policies of the City. To ensure that City representatives are appropriately reimbursed for participation in these events or reimbursed for sponsoring these events, the Mayor, Councilmembers or the City- Manager may authorize employees, guests and officials to be reimbursed for the representation expenses provided in this Section. When authorized "representation expenses", the City's representative(s) is expected to use good judgement and incur only those expenses that are reasonable and appropriate based on the occasion or event, place, time, setting and participants involved. Representation expenses may be authorized to: * Reimburse officials and employees for expenses of a spouse, family member or other adult guest when they are official guests of the City at events, meetings, celebrations or activities sponsored by the City of Lodi. * Pay for the cost of sponsoring or participating in State-wide or regional activities and events to promote good government. business, or activities in the City of Lodi. * Pay for the cost of hosting sister city events and activities. B. Summary of Allowances See Summary of Allowances - Representation C. Authorization and Approval Prior authorization must be given by either the Mayor or City Manager to incur representation expenses. Under no circumstance will payment be made for representation expenses without written approval. D. Substantiation A "Business Expense Report and Claim Voucher" must be submitted within 30 days after incurring representation expenses. A list of all guests must be attached to the "Business Expense Report and Claim Voucher". Receipts must be provided if appropriate and must be attached to the "Business Expense Authorization and Claim Voucher" except as provided in the Summary of Allowances. 12 Summary of Allowances Representation 1. COMMERCIAL TRANSPORTATION Airplanes, buses, trains, public transit, Cost, receipts required for individual expenses greater than $15 per purchase. rental vehicle to and from destination, etc 2. LODGING Room at motels, hotels, bed and breakfast, etc Valet, maid service, room bar, pay television, personal telephone calls, and meals in room 3. MILEAGE Reimbursed for use of private automobile 4. PER DIEM Meals, personal telephone calls, pay television, room bar, meals in room, entertainment, valet, room service, etc 5. INCIDENTAL TRANSPORTATION EXPENSE Airport limousines, buses, taxi's, tolls, parking fees 6. CONFERENCE/REGISTRATION EXPENSE Registration fees; purchase of printed material, tapes and other training material directly linked to program or conference; meals and activities for banquets and activities directly linked to program or conference. 7. OTHER EXPENSES Meals, official telephone calls, tips, and other expenses 13 Cost, receipts required Not reimbursed Reimbursed at mileage rate published by IRS to owner/operator. Passenger(s) not reimbursed. Employees with auto allowance will not be reimbursed for mileage. See "Other Expenses" below Cost, re--eipts required for individual expenses greater than $15.00 per purchase. Cost, receipts required Cost, receipt required for individual expenses greater than $15 per purchase Section VI Accounting for Expenses A. General The following expense codes will be used to charge and budget expenses for city business expenses: Object Code 314 Business Expense Costs associated with day travel and business meals. Includes meals reimbursement, mileage, incidental transportation expenses, registration, supplies, materials, books, etc 315 Conference/Training Costs associated with travel, transportation, training and meeting expenses. Includes meals, lodging, commercial transportation, mileage reimbursement, incidental transportation expenses, registration costs, supplies, materials, books, etc. 358 Representation Costs associated with attending meetings, conferences, and celebrations to promote the City of Lodi, to recognize individuals or groups and/or to promote good government. Includes the costs of meals, lodging, transportation, gifts, decorations, for employees, guests, elected and/or appointed officials. 367 Transportation of Material Costs associated with transporting material by private or city auto in lieu of using a commercial carrier to transport material. Include; mileage reimbursement and incidental transportation expenses. Not used to accoui t for the cost of meals, lodging, conference, training or meeting expenses. The following object codes will no longer be used to charge training, conference or meeting expenses: 309 -Membership and Dues; 365 -Post Training; 3(6-Training(Fire); and, 316 -Auto Allowance B. Tax Withholding City Provided Vehicles Personal use of a City owned vehicles is prohibited other than commutin- to and from work and de minimis personal use. The value of commuting use will be included in the employee's income for tax purposes. Accordingly, employees will be required to maiwain records w show personal miles for commuting purposes. 14 zl ' The employees that use the following vehicles for personal reasons (commuting) are not required to maintain records. For tax purposes these vehicles are considered tax-exempt. * Clearly marked police and fire vehicles * Unmarked law enforcement vehicles, provided personal use is officially authorized as assisting law enforcement * Any vehicle designed to carry cargo that has a loaded gross weight of more than 14,000 pounds. * Delivery trucks with seating only for the driver or only for the driver plus a folding jump seat * Special marked public works and utility vehicles used for emergency response Travel and Business Expenses The Finance Department will report advances, credit card charges, pre -paid expenses and paid expenses as taxable income unless the following conditions are met: * A business connection is established by a "Business Expense Report and Claim Voucher" * Receipts are provided for the expenses as provided in this policy. * Excess payments are not returned to the City within 30 days. To qualify as a deductible expense, employees must submit a Business Expense Report and Claim Voucher within 30 days of completing travel or end of the month and submit supporting receipts as provided in these policies. Excess payment will be returned to the City. 15 Section VII Business Expense Report and Claim Voucher The following instructions are provided to assist in preparation of the "Business Expense Report and Claim Voucher". AUTHORIZATION Date: Enter the date authorization is prepared Name (Last, First, MI): Enter name of employee, City official, official guest or representative to be paid. Employee Number: Enter employee number, for official guests or representative give Social Security Number Department: Enter employee Department, for official guests or representatives show City Manager's Office Destination: Enter city and state to which employee/official will be traveling Purpose: Enter purpose of travel or expenses Expense Authorization: Check one of the expense categories which will be used to pay for official travel and/or business expenses Dates: Enter dates that employee/official will be traveling Transportation Authorized: Enter the type of transportation employee/official authorized to use. Passengers in City owned or private auto will not be authorized transportation to and from destination. Comments: Enter special authorizations or restrictions such as "reimbursement for spouse authorized", "Room to be shared with Tim Stone", "Room expense to be paid by John Wayne", "Purchase of decorations and gift for guest speaker authorized", etc. Department Head Approval: Signature and date of Department Head, City Manager, Councilmember Mayor or their designated representatives. 16 CLAIM Check One: Enter a check to indicate whether the voucher is for payment of an advance or for payment and reporting of final claim amount. Total Cost: Enter the total cost of travel and/or business expense whether pre -paid by City or by City credit card. The only offset to this column is fees paid by participants or reimbursements from other agencies for expenses incurred by the City of Lodi Claim: Enter the amount to be reimbursed employeelofficial not previously paid. The amount of the "cash advance" is not considered to be a pre -paid expense. When amount has been prepaid by City write in: "Prepaid by City". When amount has been paid by City credit card write in: "Paid by Credit Card". Commercial Transportation: Enter total cost to City under "Total Cost" and amount claimed by employee/official to be reimbursed under "Claim". Receipts required and copy of standard "Claim Voucher" if prepaid by City and/or Credit Card Statement if paid by City credit card. Lodging: Enter total cost to City under "Total Cost" and amount claimed by employee/official to be reimbursed under "Claim". Receipts required and copy of standard "Claim Voucher" if prepaid by City and/or Credit Card Statement if paid by City credit card. Mileage: Enter the number of odometer miles from time of departure to time of return when p►ivate auto is authorized. Only vehicle owner may claim mileage. Days of Per Diem Claimed: Enter number of days and quarter days for per diem giving the date and time of departure and return. Quarter days are from 12:01 am to 6:00 am, 6:01 am to 12:00 am, 12.01 pm to 6:00 pm, and 6:01 pm to 12:00 pm. Enter total per diem cost under "Total Cost" and amount claimed by employeelofficial to be reimbursed under "Claim". Total Cost and amount claimed should always be equal. 17 Incidental Transpo'mtion Expenses: Enter total cost of incidental transportation expenses under "Total Cost" and enter the amount to be reimbursed to employee under "Claim". Incidental transportation expenses include: tolls; parking fees; purchase of gas and oil for city owned vehicles; taxi; and, rental vehicles at destination. Receipts required and copy of standard "Claim Voucher" if any amount prepaid in part or full by City and City Credit Card Statement if any part of cost paid by City credit card. Conference/Registration Expense: Enter total cost under "Total Cost" column and amount to be reimbursed employee/official under "Claim". Conference/registration expenses directly linked to the program or subject matter will be included on this line, included are: printed material; tapes; other training material; books and periodicals purchased at the conference; and banquets or other special gatherings. Receipts required and copy of standard "Claim Voucher" attached if any amount prepaid by City and/or copy of Credit Card Statement if any amount paid by City Credit Card. Business Meals: Enter total cost under "Total Cost" column and amount to be reimbursed employee/official under "Claim". Receipts required, list of guests paid for by City, a copy of the standard "Claim Voucher" if any amount prepaid by City and/or copy of Credit Card Statement if any amount paid by City Credit Card. Other Expenses: Enter total cost under "total Cost" column and amount to be reimbursed to employee. official under "Claim". Other expenses include: Receipts required Less Amount To Be Paid By Others: Enter the amount reimbursed or to be reimbursed by another agency or individual to offset the City's cost. This includes reimbursements for the cost of family members or guests not authorized travel, lodging, meats and incidentals at City expense. Less Advance Paid: Enter the amount paid by check or cash as an advance payment to offset the cost of travel and business expenses. Accounting and Budget Data: Enter account codes and amounts to be charged. To be completed by Department. iD Section VIII Sample Vouchers Overview The following sample vouchers are provided to assist in preparing claims for reimbursement, advances and reporting of travel and business expenses. If there are any questions as to preparation of the form or information required, you should contact your Department Secretary or supervisor. WE VJC nrr %Jnl Al`rY VV\ttr,•.:, CITY OF LODI ( AUTHORIZATION DA7 MO.'.."dew 15;73 1. NAME (Last, First. MI) j b. EXPIiNSC At MIUR17-S71ON (Check One)t AIM Check One: Advance a( %ctticmcnt 1[ M Coarcrcncelrraining(Owrnight) 315 ' -- Lout Tract A Business Steals 314 2. EMPLOYEE NUMB11111. Representation Expenses us 123456 Clmm •:: 7. DATES 3. DEPAR 1 MI:N'rI FUNC17oN — Ileginning Date I's-- --- P,, b I; c Wo R ks ' utding Date 'TRANSPORTATION ,—� :t. ALT17Ioit1" 1sD (t7tcct a. DESTINATION Comrtw cIal I`40N fCREu I Private Auto �� !.S- S-4. ! Rental Car S. PURPOSE CityAulo ; S —�_ _ Pt,bl,c l.JoklCs �o,V �reEiuCE Taxi 't lea 0 I I Otttcr 1 9. COMMENTS L L Roots Rwit d t-RRn1 S PORE A ri0 N Department 11cad Approval A n { SA.QClc/ w,zr A /its SAO-e- u�rQ K ignalurc of fimpinyce Suhmtlting C t om l Dcparmcnt Appr,wal Sign: cure 'ACC01WHNG AND 1t11DG1 1 DA ['A _1_'��•O.-°7.l--1 Z3�:�- -- -'797_=- _ C'AM PLE / % t - / /L�; %3 - ------ . - - - DATE PAID: WARRAti I' NO: Y / 23 S� VOUCIIHR NO: -6 78 ?/ ?- AM 0 W N AMOUN 1': 797 — --� AIM Check One: Advance a( %ctticmcnt -- Total Cost Clmm •:: I. COMMr:RClAL7"RANSPOR'rA'r10N (receipt attached) I's-- --- s LODGING. (receipt attached) �2. 3. MILEAGE (private auto) Odometer miles: K00 . AY¢ !.S- S-4. � 4. DA. S OF PER DIEM CLAIMED (not less than ylr Jays) ; S —�_ _ S— lea 0 I Nur er of Da1S j Date and'rama: of Departure t Date and Time of Return S. INCIDEN'rAL TRANSI.OR'17KHON IiXPF.4S1E (rcc_ipt attached) i6. CONEERENCIJREGisTiwrION I•:XPENSIi(receipt attached)— 7. I(USINI:SSMEALS — LOCAL TRAVEL. ONLY (receipt attached) t x. O'l711SR liXl'IENSI•S (receipts attached) � S S i 9. F.IESSAMOUrir'1"Otit: PATI) BYO"1711:ltS: NAME: j TOTAL cosi Olt ADVANCE S _-- _ _ _ _ _ _- ?----797- 9 7-1t1. 14). l.!»tiSADVANCE PAID: (.'heck or C_;tsh (circle) t I! 'rOTAI. CLAIM p (' IEspenses paid by credit cud or prepaid by Finance Department arc lislcd to this column (Claim Vouchers and Credit Card Statements attached) L•_IsxpcnscspaiJ hy-credit card_ar prepaid by Finance Department arc not IisirJ in this column I reyucsl payment of amount elrimcJ above and hcrelty certify that the information se above is correct and in conforance coil prttded abm the City's llusincss Expense Policy. ignalurc of fimpinyce Suhmtlting C t om l Dcparmcnt Appr,wal Sign: cure 'ACC01WHNG AND 1t11DG1 1 DA ['A _1_'��•O.-°7.l--1 Z3�:�- -- -'797_=- _ C'AM PLE / % t - / /L�; %3 - ------ . - - - DATE PAID: WARRAti I' NO: Y / 23 S� VOUCIIHR NO: -6 78 ?/ ?- AM 0 W N AMOUN 1': 797 BUSINESS EXPENSE REPORT AND CLAIM V HER �CtTY OF LODI ��,; 4: I AUTHORIZATION DATE:WoyEM• 6ER le. /993 1. NAME (Last, First. MI) G. I:XPI:NSE Atrnioximnom (('heck Onc G SMI TAN M. > Cuafcrcnmrrsinmg(O%-cml;.1t) 315 —` ilt t I L=ITrml.k Iiusincss.w." ass �- 2 I:MI'J.UYIEIi NUMIiJ:R � Rcprcxntatton Fapcnsrs •i,SB 7. DA'I7:S • 7. Uli1'AR'I'MItNl'/ FUNCI'tON lTcgtmm�g Datc >Pu6I fc WoRk5 1�xl,n� D::te « kK�__ --- — L TRANSPORTA•r1ON Alrnzoki' .:D (C t+cct 14. DESIIN/C110N CA _ Comm.crcol rnrdcAuto r onfER& �) Rcnr:dCar is. PURPOSI-1 CnyAuto t ; Public Joa ks CIoM-FreeAjc -' I:m-- j other 9. C:UMMI:NSI'S tt Ucpartinc IApprrnnt � L / / / I .Sr7RRE�0' Lc�,-Z/T 7/M SrD.V£ J CL IM Chcck Onc: AJv:tncc --- - - — Sctticmcnt�_ L Total Cont - Claim •' t 1. COMMIiRC1Af.'1'ItANSPOR"1'n'1'1oN (rcc.8pt . tlacncJ) SS 2 LODGING (rcccipt attached) ; S_—._ .33 �� Z 5 337-Y2 3. MILMGB (private auto) Chlomctcr ».Iles 4. DAYS OF ITIt DIEM CLANMIED (not Icss than ytt days) i S Numcr of Das 1 Datc and 1-=c of Dep trturc //t[_�S 4 Date andTimc of Return %T kTq3 ?: 36 PM s , 5. INCIDCsNrALTRANSPORTArION EXI'I:NSI-'(receipt attached) S G. CONI:IiRt-NCWltl-GISI'ItNI'ION IEXITNSF (rcccipt attached) �S__�Y-3 S i 7. BUSINESS MCALS - LOCAL TRAWL ONLY (rcccipt attached) iS ____ S i R O"t711?R EXPENSES (receipts attached) `9. LESS AMOUN'1 TC III: J'AlD BY (yRIIiRS: NAMR' ` I rornl.COSrOlt ADVANCIi lo. LESS ADVANCE PAID Chcc or Cash (circle) 11Y."Al. CLAIM Expenses paid by crcdit card or prepaid by Financc Department arc listed in this column (Claim Vouchers and Credit Card Statements attached) •• lispcnsespttid ny crcdit card or prcpaid_hy.l'inancc_Departmcni arc not listed in this column A I reyucu payment of amount claimed alxw-c and hereby certify that the information prtwided atx+ve is correct and [n conformance wd' jmic City's Itusincss li:pcnsc Policy. !I Si nahuc of Fm to cc Suhmmin Claim Dale _ Department Approval i------ Signature. - - -(I7 itc) . - - - -- - - -- -- --- - ACCO11N 1'ING AND INL/UGIC1' DATA % 6E cGM�oli�t 6 y j- DATV I AID: L rL _.ColEcf Al 1- �,�AvcE DEPR�{M6.v7 WARRA;f1' NO: L _ _.. - -- ------ --- - - - VOUCI IEIt NO: AMOI:N-r: SAM PL. 6- USiNESS EXPENSE REPORT AND CLAIM Vf' -,HER CITY OF LODI ✓) (AUTHORIZATION DATE: A1o✓Er76ER 1../ 1993 ! 1. NAM Ii (last, First. MI) 6. liXP1:NSL' AtMIORI%A'T1ON (Check Onc :5 J�'O+k1E %/M ✓• ConfercncciTrautwg(Overmghl) 315 y Local Tra.-cldoBusiness Meals 314 � 2 EMPLOYEE NUMIllat j Itcarcscmatun li%,a:ues 2 3 4674 7 _ _ _ ! 7. DA'ITS Ilegaramns Dane i Iltding Date x '1'ItANSI.ORTAI"lON AIrnIORIA:D (ChCelt C(u macral Private Auto I 3. Dlil' (i i t AIYTMEN'C1 FUNCTION PsJ D ttJdRks lEA1G iuEERiNG 4. DESTINATION Mo,A� CA / Rental cv ---; S. PURPOSE�+ Pub be L(%Rks Cta vjczk.--wCE i CitvAuto i ! o n�- —� PASSENGER Department Head Approval �ae i 9. COMMENTS l i bt Check One. Advance Settlement X I. COMMIiRC1AL TRANSPOirrKnON (receipt attached) is �_— _ _ S _ t 2. LODGING (receipt attached) S 3. MILEAGE (private auto) Odumctcr m" S S —j e. DAYS Olr PER D11'M CI�+IMIit) (not fess than qtr drys) L4 Numcr of Da -'s i Date and Time of Deparlurc I iDatc and Tintc of Return /l� $193 7' 36 P M i_r--—_-----•-.---.... --- __ --- —.r 15. INCIDEN`rAI_MEANSPORTA•IIONrAPENSI-(receipt attached) _S__.___ -_----___________.S__ 16. CONFEitHNCIJItIiGISI"RAI"ION EXrENSE (receipt attached) 17. BUSINESS MEALS — LOCAL'IItAVI]. ONLY (receipt attached) Illi It. O 1III:R E-XITNSI•S (receipts allachcd) 19. LESS AMOUN"I"1'O III* I -All) 11Y 07111:1(S: NAME: i i' ! TOTAL COST Olt ADVANCE 110. LESS ADVANCE: 1'AEI). Chcck rq CaSh (circle)TO'I'Al. CLAIM • lapcnses paid by credit card or prepaid by Ftnancc 1)ep:irtmcnl art: listed in this column (Claim Vouchers and Credit Card Statements attached) i •' I:apcnses paid by e—rcdit card or prcpa d by I-.nancc Ocpatiment are_nrrt listed in this column 1 request payment of amount claimed ahimc and herchy ccrtaly that the information prtmrdedadoove is correct and to conformance wil' ;�thcCity's Business Espcnsc Policy. :i--./1�i6�93------ aturc of lam tln cc Submmm Claim Da1c _ �j Department Approvals / !�-- Si nature_.._(.Waite) ;ACCOUNTING T 6 ca Mfl(ECFc� 6.1 AND BUDGE -1" DATA NAulf ! ,C DE�O/I.v�r1Ev ( I r r_6E:_ca.c4P1��Ed. 6�:_DEPe�t�ffNr`).. DATE PAIL) :i WARRAN 1' NO: - — ---- — --- -- - VOUCHER NO: ;_.__-- .._.__.. .._. ...._.. _. .. .. Ah101INf. SA r? Pt- E 3-1d WVS I.N:IOPiV MON, WAl L)i I 0A 0N,.1.NV1DI%1,%% 7ZWff(7_ 7(7 Iva: I.'vo zz fill C1Nv!)NI.INI1o:):)V; IrAoiddv IV..lwljl..d3cl 11 I.;(I) UJI11m) 1-ru.!I,w Atli a jo -Ijn1I!114F% A31lod avundr.l n1u!Tnjl 1.41!-) mil ll. 02UMAIJI1103 U! PW! 13'.1,IJ03 St 20AUKII! PIPI.Mlid uv'!f.Lujf1IuI Itil Ivqj ApijiD Aqijiq pizz 3,tmic patu!I:12 junotur jo juatuf". ls3nb3i I - . .. . . __ - .. - - - - .. -- :-; , �_Vv. utunlo:0 S1941 III pllvq Iou Me juatulmd1cl 3.1tivul'.1 i�q "11A.1id-jo-pirzo S11.131133111S PArD W13K) pur. vj3q3no,% Lu!rL)) tittinpii vitil u± plisq oje luoLuixrdi(j iiurtij.1 (q pirdaid it) pj,-3 I!p3ja fq r.!r-d s3vuodr.l (31"J") qvf') J(1 133qJ !(IIV-1 IONVACIV %S.11 '01 'I.).%1VA(IV W0.1 -SM) !SIMIL1.0 All UIVA :III 0.1. INn0WV SSA -1 '61 _T 0 U S S (11-10431- W Id- -.1%%:14M.-I N0I.I.V.L)I0.I%N%rjU. -IV.Lw.IaI.)Nj —Vid OF: 9 r uJ-I;1)Ijo3tu!j.puU3I%.Cj Loi v CAV: 0T—3jnjji%!3G joalul.j. put: 3w(I (%A, -p Jib U�ql snal lou) (1-.1 Kr F t�'!QjojawnN o o i G) -i I*j ZVI.) W'.1 I(] 11I.I.Io SAVC1 'r t)NIt)cI(yj Z S X lu3tu.,Ilk,% 1:luuvv :nu() 112oto 0=d d v p. a 1 &11 u W3w I j7Ld3cl '6 -isod HS0.11111`11.1 S tv:nVAit NoU.VMl_I_V'.IC1 'tl Uud oun. am su 311 won t I jw.iwj.xvt..Io WITIMN i.?XOWMI T tic aLM" UIf V. 13ACII lr-WYI 51C 0 IMU) N(M.M.-Illoumv Hs"'.1413C.1 '9 iiW'lsn:I'lscl)itWVN 'i NOUY-7111o"iny 7- tao"i U OA nIV13 ONV iU0d3U 3SN3dX3 SS3NisA__ CITY OF LODI AUTHORIZATION 1. NAM1: (Last, Irirst, MI) ��cfNN1 f� �iXaN 2 U14i"LOYI-M NUMBS R 45'6 7?9 - I DEPARTMIiNTIFUNUVION �ityArvcx 4. DM'n NA11ON �.ocnl /RRVE/`� BtIS/AJ£5S Men& S. PURPOSI: / vpRious /TEEr/NGS Department Ilead Approv CLAIM Check one: Advance DATE: &C-em6ER /, 1993 6. IimiNSti AU'f1IOK1%d•I'ION (Check CoofercncciTrammg (Ovcrmbht) .115 Local Tr.-ncl b: This icss \Meals 114 It-prc.'.ntalumGpcmvs ,iSti 7. DA11:S liegutnmg Date IMing Date L_1l_ M 'rKANsroiviwa*tON AIy11:0K IS Chccl C'.omntcrcLYt ! — 1 rrrvatc Auto f - Hertud Cir City Amo Mou L n Other R..fo /il�oG/AN� E 'l. COMMMPITI'S,� 4ISf oT9rJEs"S A�Ti4c/EEc� Setticment�_ AMOUNT SAN1 PC. E L—Trital Cost _—_� Claim 11. COMMI'sItC1A1.1'RANSI'Olt"1•A3*ION (recc,pt attached) S_ _ _- _ _ -_S 2. LODGING (rccciplattachcd) 3. MILEAGE (private auto) Odometer miles: 'tri i I S___--._,- S 4. DAYS OF PER 131061 CLAIMED (not less than ytr Jays) [f S 1 Date and Time of Departure Date and Time of Rcturn S. INCIDENTALT'RANSrO1tTAmo.s iXl'ENSIi(rccciptattachcd) S —__S____ CONFIiRL'NCIVltl:(;ISI'1tAT10N E-XPENNE (recupt attached) �6. BUSINESS WEALS — LOCAL•1'I"Vl:l. ONLY (receipt attached) i7. SIG(yl'IlIi1t1XI'ENSHS(rccciptsatm S._- ',�_ __.--5 ' 1 ^ i lichcJ) (� l.r `_A•_•.I j9. LESS AMOUNT TO Illi PAID BY 0111ERS: NAME: �iY"e ,N a _r ,,rra MA -Al ? TOTAL. COSI" OR ADVANCE i S r 4�•.Q S _ : , S_____.1 g 2.��...__—� 10. LESS ADVANCE PAID: Check or Cash (circle) S -- TOTAL CLAIM i p G • I:Ipenscs paid by crcdif card or prepaid by Finance Dcparimcnt are listed in this column (Claim Vouchers and Credit Card Statements attached) t ...lis arses aid h credo card or rc aid by Finance Deparimcniarc not liatcd in this column i ;,1 request payment of amount claimed atnrve and hcrctby certify that the information prnvided ahtive is cortect ..nd in conformance w,i' 1 "the City's Ilusincss Fitfnnsc Policqymc.. i�-- - 'a I ---_ ----Signature of limpmilting ('Maim _ _ _ _ - . (D: c)— tl tii n:durc Dal /a _ CGM�oIfIECJ 6c/ �I i AC.COIJNf[NG AND 11UDGIEI' DAT,\ DATE �i r ) DE�i4arMEtl ;1�la�E_GoMPl6.�i� ..f1cr_;DE�RRZLNEvif�_ rnlD: yRw,rF --- WARRANU NO: _.— — -- ------------ VOUCIIER NO: AMOUNT SAN1 PC. E 1 USINESS EXPENSE REPORT AND CLAIM VHEP I 1 CITY OF LODI ; AUTHORIZATION DATE: n/ovfM6tR 14" /143 1. NAME (last, First. Ml) REE ✓fS .l M G 2. I:M!'{.UYlii: NUM 11I li — S67 $4! �3. DL'rARTMIElfri FUNCrION t F7 1. DESTINATION Chico, CA S. 1•U111'OSG j !o RECEEr ✓E A44.,.4 / 1124.Aed II AR r+t£ll'CAirA a� 77>I1= y EAR ` DepartmentI lead Approval CLAIM Check One: Advance G "F ENSE AU'!1{OR117ATION (Check Gxttcrcncer rratn:.'tg (Otcrmy'uj 315 Weal Travel A flustncssAlcals 311 ltcptcx:uatitm I'xpctzses t5.4 7. DATES Beginning Date Ending Mile 3 T11 ANSroRTATION A1f111OR1/�.1 CAN"I tercCtl Priratc Auto Rental Car City Auto Taxi Other 9. COMMENTS l�ER6R% R1%t�i�op�zs,)t��o.v t Sctticmenl�_ Gnat • I Claim •• 7- LODGING. (receipt attached) 3. MILEAGE (private auto) Odwxtcr miles /0-1 i S— -g _S a S Id. DAYS OF Milt D1I:bI CLAIMED (not less titan ytr days) ' S T _� Numertar Days Date and Time of Departure - ~' Date and'lime of Return S. INCIDENTALI1L1NSPORTATION EXPENSE (receipt attached) ' S G CONTrERIiNCU111-'GISl'ltNl'lON I:XI'"Sli (recc,pt attached) S_ 7. ISUSINYSS MIEALS - LOCAL TRAVEL ONLY (receipt attached) lt. 01111:11 EXPENSES (receipts attached) 9. LESS AMOUNI'TO 1i1: MID BY O'l7IERS: NAMIi: f f t't TOTAL EMST Olt ADVANCE i I 110. LESS ADVANCE 1'AID: Check or Cash (circle)'ro-m. CLAIM $ f o p i • Expenses paid by credit card or prepaid by Finance Department are limed to this column (Claim Vouchers and Credit Card Statements attached) •• mix nus rwaid by credit card or prrpaid M Finance De artmcnt are nit liatcd in this column_ kl request p.•tyrnent of amount claimed :dxnc and hereby certify that the iafurmatiun prwidcd aixave as correct and in conformance wit+ 1!thc City's Business I_xpensc Policy. _ tiagrtaturc-ot_I?mployce tiuhmarmg-Ct:aim `Dei; t,- cnl Approval �I (1); C)-__ : _ 72c,6,- Cr,;; er; zy IACCOUNrIN : AND IfUDQ1sr DATA - --- --- - - -- - Dn'rr•. inn): �tii�,v�c 1�Es»Q� i 1lo-6E_CoylE�Lclby_-DfP/1Rfs�EN��.. _ WARRAN-1' Nr): VOUCIIIAL NO: SAMP'LE' r� �1 BUSINESS EXPENSE REPORT AND CLAIM VP HER ' CITY OF LODI AUTHORIZATION DATE:11�a✓6y6ER IS)- /993 1 1. NAME(iast,l'irst.MI)11 6 ILYPI-.NSE AtMIORI7ATION (Check0ne ' (� �R(� NES JORNi u • j Crutfcrc-40Traming(Osernibht) 393 `2. liM1'I.OYIiE NUMBER� Losc a t Sc Rosiness hicals 313 Rcchprexntalatian Egtcttxs 333 479912 �--1 7. DATES 3. DEPARTMENT! FUNCTIONBeginning i Date //�� l� /it�n+tinl sTl RaTlo^! t Ending Due x TRANSP0RTNI'10N AUT1101C1/,ED (Check) � 4. DES17NA770N + C., cial L ! ,Lod CA I - 1'ri+�tc Auto Rental --j & PURPOSE i CityAato C f rt� f CQvrJTy % (E'Ej r^!6 I Tasi } Othcr ---� I .1 R COMhC1:Y1'S �� ---� �uRCitASf o�eJfCoRA77ovS R Department Head Approval i 9�%tf {eR Gad -SIL S'pe,Q EQ CLAIM Check One: Advance ;Ctttcmcnt__�_ _ , '1'ntal Coat •__ Clatm •' 1. COMMERCIALTl(ANSI.OWI-NI ION (rcccipt auachcJ) j2. LODGING (rcccipt attached) , S.-. �3. MILEAGE (private auto) Odometer nt.ks: ' S S 4. DAYb OF PER DII:M CLAIMED (not less than qtr Jays) Numer of Days _—_ f 1 S _ S '- Date and Time of Ocpanw:�� U:nc:tncs'tlmcorRctwn E _ S. INCIDENTAI. TRANSI'Oli'I'A'I'ION I:Xl'IiNSl- (rcccipt attached) 16. CONI-ERL'NCIJRI:GIS-l'ItNI'ION EXPENSE (receipt attached) I S S___I 7. [IUSINIiS5MliAIS-LOCAL'l"IL1V'fiLONLY (rccciptat::¢hcd) _PDAI 6LLy_C//sr.C.I-. +I j 1C 0-1711:8 1SX1'l:NS1sS (receipts attached) ). I.14SS AMOUNT TO Iii: PAID BY 0-111 ERS: i ; NAStI ��FS • i f j 1 TOTAL COSI' Olt ADVANCE to. LESS ADVANCE PAID: Check or Cash (circle) TO'I'Al. CLAIM lispenaes paid by credit card or prepaid by Finance Department arc listed in this column (Claim Vouchers and C•cdit Card Statements attacacd) :11 request payment of amount claimed above and he rchy certify that the Information pro Lded ahuve Is currect and In cunfonr+ance w+L it `the Cily's liusincss lispcnsc Policy. !. Si);.%.1 um oC Empin •c tiuhmuting Claim (pa:�) ?.Ocpartm t Apprtwal-=- Signature -. _ (Date). 7 6E' Ca w� 1:ACCOUN'1'lNG AND BUDI PI' DATA _ _ DA'1'I: I'A11)- I�.✓ANr� QE)[J.4eQt�.�s�e' .i_ . WARRANT !C!_a _.. b E. _ . tCO MrFJ lE�fa�_. �b c/ . DEPRR�.'+E.✓C` � _- VOUC111:1: NO: SAMPLE ,-• flUSINESS EXPENSE REPORT 1 CITY OF LODI AUTHORIZATION � 1. NAME S�o-ttu IRANdoI�' G_ 2. EMPLOYER NUMBER j 789!23 3. Dtil'ARTMupir) FUNCTION C'o�rvcr/ /�IE�t6Eip 4. DIrwrINAI'ION -- -,-t WAsle.wcfa,j) DC - 5. PURPOSE i %lAT1cnlR � �RC21E a7C C� a�iES i Dcp2rtmcnt I lead Approval t.�.Zi?GIZB� lq DATE: a vcrtbr* S 19c13 b. I:Xrt:NSLr AU`I110IU7-A`'ION (CheckOnc Con::rcncu rraanang (Ovtirr•.tght) 315 Local Tr..wcl St Ilusmess Mals 314 Rcprc.saedton 11mvi es 1ST I 7. DAT"- Ilegtanusg pane lWu%g Dane M TRANSPORTNI'ION At Cbntmcrcr.d 1'tivate Auto Rental nir City Auto Tau Other 9. COMMENTS S�uSE RVT/I�DI�(ZEV (O /(l(LYQ' i I '11 67 ExPcNsE I CLAIM Chcck One: Advance -- Settlement_ 1. COMMIi1tCIA1.'ritANSI'Olt'1'A IO:1 (receipt attachcd) 2. LODGING (rcccipt attached) 3. MILEAGE"(private auto) Odmictcr mics: S —--_C37.S—Pcs� 4. DAYS OF PER WIN CLAIMED (nut less than qtr days) a S S Nurmr of Days Date and Tune of Departure Ileac and 1'bnc of Return I5. INCIDENTAL TKANSI'ORTAIIONIiXPIiN51i(iccuiptatlachcd) ;S_-__-_-__ Q�___,S CONFI:I(I:NCI114.1:GIS"I'RKI'ION EXIIENSE (rcccipt attachcd) �G 7. 1IUSINESS MEALS - LOCAL *mAwl. ONLY (rcccipt attachcd) ' S _—_ S Ix(rrnliRtixrENSC.S(recciplsattached) Is !9. LESS AMOUNI'TOIII: IIAIDBYO'11IERS: �S__(,_-____-__.�__,__-,-__)` k _ NAME." I '1'0l'AI. COSI' Olt ADVANCE T . _ [) _/4 a...2.Q�t S-----=r 71 10. LESS ADVANCE t'AID: Checker ash (circle) `j r0•rAl.CLAI\1 's.:.:__(ZQ,_ I?rpcnscs paid by credit card or prepaid by Finance Dep:artmcal arc listed in this column (Claim Vouchers and (:redit Card Slatr•.mcnts attached) ' •• lasnscs paid by credit card or prcpaid by Finance l3cpartricat are rill lasted in this column PC ied .d>.rve and hereby cetldy that the Li 1 request payment u[ amount clam m furmaaaon provided arx,ve a cuttect .and in conformance wil' ;!thc City's Ilusrnc.m I:Irma Policy. a SafrlaturC,o( 1•:mptbyee :;uhmillanr Claim Mile) Deparlmcnt Approval 'A(:CO(IKI'IN(; AND 1101)(.1'7- DATA _ DATE PAID: Y�O.S'rf��trl7NEu/ f IL— �Y-DE�ARif�stuf) ---- WARRANTNO V014:111.1( No SnM PRE