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TRAVEL` <br />AUTHORIZATION # <br />DATE <br />ALL ABOUT TRAVEL <br />ACCOUNT NUMBER <br />AIRFARE ONLY <br />(XXX-XXX-XXX-XXX) 900450.491491 <br />(attach ticket stub) <br />NAME: Tammv Donahue <br />STAFF LIASON (if applicable) Ann Daniels <br />MAKE CHECK PAYABLE TO: Tammy Donahue <br />MAILING ADDRESS: 101 East Broadway, Suite 400 <br />CITYISTATE: Eugene OR ZIP CODE: 97401 <br />TRIP FROM Eugene OR TO Thousand Oaks CA <br />TRIP PURPOSEI PROGRAM TITLE APWA: City of Thousand Oaks, CA <br />APWA POLICY AND TRAVEL <br />GUIDELINES APPY TO THE <br />REIMBURSEMENT OF ALL EXPENSES <br />REPORTED ON THIS FORM. The policy <br />and guidelines appear on the back of this <br />form In printed format or in the text <br />document stored alongside this <br />spreadsheet In electronic format. If this <br />form was <br />e-mailed to you and does not Include the <br />policy I guidelines, please notify the <br />sender. <br />Project # <br />Date <br />Mileage <br />Busrrml <br />Room <br />Meals <br />Phone <br />Tolls/Park <br />Other <br />Explanation <br />(XXX) <br />(Miles) <br />(Including Tips) <br />(Including Tips) <br />( Mist! Tips) <br />(Enter Ref <br />Brkfst <br />10110/10 <br />Lunch <br />$21100 <br />Baggage Fee <br />Dinner <br />0 <br />$000 <br />$000 <br />$0 00 <br />Total <br />$000 <br />$000 <br />$2000 <br />Brkfs( <br />10111110 <br />Lunch <br />$9.96 <br />Inemet Fee <br />Dinner <br />0 <br />$000 <br />$000 <br />$0 00 <br />Total <br />$000 <br />$000 <br />$995 <br />Brkfst <br />10112/10 <br />Lunch <br />$9 95 <br />Internet Fee <br />Dinner <br />0 <br />$000 <br />$000 <br />$000 <br />Total <br />$000 <br />$000 <br />$995 <br />Brkfat <br />10/13110 <br />Lunch <br />$2000 <br />Baggage Fee <br />$17 25 <br />Dinner <br />0 <br />$000 <br />$000 <br />$1725 <br />Total <br />$000 <br />$000 <br />$2000 <br />Srk <br />Lunch <br />Dinner <br />0 <br />$0.00 <br />$000 <br />$0 00 <br />Total <br />$000 <br />$000 <br />$000 <br />TOTAL MILES <br />0 <br />TOTAL <br />RATE <br />0.50 <br /> <br />- <br />- <br />- <br />- <br />EXPENSES <br />TOFAI' <br />7-2 <br />,7, <br />$40001 <br />0 -QO <br />77 <br />9 <br />0 <br />„a 90 <br />. , - i. 77A5 <br />REIMBURSABLE AIRFARE <br />TRAVELER SIGNATURE (PAID DIRECTLY BY INDIVIDUAL) <br />DATE G T [ C / CF LESS ADVANCE (APWA staff only) <br />PROGRAM MGR: BALANCE DUE <br />DATE <br />If the balance is due to APWA please attach your personal check to the <br />DEP /EXEC DIRECTOR expense report and record your check # In this blank <br />DATE Explanations/ Comments: <br />1. <br />A HARD COPY OF THIS COMPLETED FORM WITH AIRLINE TICKET STUBS 2 <br />AND ALL ORIGINAL ITEMIZED RECEIPTS MUST BE SENT TO THE <br />FOLLOWING ADDRESS BEFORE REIMBURSEMENT MAY BE PROCESSED. <br />PHOTOCOPIES OF RECEIPTS WILL NOT BE ACCEPTED 3. <br />APWA 4. <br />ATTN: Accounts Payable S. <br />2345 Grand Blvd., Suite 700 6. <br />Kansas City, MO 64108.2625 <br />