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COUNTY OF ALPINE TRAVEL REIMBURSEMENT REQUEST Check this box if this request is a travel advance Date prepared (mm/dd/yyyy) Employee Job title Department Title of event and purpose of travel Destination Travel period: From (mm/dd/yyyy) To (mm/dd/yyyy) Air County vehicle Private car Per Diem Amount from worksheet Lodging Mileage reimbursement Othe travel related reimbursements Registration Parking Other (taxi, tolls, bus or train fares, telephone,fax, internet charges) TOTAL REIMBURSEMENT I declare that I will reimburse all advanced amounts not actually expended, that I have read and understand the Alpine County Travel Policy and that I will provide appropriate documentation of travel expenditures. I declare under penalty of perjury that I am a County employee and that the foregoing is true and correct. Date Claimant Signature Approved Disapproved Date Department Head ITINERARY MODE OF TRAVEL CALCULATION OF REIMBURSEMENT. Do not enter expenses paid for with the County credit card or with a County warrant. Only enter those amounts for which the employee is requesting as an advance or as a reimbursement. Attach conference agenda or training itinerary. Attach all appropriate original receipts. REIMBURSEMENT AMOUNT ATTENDANCE INFORMATION ONLY IF PRIVATE CAR SELECTED: Enter number of miles and attach mapquest printout or other mileage calculator. IRS Standard mileage rate for 2021 is .58.5 cents per mile for business miles driven. This form will automatically calculate your reimbursement. 2022 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Print Reset Form 0.00 ---PAGE BREAK--- PER DIEM REIMBURSEMENT PER DIEM WORKSHEET S M T W T F S TOTAL RATE REQUEST Date of Travel (M/D) Breakfast 10 $ Lunch 15 $ Dinner 30 $ INSTRUCTIONS: Enter 1 In the corresponding cell if meal qualifies for per diem reimbursement. Enter 0 in the corresponding cell if meal was provided or does not otherwise qualify for reimbursement. POLICY GUIDELINES: Meal reimbursements include gratuity but exclude alcoholic beverages. Receipts are not required. Meal costs incurred during an employee's time away from normal conference activities will be reimbursed at the regular County rate. Employees will not be reimbursed for meals if the cost of a meal is included in the conference fee. Snacks and/or continental breakfasts are not considered to be meals. A detailed agenda specifying the dates, times and what is included in the registration fee is required to be attached to any claim requesting per diem reimbursement. Travel within Alpine County Meal reimbursements are not permitted when employees are traveling on official County business within Alpine County, except during lunch meetings where employee attendence is required and during which County business is conducted with the public or representatives from organizations other than the County. Lunches with other County employees, whether or not County business is conducted, are not eligible for reimbursement. Travel outside Alpine County Meals are reimburseable to County employees when traveling outside Alpine County on official County business. Where an employee is required to travel the day before the scheduled event, the employee is eligible for reimbursement of one meal, either lunch or dinner. Where an employee is required to travel beyond the conclusion of his or her regular work day, the employee is eligible for reimbursement of one meal, either lunch or dinner. For business‐related travel to and from/or from Bear Valley when SR 4 is closed, an employee is eligible for reimbursement of meals. PER DIEM WORKSHEET 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00 0 0.00 0 0.00 0.00