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EMPLOYEE NAME: WORK PHONE: DIVISION: DEPARTMENT: TRAVEL FROM: TRAVEL TO: Date Time Date Time LOCATION: City and State ESTIMATED COSTS EMPLOYEE’S SIGNATURE: DATE: MANAGER/DIRECTOR/CAO SIGNATURE: KEEP ORIGINAL UNTIL RETURN. PROVIDE COPY TO PURCHASING WITH YOUR TRAVEL PAYMENT REQUEST. PER DIEM: Go to WWW.GSA.GOV and calculate your per diem for Meals and Incidental Expenses (M&IE) for the duration of your travel. Once calculated, print the page that displays the Breakdown showing first and last day rates. *The first and last calendar dates of M&IE are calculated at 75%. Full Days Number of Days Daily Rate (M&IE) Total Per Diem Partial Days Number of Days Daily Rate (M&IE) Total Per Diem REGISTRATION FEES: (Attach registration form) AIR TRAVEL/BAGGAGE FEES: RENTAL VEHICLE: (Receipts required upon return) PRIVATE VEHICLE: = # of Miles Mileage Rate Total Estimated Mileage LODGING: = Number of Days Lodging Daily Rate Total Estimated Lodging OTHER: (Ground Transportation, parking, ect) OTHER: (Ground Transportation, parking, ect) TOTALS: Ogden City Travel Authorization – Step 1 1. Use this form to obtain authorization for travel that will incur costs. Please include all costs. 2. This form should be submitted to the employee’s manager first, prior to requesting payments or traveling. Save Print 0.00 0.00 0.00 0.535 0.00 0.00 0.00 0.00 0.00 ---PAGE BREAK--- Ogden City Travel Payment Request – Step 2 PAYMENTS REQUESTED TO EMPLOYEE VENDOR PAID BY EMPLOYEE DESCRIPTION AMOUNT PER DIEM (Request no sooner than 14 days prior to travel) PRIVATE VEHICLE TRAVEL AIR TRAVEL/BAGGAGE FEES REGISTRATION FEES LODGING RENTAL VEHICLE OTHER EXPENSES OTHER EXPENSES TOTALS: PAYMENTS REQUESTED TO VENDORS VENDOR NAME DESCRIPTION AMOUNT AIR TRAVEL/BAGGAGE FEES REGISTRATION FEES LODGING RENTAL VEHICLE OTHER EXPENSES OTHER EXPENSES TOTALS: Vendor PO Vendor PO Vendor PO Vendor PO DOCUMENT CHECKLIST: Please attach the following items when applicable. Agenda Per Diem Printout Air Travel Confirmation Map with Mileage Hotel Confirmation EMPLOYEE SIGNATURE: DATE: MANAGER/DIRECTOR/CAO SIGNATURE: KEEP ORIGINAL UNTIL RETURN. PROVIDE COPY TO PURCHASING WITH REQUISITIONS. 1. Use this form to obtain prior approval for travel payments paid to the employee and/or vendor. 2. Type and get authorized signature(s) then forward it with substantiating documentation to the Purchasing Office. Save Print 0.00 0.00 ---PAGE BREAK--- Ogden City Travel Reconciliation- Step 3 TRAVEL RECONCILIATION DESCRIPTION ADVANCE PAYMENTS PAID TO EMPLOYEE OR VENDOR ACTUAL COSTS* DIFFERENCE REIMBURSE CITY OR EMPLOYEE PER DIEM PRIVATE VEHICLE AIR TRAVEL/BAGGAGE REGISTRATION LODGING RENTAL VEHICLE OTHER OTHER OTHER OTHER TOTALS: DOCUMENT CHECKLIST: Please attach the following items when applicable. Agenda Per Diem Printout Air Travel Confirmation Map or Odometer Reading Hotel Confirmation This is a true and correct accounting of my travel: Employee Name Employee Signature ADDITIONAL AUTHORIZATION (only required if there are total additional costs over $50 to be paid to vendor or employee) Signature Title Division Manager, Department Head, CAO, Mayor, or Council Executive *Receipts must be attached for all items claimed in this column, except per diem. Any item under $20.00 may be itemized on a log if receipts were not obtained. THIS FORM IS DESIGNED TO COMPLY WITH OGDEN CITY’S POLICY ON TRAVEL REIMBURSEMENT, WHICH WAS WRITTEN TO COMPLY WITH INTERNAL REVENUE SERVICE REQUIREMENTS. IF YOU ARE NOT FAMILIAR WITH IT, OBTAIN A COPY OF THE CITY POLICY BEFORE APPLYING FOR TRAVEL REIMBURSEMENT. 1. Use this form after your travel to reconcile differences between previous payments and new travel costs. 2. Type and get authorized signature(s) then forward it with substantiating documentation to the Purchasing Office. 3. Please submit within 10 days of return. Save Print 0.00 Emp 0.00 0.00 Emp 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ---PAGE BREAK--- Travel Flow Chart Submit to supervisor Submit to Purchasing Scan to R Drive: • Travel Authorization • Payment Request • Supporting Documents Receive Items Submit to Purchasing within 10 days of travel Even if amount owed is zero Travel Authorization Payment Request Requisition Purchase Order Travel Reconciliation