Travel Authorization & Expense Reporting Form
each payment expense submitted. Upon returning from travel, complete Part Il of this form to confirm total expenses including any approved adjustments instructions: Enor to any travel, complete Part of this form to have travel and anticipated expenses approved. Submit a copy of this approved form with Submit form to Accounts Payable within 15 days of the travel end date. Always use the most up-to-date Travel Form located on the City's Intranet Employee Signature Immediate Supervisor Signature
Part | - Travel Authorization
X
Name: Cheylynda Barnard Purpose of Trip: League of California Cities 2024 Annual Conference Long Beach, CA Long Beach Convention Cent Out of State? Job Title: Mayor Pro Tem Destination:
Enter below the departing date and time then the retur date and time. Per diem travel days will Division: City Council automatically be calculated
GL Org Sets) % Split Departure 10/16/24 10:00 AM
1010-10-01-10014 100% Split Total Equals Date & Time:
Return Example:
10/18/24 12:30 PM 1/2/185:30 PM
100% Date & Time:
CAL-Card?
Account # Description of Expenses Amount
Expense Type
Registration: (620510) Cal Cities Registration Fee - Early Bird $650.00 Lodging : (620510) Inn at 50 $596.52
Mileage: (620510) Miles: 33.6 Rate: $0.67 $22.51
Airfare: (620510)
*Per Diem: (620510) Long Beach, CA $86 Check box to decline Pe Total Travel Days (Enter # of Days) >>> 3
*To receive per diem, travel must include an overnight stay. Total Per Per diem on first and last day are to be calculated at 75% of daily per diem rate. Diem: $25.00 Misc. Other: (620510)
Business Meals: (620510)
Division Manager Approval Total Anticipated Expenses: $1,484.03 Ill baret Date
x City Manager Approval (as required)
Date
Dopartmeng Head Approval
Part I| - Expense Reporting (Please check the appropriate box below and provide details) No adjustments are necessary. Anticipated expenses match actual expenses incurred.
Advance payments exceeded the actual expenses incurred. Attached is my receipt as evidence of reimbursement to the City. (Explain below, use negative numbers Actual expenses exceeded the anticipated original request. Additional funds are required as listed below.
Expenditure Code Amount CAL-Card?
Expense Details
010-10-0-1004 36.29 Г
Uher Reciepts 10.17.24
-- - 7010-1501 5014 31.520.32-
Post-Trip
I certity that this document is Employee GL Org Set
a true and accurate record of Signature: X Split Totals:
travel expenses for official
Date: 10/30/24(Ext.
City business. .--
Date Final Total Expenses: $1,520.32
Division Manager Approval
× 10/31/2024 City Manager Approval (as required) Date
Date
Depargeng Head Approval
- x 10/31/2024 x
Version 4.0
Owner Floa
7/11/2024
Per Diem Worksheet
Travel Destination: Long Beach, CA
(City, State)
Total Travel Days: 3
(# of Days)
Per Diem Rate: $86.00
(Daily M&lE Rate)
Breakdown
Travel Days Rate
irst Day ~ Check if you began travel aft $64.50
- 12:00PM (Noor
Travel Days $86.00
Last Day • Check if you ended travel before $64.50
12:00PM (Noon)
Total Per Diem $215.00
Uber October 16. 2024
Thanks for tipping, Cheylynda
Here's your updated Wednesday evening ride receipt.
Total $17.93
Trip fare $693
Subtotal $6.93
Booking Fee $5.11
CA Driver Benefits S0.79
Access for All Fee SO.10
Tip $5.00
Payments
Visa *•-•3242 $17.93
10/16/247:31 PM
Visit the trip page for more information, including invoices (where available) You rode with Gihan
UberXL 0.60 miles | 5
min
7:10 PM | 50 Allantic Ave, Long Beach, CA 90802, US
7:15 PM | 101 Pine Ave. Long Beach, CA 90802-4415, US
Fare does not include fees that may be charged by your bank. Please contact your bank directly for inquiries.
Uber October 16. 2024
Thanks for tipping, Cheylynda
Here's your updated Wednesday evening ride receipt.
Total $18.36
Trip fare $6.93
Subtotal $6.93
Booking Fee $5.11
Wail Time $0.43
Access for All Fee S0.10
CA Driver Benefits $0.79
Tip $5.00
Payments
Visa •...3242 $18.36
10/16/249:25 PM
Visit the trip page for more information, including invoices (where available) You rode with ESTEBAN
We 0.60 miles 15
9:06 PM| 101 Pine Ave, Long Beach, CA 90802-4415. US
9:11 PM | 50 Atlantic Ave, Long Beach, CA 90802, US
Fare does not include fees that may be charged by your bank. Please contact your bank directly for inquiries.
Thank you for your purchase!
Order SC-C-971342-IBZMJ
Date of purchase: 7/11/2024
Payment: Credit Card **** 1014
Bill To: Killion, Patrick
Gift Card: -
PO#:
Bill To Address
Patrick Killion
14177 Frederick St
Moreno Valley, CA 92553-9014
INV-19718-W8G9C6
a) Early Bird Full Conference - Member City Officials & City Staff - Barnard, Cheylynda Price per unit
$650.00
Quantity
1 Discount
$0.00
Taxes
$0.00
Charges
$650.00
Total Charges $650.00
Sales Tax $0.00
Order Total $650.00
Gift Card $0.00
Previous Payments $0.00
Payment $650.00
Balance Due $0.00
1/2
Patrick Killion
From: [email protected]
Sent: Monday, June 24, 2024 3:10 PM
To: City Clerk; [email protected]
Subject: Booking confirmation for INN AT 50 LONG BEACH CONVENTION CENTER Jun 24, 2024 Some people who received this message don't often get email from [email protected]. Learn why this is important Warning: External Email - Watch for Email Red Flags!
Confirmation Letter
Confirmation No # 0342ACN667
Phone 5624358369
LINN AT 50 LONG BEACH CONVENTION CENTER Email [email protected] 50 Atlantic Ave, Long Beach CA US - 90802 Website http://www.innat50.com Guest Details
Guest Name Cheylynda Barnard Contact +19514133008
Stay Details
Check In Date Oct 16, 2024 Number Of Nights 2
Check Out Date Oct 18, 2024 Check In Time Oct 16, 2024
Guests 1
Room Type Details
Room Type 1 QUEEN BED NON SMOKING Max Occupancy 2
Description
Reservation Details
Estimated
Date Charge Rate Estimated Estimated Estimated
Nights Per Night
Range Type Type Rate Tax Total
Total
1 BEST
Oct 16, 2024 $83.52 $596.52
2 AVAILABLE $513.00 $298.26
- Oct 17, 2024 ROOM RENT
RATE
Reservation Summary
Type Amount
RR $596.52
other $0.00
Total $596.52
Min Amount To Collect $0.00
Cancellation Policy
You may cancel free of charge until 2 days before arrival. You will be charged the total price of the reservation if you cancel in the 2 days before arrival.
General Policy
Your reservation has been confirmed for the above-listed dates and is guaranteed for arrival by your CREDIT CARD. You may cancel free of charge until 2 days before arrival. You will be charged the total price of the reservation if you cancel in the 2 days before arrival.
In case of a no- show, By making a reservation with an accommodation provider, you accept and agree to the relevant cancellation and no-show policy of that accommodation provider, and to any additional (delivery) terms and conditions of the accommodation provider that may apply to your reservation or during your stay, including for services rendered and/or products offered by the accommodation provider (the delivery terms and conditions of an accommodation provider can be obtained with the relevant accommodation provider). The general cancellation and no-show policy of each accommodation provider is made available on our website on the accommodation information pages, during the reservation procedure and in the confirmation email. Late payment, wrong bank, debit or credit card details, invalid credit/debit cards or insufficient funds are for your own risk and account and you shall not be entitled to any refund of any (non-refundable) prepaid amount unless the accommodation agrees or allows otherwise under its (pre)payment and cancellation policy. If you wish to review, adjust or cancel your reservation, please revert to the confirmation email and follow the instructions therein. Please note that you may be charged for your cancellation in accordance with the accommodation provider's cancellation, (pre)payment and no-show policy or not be 2