Travel Authorization & Expense Reporting Form
Immediate Supervisor Signature
Part | - Travel Authorization
Name: Edward Delgado Purpose of Trip: League of Cal Cities - Public Safety Committee Out of State?
Job Title: Councilmember Destination: 1400 J St, Sacramento, CA 95814 Enter below the departing date and time then the return date and time. Per diem travel days will Division: City Council
automatically be calculated.
GL Org Set(s) % Split Departure Example:
1/22/25 12:30 PM 1/2/18 7:30 AM
1010-10-01-10012 100% Split Total Equals Date & Time:
Return 1/23/256:00 PM Example:
Date & Time: 1/2/18 5:30 PM
100%
CAL-Card?
Expense Type Account # Description of Expenses Amount & If Yes Registration: (620510) Cal Cities - Policy Registration Г Lodging : (620510) Hyatt Regency - Sacramento $624.63
Mileage: (620510) Miles: Rate: $0.67
Airfare: (620510) Southwest ONT - SMF $533.96 T
*Per Diem: (620510) Sacramento, CA $86 - Check be to dealine Per Total Travel Days (Enter # of Days) >>> 2 receipts must be submitted *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: $96.75 Г
Misc. Other: (620510)
Business Meals: (620510)
Division Manager Approval Date Total Anticipated Expenses: $1.255.34 City Manager Approval (as required) Date
X
Depa ment Head Approval Date
x 1/13/25
Part 11- 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 CAL-Card?
1010-10-01-10012-620610 $48.00 Г
ONT Airport Parkin, Huart Sac Services SMF Lel0 10-21-10012-620510 $80.74
1.2 1010-10-01-10012 $1.855,34
a true and accurate record of Signature
Dae/4/25 Ext.
Date Final Total Expenses: $1, 384.08
Division Manager Approval
City Manager Approval (as required) Date
X
eparment He Approval Date
× 214/25 x
Version 4.0
Owner:
1/8/2025
Per Diem Worksheet
Travel Destination: Sacramento, CA
(City, State)
Total Travel Days: (# or Days)
Per Diem Rate: $86.00
(Daily M&IE Rate)
Breakdown
Travel Days Rate
First Day L Check if you began travel after 12:00PM (Noon) $32.25 Travel Days $0.00
Last Day • 12:0/ (Nended travel before $64.50
Total Per Diem $96.75
1/8/25, 10:58 AM Purchase Confirmation | Southwest Airlines & Log In | Create account Español @
Southwest® FLIGHT | HOTEL | CAR | VACATIONS | CRUISES SPECIAL OFFERS RAPID REWARDS® Q Thanks for flying with us!
Trip summary
* Flight
CONFIRMATION #
213BTI
JAN 22 - 23
ONT + SMF
FLIGHT TOTAL
$438.95
1/22 - Sacramento
JAN 22 - 23
Ontario/LA, CA to Sacramento, CA
Confirmation # 213BTI
EST. POINTS EXTRAS O FARE
PASSENGERS
Edward Delgado + 3,800 PTS Anytime
Rapid Rewards® Acct # 22522485182
Anytime $189.93
Departing 1122/25 Wednesday
FLIGHT
DEPARTS 12:25 PM ONT 4198 9 + 0
Ontario/LA CA - ONT SCHEDULED AIRCRAFT
Boeing 737-700
Subject to change
Nonstop
TRAVEL TIME
ARRIVES 1:55 PM SMF 1hr 30min $ 189.93
Sacramento, CA - SMF
1/2
https://www.southwest.com/air/booking/confirmation.html 1/8/25, 10:58 AM Purchase Confirmation | Southwest Airlines Anytime $189.93
Returning 112325 Thursday
FLIGHT
DEPARTS 4:45 PM SMF 4900 ÷ + 9
Sacramento, CA- SMF SCHEDULED AIRCRAFT
Boeing 737-700
Subject ta change
Nonstop
TRAVEL TIME SUBTOTAL
ARRIVES 6:05 PM ONT thr 20mir $189.93
Ontario/LA, CA - ONT
Taxes & fees $59.09
Flight total $438.95
Icon legend
= WiFi available Live TV available EarlyBird Check-In
Helpful Information:
• Starting July 1. 2023(12:00 a.m. CT), for Wanna Get Away® or Wanna Get Away Plus" reward travel reservations (booked with points). If you do not cancel your reservation at least 10 minutes before the flight's original scheduled departure time, any points used for booking will be forfeited, along with any taxes and fees associated with your reward travel reservation. For Anytime or Business Select® reward travel reservations: the points used for booking will be redeposited to the purchaser's Rapid Rewards® account, and any taxes and fees associated with the reward travel reservation will be converled into a Transferable Flight Credit ™ for future use. • Please read the fare rules associated with this purchase. • When booking with Rapid Rewards points, your points balance may not immediately update in your account. • For more information regarding Cash + Points, visit Southwest.com/rderms • REAL ID Requirement: Do you have a REAL ID? Beginning May 7, 2025, you will need a state-issued REAL ID compliant license or identificalion card, or another acceptable form of ID (such as a U.S. Passport), to fly within the United States. Visit www.Isa.gov for a list of acceptable forms of ID and additional information regarding REAL ID requirement.
Payment summary
AMOUNT PAID
PAYMENT INFORMATION
CARD HOLDER BILLING ADDRESS
Visa 1014 Patrick Killior 25180 Santiago Dr
• VISA xXXXXXXXXXXX1014 $438.95
Moreno Valley, CA US 92551
Expiration: 8/27
Total charged
$379.86
SUBTOTAL
TAXES & FLES $59.09
TOTAL DOLLARS $438.95
Float he sag
212
https://www.southwest.com/air/booking/confirmation.html 1/8/25, 12:01 PM Hyatt | Reservation Confirmation
HYAIT
Thank you for choosing to stay with Hyatt Hotels & Resorts Confirmation: 27568443
Hyatt Regency Sacramento
1209 L Street Sacramento, California, 95814 United States Tel: +1 916 443 1234
Reservation Summary
Check-in Wed, Jan 22, 2025 Rate
04:00 PM
Checkout Thu, Jan 23, 2025 Total Cash Per Room* $624.63 11:00 AM
Wed, Jan 22 $535.50
(1) 1 King Bed Subtotal $535.50
Room
2 Adults STID ASSESSMENT $5.36
Guest
CA TOURISM ASSES $1.04
Edward Delgado SAC TOURISM ASSE $18.47
Guest Details
[email protected] OCCUPANCY TAX $64.26
25180 Santiago Dr
Moreno Valley, CA 92551 US Taxes & Fees $89.13
(951) 413-3008
*Changes in taxes or fees will affect the total price.
Payment Details Visa xxxx1014
8/2027
Special Requests
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https://www.hyatt.com/en-US/book/confirm/hHpW7NXNIvUcJfBq4S%2BYowZPxQHTLengNSizU%2FrBGR1FxUkcRaMX%2FCZe6MERPq0aCVylaXC 1/14/25, 10:14 AM Change Confirmation | Southwest Airlines ¿ Log in | Create account Español *
Southwest'® FLIGHT | HOTEL | CAR | VACATIONS | CRUISES SPECIAL OFFERS RAPID REWARDS® i Q Change flight: Step 5 of 5
Change Select flights Price Review Confirmation
© Your change is complete! No need to call to confirm.
We're sending you a confirmation email to the address below. If the email hasn't arrived in 2 minutes, check your junk or spam folder. [email protected]
Trip summary
* Flight
CONFIRMATION #
213BTI
DEPART
1/22 ONT SMF
Wednesday 6:05 PM 7:35 PM
RETURN
1/23 SMF ONT
Thursday 4:45 PM 6:05 PM
PASSENGERS
Edward Delgado
See more passenger details >
AMOUNT PAID
$95.01 There was no fee to change
your flight today.
See more flight details It's our way of saying thank you...today, and everyday. 1/22 - Sacramento
JAN 22 - 23
Ontario/LA, CA to Sacramento, CA
Confirmation # 213BTI
PASSENGERS EXTRAS O FARE
Edward Delgado Anytime
Rapid Rewards Acct # 22522485182
Icon legend
https://www.southwest.com/air/change/confirmation.html 1/2 1/14/25, 10:14 AM Change Confirmation | Southwest Airlines Anytime
Departing 1/22/25 Wednesday (Passenger x1)
6:05 pM ONT FLIGHT
DEPARTS 46207 + 9
Ontario/LA, CA - ONT
Nonstop
SMF TRAVEL TIME
ARRIVES 7:35 PM 1hr 30min
Sacramento, CA - SMF
Anytime
Returning 1/23125 Thursday (Passenger x1)
FLIGHT
DEPARTS 4:45pM SMF 4900 - + 0
Sacramento, CA - SMF
Nonstop
6:05 PM ONT TRAVEL TIME
ARRIVES 1hr 20min
Ontario/LA, CA - ONT
= WiFi available Live TV avallable 1* EarlyBird Check-In® Helpful Information:
• Starting July 1, 2023 (12:00 a.m. CT), for Wanna Get Away® or Wanna Get Away Plus™ reward travel reservations (booked with points): If you do not cancel your reservation at least 10 minutes before the flight's original scheduled departure time, any points used for booking will be forfeited, along with any taxes and fees associated with your reward travel reservation. For Anytime or Business Select® reward travel reservations: the points used for booking will be redeposited to the purchaser's Rapid Rewards® account, and any taxes and fees associated with the reward travel reservation will be converted into a Transferable Flight Credit ™ for future use. • Please read the fare rules associated with this purchase. • When booking with Rapid Rewards points, your points balance may not immediately update in your account. • For more information regarding Cash + Points, visit Southwest.com/rrterms • REAL ID Requirement: Do you have a REAL ID? Beginning May 7, 2025, you will need a state-issued REAL ID compliant license or identification card, or another acceptable form of ID (such as a U.S. Passport), to fly within the United States. Visit www.tsa, gov for a list of acceptable forms of 1D and additional information regarding REAL ID requirement.
Pricing & funds summary
Visa 1014 CARD HOLDER BILLING ADDRESS
VISA XXXXXXXXXXXX1014 Patrick Killion 25180 Santiago Dr Moreno Valley, CA US 92551 $95.01
Expiration: 8/27
$95.01
TOTAL PAID
Government taxes & fees included.
https://www.southwest.com/air/change/confirmation.html 212 Edward A. Delgado
From: Yellow Cab of Sacramento <[email protected]> Sent: Friday, January 24, 2025 9:03 AM
To: Edward A. Delgado
Subject: Thank you for booking with Yellow Cab of Sacramento You don't often get email from [email protected]. Learn why this is important Warning: External Email - Watch for Email Red Flags!
Thank you for booking with Yellow Cab of Sacramento, please find your receipt below. If you have any questions in relation to your booking, please call us on 9164442222.
Booking Reference 7087132A
Passenger Guest
Passenger Phone 009164442222
Account Mastercard
Pickup 1209 L Street, Sacramento, 95814
Destination 6851 Lindbergh Dr, Sacramento, Ca 95837,
Usa
CO2 Emission 4,578g
Trip Distance 11.33MI
Driver Number 6494
Vehicle Toyota Rav 4, License: 25200L2
Pickup Date Thu 23rd Jan 2025 13:48
Your driver arrived 13:56
Journey Start 14:00
Journey End 14:14
Payment USD Credit Card
Price $37.00
Tip $5.64
Tolls $0.00
Extras $0.00
Waiting $0.60
Service Charge $0.00
Total $43.24
Your transactions are detailed below.
Date Amount Reference
Thu 23rd Jan 2025 14:14 $37.60
1 Thu 23rd Jan 2025 14:15 $43.24 390931
Your booking route is available below
Ri
307
E14
Socramenta
internationa 307
Airport
306
5284528
ISB
sment
9 QN 2
-89% 89
88 86
86 TA
468 *47Am
46A
STOB.
West Sacramento Sacra into
118 3
Midtown 7B
4*519A Fact S.
Yellow Cab of Sacramento, 9229 Beatty Drive Suite B, Sacramento, 95826 2 AIRPORT PRE
Ontario International Airport
Authority
Lot 4
H0442501201001
Receipt Number 410136209
Ticket-Ni:
01/22/2025 16:26
In: 01/23/2025 18.23
Out: 1,01:57
Duralion:
$ 48.00
Transient Parker
$ 48.00
Total:
$ 0.00
Validalions:
$ 48.00
Balance Due:
$ 48.00
Credi-Card
$ 0.00
Change:
--ORIGINAL--
SACRAMENTO INDEP
0093
DRIVER: 3727124
CUSTOMER COPY
01/22/25 TR 3425
START END MILES
19:32 19:48 12.5
DOWNTOWN
RATE 3:$ 35.00
SMFFEE:$ 2.50
SURCH: $
---STSRCH:$
TOTAL: S
CARD TYPE: MAST
XXXXXXXXXX1753
AUTH: 320164
THANKS
TO CONTACT SITOA
916-444-0008