Travel Authorization & Expense Reporting Form
instructions: Prior to any travel, complete Part 1 of this form to have travel and anticipated expenses approved. Submit a copy of this approved form with each payment expense submitted. Upon returning from travel, complete Part I/ of this form to confirm total expenses including any approved adjustments 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
Name: Ulises Cabrera Purpose of Trip: 2025 Create Karma Event Out of State?
Job Title: Mayor Destination: 9950 Jeronimo Rd, Irvine, CA 92618 Г 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 Example.
3/20/255:00 PM 1/2/18 7:30 AM
1010-10-01-10015 100% Split Total Equals Date & Time:
Return Example:
3/21/25 12:30 PM 1/2/185:30 PM
100% Date & Time:
CAL-Card?
Expense Type Account # Description of Expenses Amount Elf Yes Registration: (620510)
Lodging : (620510) Residence Inn - Irvine Spectrum $341.35 Mileage: (620510) Miles: 8.4 Rate: $0.70 $5.88
Airfare: (620510)
-
*Per Diem: (620510) Irvine, CA $86
Total Travel Days (Enter # of Days) >>> 2 eceipts must be submitte "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 Misc. Other: (620510) Г
Business Meals: (620510)
Division Manager Approval Date Total Anticipated Expenses: $443.98 City Manager Approval (as required) Date
x
Department Head Approval Date
4/7125
X
Part II - 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.
Expense Details Expenditure Code Amount CAL-Card?
Post-Trip 1010-10-01-10015 $443.98
Employee
I certity that this document is I GL Org Set
a true and accurate record of Signature: X I Split Totals:
travel expenses for official
Cily business. Date: Ext.
Division Manager Approval Date Final Total Expenses: $443.98 City Manager Approval (as required) Date
Departmept Head Approval Date
41755
x
Owner: Finance Version 4.0
4/7/2025
Per Diem Worksheet
Travel Destination: Irvine, CA
(City, State)
Total Travel Days: 2
(# of Days)
Per Diem Rate: $86.00
(Daily M&lE Rate)
Breakdown
Travel Days Rate
First Day Check if you began travel after $32.25
12:00PM (Noon)
Travel Days $0.00
Last Day • Check if you ended travel before $64.50
12:00PM (Noon)
Total Per Diem $96.75
Residence IN.
BY MARRIOTT
Residence Inn® Irvine Spectrum
10 Morgan, Irvine, CA 92618 P 949.380.3000
Marriott.com/SNAIR
Ulises Cabrera Room: 1011
25180 Santiago Dr Room Type: STDO
Moreno Valley CA 92551 Number of Guests: 1
Leisure Rate: $299.00 Clerk: V
Arrive: 19Mar25 Time: 02:18AM Depart: 20Mar25 Time: 08:52AM Folio Number: 57995
DATE DESCRIPTION CHARGES CREDITS
19Mar25 Room Charge 299.00
19Mar25 Occupancy Sales Tax 23.92
19Mar25 Local Bid Fee 5.98
19Mar25 Calif/Local Tourism Fee 0.45
19Mar25 Daily Parking 12.00
20Mar25 Visa 341.35
Card #: VIXXXXXXXXXXXX1014/XXXx
Card Type: VISA Card Entry: MANUAL Approval Code: 003324 BALANCE: 0.00
As a Marriott Bonvoy Member, you could have earned points towards your free dream vacation today. Start earning points and Elite status, plus enjoy exclusive member offers. Enroll today at the front desk.
Thank You For Choosing The Residence Inn, Irvine Spectrum For Your Stay! We Hope You Enjoyed Your "home Away From Home". If There And Let us Thowtel Can Do To Make Your Next Stay With Us As Enjoyable And Relaxing As This One Was, Please Stop By The Front Desk See our "Privacy & Cookie Statement" on Marriott.com.
To plan your next stay, visit Residencelnn.com.
3/18/25, 4:32 PM 14177 Frederick Street, Moreno Valley, CA to Karma Automotive - Google Maps Google Maps 14177 Frederick St, Moreno Valley, CA Drive 54.2 miles, 1 hr 23 min 92553 to Karma Automotive, 9950 Jeronimo Rd, Irvine, CA 92618 Morterey Part
Los Ahgeles-
WHA LOMA
La Habea
La Mrade 14177 k
Cypress
Non Rood.
North Taste
Google
Map data ©2025 Google 2 miL
14177 Frederick St
Moreno Valley, CA 92553
Get on CA-91 W in Riverside from Alessandro Blvd and
Arlington Ave
19 min (8.8 mi)
T 1. Head southwest toward Calle San Juan De Los
Lagos
243ft
~ 2. Turn right onto Calle San Juan De Los Lagos
0.2 mi
• 3. Turn right onto Newhope St/Veterans Way
0.2 mi
* 4. Turn left onto Alessandro Blvd
6.1 mi
7 5. Use the left 2 lanes to turn left onto Arlington
Ave
2.1 mi
& 6. Use the 2nd from the left lane to turn left to
merge onto CA-91 W toward Corona
0.2 mi
https://www.google.com/maps/dir/14177+Frederick+Street,+Moreno+Valley,+CA/Karma+Automotive,+9950+Jeronimo+Rd,+Irvine, +CA+92618/@33.79... 1/2 3/18/25, 4:32 PM 14177 Frederick Street, Moreno Valley, CA to Karma Automotive - Google Maps Continue on CA-91 W. Take I-5 S to Enterprise Dr in
Irvine. Take exit 94 from 1-5 S
40 min (43.0 mi)
A 7. Merge onto CA-91 W
• Pass by AutoZone Auto Parts (on the left in 0.7
mi)
27.1 mi
Use the left 2 lanes to take exit 34 for CA-55 S
toward Newport Beach
0.5 mi
T 9. Continue onto CA-55 S
6.6 mi
/ 10. Use the right 2 lanes to take exit 11A to merge
onto I-5 S toward San Diego
8.7 mi
/ 11. Use the right lane to take exit 94 for Alton Pkwy
0.2 mi
Follow Alton Pkwy and Jeronimo Rd to your destination
5 min (2.4 mi)
* 12. Merge onto Enterprise Dr
387 ft
~ 13. Use the right 2 lanes to turn right onto Alton
Pkwy
1.8 mi
• 14. Turn right onto Jeronimo Rd
0.5 mi
~ 15. Turn right
102 ft
+ 16. Turn left
• Destination will be on the right
328 ft
Karma Automotive
https://www.google.com/maps/dir/14177+Frederick+Street,+Moreno+Valley,+CA/Karma+Automotive, +9950+ Jeronimo+Rd, +Irvine, +CA+92618/@33.79... 2/2