Appendix D
CITY OF SOUTH SAN FRANCISCO
CITY COUNCIL EXPENSE REIMBURSEMENT
Rev. 2/26
NAME
DATE DESCRIPTION AMOUNT PURCHASED
ON CITY
CARD? (Y/N)
A) TOTAL SPENT: ___________________
MONTHLY MILEAGE REPORT
MONTH/YEAR
DATE EVENT DESCRIPTION MILES
* REIMBURSEMENT RATE (.725 per mile, eff. 01/26-12/26): B) TOTAL MILES: _______________ Submitted by: Date:
AMOUNT OF CLAIM (A PLUS B): __________________
Approved By: __________________________ Date: ____________ City Manager