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HomeMy WebLinkAboutOut of State Travel Request - Renew (002)GRANT COUNTY COMMISSIONERS AGENDA MEETING REQUEST FORM (Must be submitted to the Clerk of the Board by 12:00pm on Thursday) REQUESTING DEPARTMENT: Renew REQUEST SUBMITTED BY:Anna Serrano CONTACT PERSON ATTENDING ROUNDTABLE, Dell Anderson CONFIDENTIAL INFORMATION: DYES NO DATE:8/28/24 PHONE:(509)765-9239 [oil OA.greement I Contract DAP Vouchers OAppointment / Reappointment DARPA Related 013ids / RFPs / Quotes Award OBid Opening Scheduled [Boards / Committees 013udget ElComputer Related OCounty Code OlEmergency Purchase DEmployee ReL E3 Facilities Related OFinanclal 017unds OHearing D Invoices / Purchase Orders OGrants — Fed/State/County ElLeases DMOA C MOU ©Minutes 0 Ordinances WOut of State Travel El Petty Cash 0 Po Ii cies 0 Proclamations ORequest for Purchase EIResolution 0 Recommendation OProfessional Serv/Consultant ElSupport Letter OSurplus Req. [--]Tax Levies ElThank You's E]Tax Title Property EIWSLCB 10 1.11, - ------- F --- -- ------ TC -- -- - --------- -- ----- -TeOn, cos ' e c. tNo* W Darc'l Alamos - 2024 Behavioral �Health Tech Conference - Phoneix, AZ Conference Dates: November 4-7, 2024 Estimated Cost: $.3,869..02 Funding: 108.150.00.0000.566.00.xxxx If necessary, was this document reviewed by accounting? 0 YES F-1 NO W N/A If necessary, was this document reviewed by legal? 0 YES 11 NO A N/A DATE OF ACTION: APPROVE. DENIED ABSTAIN DI: h�Q D2: D3: 4/23/24 DEFERRED OR CONTINUED TO: 8/28/24,4:16 PM Grant County, WA OUT OF STATE TRAVEL REQUEST APPLICATION Traveler"s Name* DarciAlamos ..' ...... ... .... -.0-00Y0.0 I - -1- Departure Date* 11/4/2024 . . . . . . . . . . . ---- ----- --- ----- 103:00 AM Dept/Corn mittee* SUIT -- Return Date* E1118/2024 i 1:82ai 01:30 AM Date of Request* 8/281 2024 8:) .......... - Grant* No Travel Type* Out of State Travel %1101. Fund/Dept* SUIT .......... Destination (City, County., State)* Purpose of Travel* Phoneix, AZ 2024 Behavioral Health Tech Conference .... ... ......... Hotel - GSA Rate* $160 Hote I Tota I* Hotel - Nightly Rate* $160 Cost Application* Government Rate V Conference Fee* Daily M&IE at $540.34 $2500.00 Destination* $69.00 ------ -- - Ile Rental Car Required No V Rental Car Cost per day* 0 Explanation for Rate (required if hotel cost is greater than per diem, or government rate)* . . .............. . Hotel rate same as government rate. Air Carrier* Cost of Flight* Total trip cost (include all cost totals)* American Airlines $267.00 $3,869.02 Preparervs Name* Preparer's Title* Anna Serrano Accounting Technician 4 Preapproved by E01DH? Yes %0 Use of travel card to fill a rental vehicle gas tank prior to its return is recommended. https:llwww.grantGOuntywa.gov]FormCenterlPrint?form[D=86&Proview=YE,9&Save=False&savedProgresslo= 111 RECEIVED TRAINING REQUEST ^"IW 0 TRAVEL REQUEb i STAFF NAME.- Dard Alamos DATE: 8/21/2024 NAME OF TRAINING: The Behavioral Health Tech Conference TRAVEL PURPOSE: NA LOCATION: Phoenix AZ LOCATED IN WA STATE? 0 Yes Z No DATES OF TRAINING: 11/5/24-11/7/24 DEPARTING DATE & TIME: NA 11/4/24 RETURNING DATE & TIME: NA 11/7/24 HOTEL NEEDED? 1ZYes E]No AIRFARE NEEDED? 0 Yes 11 No FLIGHT PREFERENCES: i.e. FlIght Times 10 REGISTRATION NEEDED? 0 Yes El No.https://events-behavioralhealthtech.com/2024/`­­­begin WHO WILL BE IMPACTED BY THIS TRAINING? N Employee NTeam Members ❑ Other Agency Staff DAII Agency staff AUG 2 2 2024 RENEW WHAT WILL YOU BE ABLE TO BRING BACK TO THE AGENCY? (What can you then train your team, other teams, agency leadership, and other groups on?) The 2024 Behavioral Health Tech (BHT2024) conference focuses on expanding access to mental health and substance use care through technology, health equity and innovation.. Attending this conference will provide me with the opportunity to gain knowledge on behavioral healthcare and technology and connect with other professionals for the purposes of advancing Renews services to provide better services to our clients and community partners. NOT TO BE COMPLETED BY EMPLOYEE MANAGER APPROVAL TO TAKE PERSONAL CAR: Manager init.ials, MANAGER APPROVAL (CIRCLE ONE) YES, end form to Leadership for further approval Training is denied Manager Initials ESTIMATED COST: LEADERSHIP APPROVAL (CIRLCE ONE) YES NO IN ITALS(__ T Date 2- 3/21/19