HomeMy WebLinkAboutOut of State Travel Request - RenewGRANT 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: OYE,S RNO
. 00/28/24
DATE.
PHONE: (509) 765-9239
DAgreement / Con
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®Boards Committees
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0 Facilities Related 171171nandal 11 Funds
Cl Hearin
0 Invoices / Purchase Orders DGrants — Fed/State/County 1:1 Leases
EIMOA I MOO
0Minutes 1:1 Ordinances WOut of State Travel
El Petty Cash
n Policies M.Proclamations El Request for Purchase
DResolution
0 Recommendation ElProfessional Serv/Consultant ElSupport Letter
DSurplus Req.
EITax Levies EIThank You's DTax Title Property
FlWSLCB
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3MM
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Tina Steinmetz'' Behavioral Health Tech Conference - Phonei , AZ
Conference Dates: November 4-7, 2024 Estimated Cost' $3,869.02
Fun-d--Ing: 125.167.00.8001.568.14.xxxx (88%) 125.167.00.8004.568.14.xxxx (12%)
If necessary, was this document reviewed by accounting ?, 0 YES 0 NO R N/A
If necessary, was this document reviewed by legal.? 0 YES 0 NO W N/A
DATE OF ACTION-- 1 3, -z'
APPROVE: 'DENIED ABSTAIN
D1:
D2:
D3:
4/23124
DEFERRED OR. CONTINUED TO:
8/28/24o 4:17 PM
Grant County, WA
OUT OF STATE TRAVEL REQUEST APPLICATION
Traveler's Name*
Tina Steinmetz
Dept/Committee*
IYMWMYYIWY CL - Compliance
�wwf---
Date of Request* Travel Type*
E8/2:8j/2024 Out of State Travel
Departure Date* Return Date* Grant* Fund/Dept*
11/4/2024 11/8/2024 No DCL
E
03:00 AM 01:3:0 AMD
Destination (City, County, State)* Purpose of Travel*
Phoneix, AZ 2024 Behavioral Health Tech Conference
Hotel - GSA Rate*
$160
Hotel Total*
lHotel - Nightly Rate*
Cost Application*
Government Rate V
Conference Fee* Daily M&IE at
$540.34 $21500.00 I)estination*
$69.00
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)*
. .. ................ .
lHotel rate same as government rate.
Air Carrier* Cost of Flight* Total trip cost (include all cost totals)*
...... .........
. .........
American Airlines $267.00 $3,869.02
-Ile
Preparer's Name* Preparer"s Title*
Anna Serrano Accounting Technician
Preapproved by rDH?
Use of travel card to fill a rental vehicle gas tank prior to its
Yes
V
return is recommended,
https:llwww.grantcountywa.govIFormCenterlPrint?formlD=86&Preview=YES&Save=False&savedProgressID� 1/1
RECEIVED
FAA
STAFF NAME:. Tina. Steinmetz
[� TRAVEL REQUEST AUK 2 7 2024
RENEW
EMAIL ADDRESS: tsteinmetz@granteountywa.gov
NAME OF TRAINING: 2024 Behavioral Health Tech Conference
LOCATION: Phoenix, AZ
LOCATED IN WA STATE? ❑Yes 9No
DATES OF TRAINING: 111,05/2024 through 11/072024
DEPARTING DATE & TIME: 11/0412024 @ 12-00 p.-m,
RETURNING DATE & TIME: 11/07/2024 @ 11:00 p.m.
HOTEL NEEDED? EZ Yes [:]No
AIRFARE NEEDED? [Z Yes [:]No
FLIGHT PREFERENCES:
DATE: 08/20/2024
TRAVEL PURPOSE: Attend Conference
A,
REGISTRATION NEEDED? [oYes [:]No —Already Registered I will register myself
WHO WILL BE IMPACTED BYTHIS TRAINING?
OEmploye'e Team Members El Other Agency Staff QAII Agency Staff
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?)
This is an opportunity to participate and learn firsthand about making healthcare better and safer for people with
intellectual and/or developmental disabilties at• a conference focused on expanding access to mental health and
substance use care through technology, health equity, and innovation.
. I
NOT TO BE COMPLETED BY EMPLOYEE
MANAGER APPROVAL TO TAKE PERSONAL CAR: Manager initials
MANAGER APPROVAL (CIRCLE ON rc),:-YES S nd form to Leadership for further approval
Q—N ejraining is denied Manager initials A.
ESTIMATED COST:
Funding Source:
LEADERSHIP APPROVAL {CIRLCE ONE): MES NO
I ALS 12(ate
7/27/23