HomeMy WebLinkAboutOut of State Travel Request - New Hope DV/SAGRANT COUNTY
COMMISSIONERS AGENDA MEETING REQUEST FORM
(Must be submitted to the Clerk of the Board by 12.00pm on Thursday)
REQUESTING DEPARTMENT: New Hope
REQUEST SUBMITTED BY:SUZI FOCI@
CONTACT PERSON ATTENDING ROUNDTABLE: Suzi FOCI@
CONFIDENTIAL INFORMATION: ❑YES ONO
DATE:3.4.2025
PHONE:764-8402
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F
Out of state travel permission request for New Hope staff: Ana Rivera, Tara Dieng and
Paola Gil. Travel is for the End Violence Against Women International Conference April 21-25
in Anaheim California. Training is a requirement of the STOP grant. Total cost is $1,846
per person.
If necessary, was this document reviewed by accounting? ❑ YES ❑ NO *1 N/A
If necessary, was this document reviewed by legal? ❑ YES ❑ NO 0 N/A
DATE OF ACTION: J DEFERRED OR CONTINUED TO:
APPROVE: DENIED ABSTAIN
D1::
D2: Rt�tq
D3:
WITHDRAWN:
RECEIVED
F E B 21 2025
4/23/24 GRANT COUNTY COMMISSIONERS
OUT OF STATE TRAVEL REQUEST APPLICATION
Traveler's Name* Dept/Committee* Date of Request* Travel Type*
Ana Rivera New Hope 2/19/2025 Out of State Travel v
Departure Date* Return Date* Grant* Fund/Dept*
E4/21/:2025 4/25/2025 Yes New Hope
08:00 AM 06:00 PM
0:0:) 0 :0!
Destination (City, County, State)* Purpose of Travel*
- --- -- ------- -
Anahiem, CA Attending the EVAW1 Conference to meet training
reduirements
Hotel - GSA Rate* Hotel - Nightly Rate* Cost Application* Rental Car Required
191.00 191.00 Government Rate Y No
Hotel Total* Conference Fee* Daily MME at Rental Car Cost per day*
764.00 695.00 Destination* 0.00
387.00
Explanation for Rate (required if hotel cost is greater than per diem, or government rate)*
N/A
Air Carrier* Cost of Flight* Total trip cost (Include all cost totals)*
Delta 339.00 1846.00
Preparer's Name*
Preparer's Title*
Lead Advocate
Preapproved by EO/DH?* Use of travel card to fill a rental vehicle gas tank prior
Yes IV to its return is recommended.
OUT OF STATE TRAVEL REQUEST APPLICATION
Traveler's Name* Dept/Committee* Date of Request* Travel Type*
Tara Dieng New Hope 2 E/1 9 :/2 (0 2 5 Out of State Travel v
Departure Date* Return Date* Grant* Fund/Dept*
4/21/20-5 1 4/25/2025 Yes
New Hope
08:00 AM E06: 0 :OFP M
Destination (City, County, State)* Purpose of Travel*
Anahiem, CA Attending the EVAWl Conference to meet training
reduirements
Hotel - GSA Rate* Hotel - Nightly Rate* Cost Application* Rental Car Required
191.00 191.00 Government Rate No
Hotel Total* Conference Fee* Daily M&IE at Rental Car Cost per day*
764.00 695.00 Destination* 0.00
-------------------------------
387.00
Explanation for Rate (required if hotel cost is treater than per diem, or government rate)*
t!5
N/A
Air Carrier* Cost of Flight* Total trip cost (Include all cost totals)*
Delta 339.00 1846.00
Preparer's Name*
Preparer's Title*
Lead Advocate
Preapproved by EO/DH?* Use of travel card to fill a rental vehicle gas tank prior
Yes V to its return is recommended.
OUT OF STATE TRAVEL REQUEST APPLICATION
Traveler's Name* Dept/Committee* Date of Request* Travel Type*
----- - -- ----- - ---- ------ ------------ -----
- Paola --- Gil N - ew ---- H - ope 2 E/1 9 :/2:(0 2 5 Out of State Travel v
Departure Date* Return Date* Grant* Fund/Dept*
-------- ---------------------
/20%j Yes 4/25/2025 New Hope
E4/21E: 1 1
E08:00 AM 06:00 PM
0:0:) E - 0:01 1
Destination (City, County, State)* Purpose of Travel*
Anahiem, CA Attending the EVAW1 Conference to meet training
reduirements
Hotel - GSA Rate* Hotel -.Nightly Rate* Cost Application* Rental Car Required
191.00 191.00 Government Rate V No
Hotel Total* Conference Fee* Daily MME at Rental Car Cost per day*
Destination*
764.00 695.00 A50B09&&05§6So6o*6**o*o 0.00
387.00
Explanation for Rate (required if hotel cost is greater than per diem, or government rate)*
N/A
Air Carrier* Cost of Flight* Total trip cost (Include all cost totals)*
--- — ---- - - ----
Delta 339.00 1846.00
Preparer's Name*
Preparer's Title*
Lead Advocate
Preapproved by EO/DH?* Use of travel card to fill a rental vehicle gas tank prior
Yes Y to its return is recommended.