HomeMy WebLinkAbout*Other - AccountingEXPENSE REIMBURSEMENT CLAIM
COUNTY AUDITOR
GRANT COUNTY, WASHINGTON
Claimant: Tracy Williams
J Claimant's Dept.: [��eriff s Office
Purpose of Claim: -n Pants Destination:
------------
MEALS
DATE
BF L
D
1E
TOTAL
$0.58 $0.00
Si
D:
$0.58
a...
L *y ...
o 2 0
$0.58 $0.00
- ---------
$0.00
Grant County, W. ashington.
$0.58 $0.00
$0.00
C1
Approve
Dib. Abstain
$0.00
0
Dist#1 .
..... Dis"t #' I Dist
$0,00
TOTAL �_ $0.00 J
MII,FAr,F
-------------
DATE FROM (CITY, ST)
TO (ctTy,, sT)
MILES RATE TOTAL
- -- ----------
$0.58 $0.00
Si
D:
$0.58
a...
L *y ...
o 2 0
$0.58 $0.00
- ---------
$0.58, $0,00
Grant County, W. ashington.
$0.58 $0.00
HOTELS(receipLs required)
=CHECK-IN DATE CHECK-OUT DATE HOTEL NAME
OTHER (receipts required)
I DATE DESCRIPTION
7/9/2019 2 pairs of uniform palits
work
REASON FOR EXPENSE
TOTAL $0.00
LOCATION (COUNTY, ST) TOTAL
_A
LOCATION (COUNTYST) TOTAL
$81.09
TOTAL $81,09
------ - ----- TOTAL REIMBURSEMENT CLAIME $81.09
-- -- - -----
CERTIFICATION .......
Authorization required for Employees:
1, the undersigned, do hereby certify under penalty p of perjury that the ELECTED OFFICIAL, DEPARTMENT HEAD, OR DESIGNEE
claim is a. just, due and unpaid oblivation against the County; and that I
0
am auffiorized to certif`y to said claim.
Name (printed):
n 11 Signature, \1J
Claimant Sig at re: kN11- --- ------
Date:
Da.te,
— - - -------
Lite, uz A ect
vzkLct� C(
neals expenses
- -- ----------
Si
D:
Dated thisd
a...
L *y ...
o 2 0
Board of County Comm"ss*
t ioners
Ai
Grant County, W. ashington.
01
C1
Approve
Dib. Abstain
0
Dist#1 .
..... Dis"t #' I Dist
Dist 42
L_
Dist"# 2 Dist if 2
Z
Dist #3
Dist # 3C
Dist # 3yea
neals expenses