HomeMy WebLinkAboutOut of State Travel Request - Renew (002)k\
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: Sarah Nelson
CONTACT PERSON ATTENDING ROUNDTABLE: Dell Anderson
CONFIDENTIAL INFORMATION: ❑YES ® NO
DATE: 11 /8/23
PHONE:509-765-9239
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® Out of State Travel
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Out of State Travel request for Brian Gwinn to attend NDCl Practitioner Training
in Oklahoma
• 11 11 • 4 D 0 � - 1- 1#0 01
DATE OF ACTION:
APPROVE: DENIED ABSTAIN
D1: A�Q
D2:
D3:
DEFERRED OR CONTINUED TO:
' tct:IVED
TRAVEL ALLOWANCE CLAIM
COUNTY AUDITOR
GRANT COUNTY, WASHINGTON
Claimant: BRIAN D G'WINN Claimant's Dept,X [DISTRICT COURT
Purpose of Traveh JUDICIAL TRAINING Destination, [OKLAHOMA CITY, Q
MEALS
DATE EE,.
RATE
I the undersigned, do hereby certify under penalty of perjury tlat the
1E
11/27/2
0.00
am authorized to certify,to said claim
$0.655$46,64
11/28/2023 $10.04
6400
$25.000'
$0.00
11/29/2023 $10...,00
$.46.00
$25.00
$13.00..
11/30/2023 $10.00
$16,00
$25.01.0
3.00
x'20 ;$1: ,00
$16,00
$25.04
$13.00
1 /2,/12023 .$7.54
$12,00
$18.75
$9.75
TOTAL
$64,00
$64,00
CERTIFICATION
RATE
I the undersigned, do hereby certify under penalty of perjury tlat the
71..:20.
claim is a just, due and unpaid, obligation affair : theouktt I
0.00
am authorized to certify,to said claim
$0.655$46,64
Claimant Signature.
$0.00
'0 TRAVEL VERIFICATION
.
I
r
I
r Cr
i
r.
I, the andersigned, da hereby certify under penalt�r ofper ju, ry that the
r
,planned travel referenced on this form: did, in fact, occur on, and for the
Iduration of the dates provided on this form. Additionally, l attest that
�
l,the allowance provided prior to travel was rightfully cawed. to e as a
result ofthis travel.
r
JClaimant Name,
r.
Claimant Signature:
r
Irate;
IYLIYYW YWdYini1 ..1 ...
r.I IY
0-7epartrnents maintain, a this ford. The
shall copy of travel verification
section must be completed, on the Department's ccs upon the
p' pY� .
1 employee's return from travel, The department shall retain the full,
,completed copy for six years or in accordance with. the Washington Stater
Records Retention Schedule �C�S�2e 011-184 Rev. 3 ,
, &-.#MW W.,NW.W,A0W 1 r.MW.oT. ....�......�-.�, .�L�E .SIE -"W-N "-..W.0W' 4.W.WANW.WA
MILES
RATE
TOTAL
71..:20.
$0.655
0.00
7120
$0.655$46,64
$0.655
$0.00
*TOTAL REIMBURSEMENT CLADE $445027
*Amount may be differentdue to rounoding'
Authorization required for the County Auditor, Department Heads, meals expenses
outside of travel status, and out of stag travels
COUNTY COMMISSIONERS
Commissioner '
Commissioner Ji J."
Chairman. BOCC:
Date; I— 13 - OAOC43'
$0.655
0.655..
0.00
TOTAL
$93,217
*TOTAL REIMBURSEMENT CLADE $445027
*Amount may be differentdue to rounoding'
Authorization required for the County Auditor, Department Heads, meals expenses
outside of travel status, and out of stag travels
COUNTY COMMISSIONERS
Commissioner '
Commissioner Ji J."
Chairman. BOCC:
Date; I— 13 - OAOC43'
Amyl. Paynt.,
. ....... ..
From
Amy L. Paynter
Dept/Com,mittee
Sent:
Thursday, August 31, 2023 2:57 PM
.5/8/2023
`ftp:
Tina M. Steinmetz
Departure Date
Cc:
Dell A. Anderson; Brian D. Gwinn
12/2/2023 6,00 PM
Subject
APPROVED OUT OF STATE TRAVEL REQUEST
APPLICATION
Trac k*in g:
Re- cipient
Delivery
State)
Tina M.. Stei'llimetz
Delivered: 8/31/2023 2:57 PM
Attend NDCl Practitioner Training
Dell A, Anderson
Delivered,. 8/31/2,023 2:57 PM
Brian D. Gw*inn
Delivered- 8/31/2023 2:57 PM
From: nore4plv@civicolus.com < Y_ P -
nore 1. @cI Vi,c, [us C0M>
Sent: Monday, May 8, 202311N-02 AM
To-, Amy L. Paynter < >
Subject: Online Form Submittal., OUT OF STATE TRAVEL REQUEST APPLICATION
OUT OF STATE TRAVEL REQUEST APPLICATION
Traveler's Name
BRIAN GWINN
Dept/Com,mittee
DISTRICT COURT
Date of Request
.5/8/2023
'Travel Type
Out of State Travel
Departure Date
11127/2023 6* -00 AM
Return Date
12/2/2023 6,00 PM
Grant
Yes
Fund,/Dept
001, 1 02.00.904/ s5
Destination (City, County,
OKLAHOMA CITY, OOKLAHOMA COUNTY, O- K,
State)
Purpose of Travel
Attend NDCl Practitioner Training
Hotel - GSA Rate 104
I
Hotel - Nightly Rate
102
Cost Application
Government Rate
Rental Car Required
Yes
Hotel Total
700
Conference Fee
850
Daily M&IE at Destination
64
Rental Car Cost per day
150
Explanation for Rate
Potential for extra night accommodation at non-governmental
(required if hotel cost is
rate if flights not available (to and/or from destination), lodgiIng
t
greater thm
an per die, or
cannot be booked until registration is accepted/confirmed
government rate)
Air Carver
Alaska
Cost of Flight
900
Total trip cost (Include all
3300
cost total)
Preparer's Narne
AMY L PAYNTER
Prelparerts Title
PROGRAM COORDINATOR
Preapproved by E0/DH?
Yes
Use of travel card to. fill a rental vehicle gas tank prior to its return is recommended.
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