HomeMy WebLinkAboutOfcr. R. Weber - Officer Iinjury Mileage Reimbursement - 2/2-10/2021 FINANCE DEPT. STAFF ONLY
LINE ITEM USED 010-11-1100-1340 s
TRAVEL REQUEST Fy 2021 BUDGETED $7.0496:80 .3 &1746011
CITY OF WATERLOO EXPENDED YTD $22-5�
THIS REQUEST $17.9132 /a 3
LEFT AFTER THIS �k
REQUEST ��B t�30 o/
DATE 2/22/21 �,J 23�f
Original-Clerk/Finance Copy-Department
NAME(S) AND POSITION(S): DATE:
Officer Rhonda Weber 2/22/2021
NAME OF CLASS /MEETING: DESTINATION:
Cedar Rapids, la.
Officer Injury Mileage Reimbursement DEPARTURE POINT
IF NOT WATERLOO:
DEPARTURE DATE: RETURN DATE: DATE(S) OF MEETING:
2/2/21 2/10/21 2/2-10/21
PURPOSE OF TRAVELITRAINING:
Capt. Mohlis is requesting Mileage reimbursement for Officer Weber. Officer Weber was involved in an on duty
accident that caused her to travel to Cedar Rapids for a medical consult on 2/2/21 and 2/10/21. Officer Weber traveled miles
at the government rate of$.56 per mile each trip. This request will not exceed $123.87.
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL: X COST $
YES NO
METHOD OF TRAVEL:
XXXXX CITY VEHICLE PRIVATE VEHICLE
AIRFARE DEPARTING FROM: Waterloo PD
ESTIMATE OF COST: BUDGET LINE ITEM:
0.00 LODGING TAXI X GRANT REIMBURSABLE
0.00 MEALS PARKING YES NO
0.00 REGISTRATION AIRFARE X REQUIRED CERTIFICATION
123.87 MILEAGE/FUEL MISC/TOLLS YES NO
TOTAL FOR ALL: $ 123.87 TOTAL: $ 123.87 PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE I APPROVE THIS TRAVEL REQUEST
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WATERLOO
Capt. Dave Mohlis
DEPARTMENT HEAD MAYOR
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2/22/21 LLC�L
DATE DATE
K:\Shared Goodies\Forms\Travel Request Form January 2010