HomeMy WebLinkAboutTR_-_Paramedics Docusign Envelope ID:3A802D90-6FA4-4492-A9C1-1570DC611199 I FINANCE DEPT. STAFF ONLY
LINE ITEM USED 010-12-1410-1315
TRAVEL REQUEST FY 25 BUDGETED $40,500.00
CITY OF WATERLOO EXPENDED YTD $28,332.76
THI5 REQUEST $1,600.00
LEFT AFTER THIS
REQUEST $10,567.24
DATE 05/21/2025
Original-Clerk/Finance Copy- Department
NAME(S) AND POSITION(S): DATE:
Kaiden Peverill, FF/Paramedic,Austin Fortsch, FF/Paramedic May 21, 2025
Jacob Helgeson, FF/Paramedic, Grant Irvine, FF/Paramedic
NAME OF CLASS/ MEETING: DESTINATION: Hawkeye + Online
Critical Care Paramedic Provider Hybrid DEPARTURE POINT
IF NOT WATERLOO:
DEPARTURE DATE: RETURN DATE: DATE(S) OF MEETING:
June 2nd through July 28th, 2025
PURPOSE OF TRAVEL/TRAINING:
The Critical Care Paramedic (CCP) provider course will provide the baseline education required to
obtain the paramedic CCP endorsement. This endorsement expands the scope of practice
This is very beneficial when caring for the critically ill during long distance transports.
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL: X COST $
YES NO
METHOD OF TRAVEL:
X CITY VEHICLE PRIVATE VEHICLE
AIRFARE DEPARTING FROM:
ESTIMATE OF COST: BUDGET LINE ITEM:
LODGING TAXI X GRANT REIMBURSABLE
MEALS PARKING YES NO
$400.00 REGISTRATION AIRFARE X REQUIRED CERTIFICATION
MILEAGE/FUEL MISC/TOLLS YES NO
TOTAL FOR ALL: $ 1600.00 TOTAL: $ 400.00 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
Jason Hernandez, Medical Supervisor 6/2/2025
DEPARTMENT HEAD X11KAi;1 GRX
gned by:
May 21, 2025 F;,
u;ArW1ood
DATE
DA5F48A
X
K:\Shared Goodies\Forms\Travel Request Form January 2010