HomeMy WebLinkAboutTR_HarmonDocusign Envelope ID: DC93182E-EFC3-468E-9821-2C5F19E6OADB
FINANCE DEPT. STAFF ONLY
LINE ITEM USED 010-12-1410-1346
TRAVEL REQUEST
CITY OF WATERLOO
FY 26 BUDGETED $6000.00
EXPENDED YTD $451.23
THIS REQUEST $1845.00
LEFT AFTER THIS
REQUEST $3703.77
DATE September 11, 2025
Original - Clerk/Finance Copy - Department
NAME(S) AND POSITION(S):
Jeremiah Holt, FF/Paramedic
DATE:
September 11, 2025
NAME OF CLASS / MEETING:
EMS World Expo
DESTINATION: Indianapolis, IN
DEPARTURE POINT
IF NOT WATERLOO:
DEPARTURE DATE:
October 20, 2025
RETURN DATE:
October 24, 2025
DATE(S) OF MEETING:
October 21-24, 2025
PURPOSE OF TRAVEL/TRAINING:
This is a national Emergency Medical Services conference sponsored by the National Association of
EMT's. This conference will provide valuable updates on evidence based practice in prehospital
emergency care. This information will update continuing education topics for our paramedics & EMT's
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
X COST $
YES NO
METHOD OF TRAVEL:
X CITY VEHICLE
AIRFARE
DEPARTING FROM:
PRIVATE VEHICLE
ESTIMATE OF COST:
$800
$440
$445
LODGING
MEALS
REGISTRATION
MILEAGE/FUEL
$160
TOTAL FOR ALL: $ 1845.00
TAXI
PARKING
AIRFARE
MISC/TOLLS
BUDGET LINE ITEM: 010-12-1410 1346
X GRANT REIMBURSABLE
YES NO
X REQUIRED CERTIFICATION
YES NO
TOTAL: $ 1845.00 PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WATERLOO
DATE APPROVED BY FINANCE COMMITTEE:
Jason Hernandez, Medical Supervisor 10/6/2025
DEPARTMENT HEAD
September 11, 2025
DATE
K:\Shared Goodies\Forms\Travel Request Form
DATE
Signed by:
Birietpar Woo et
D88E184FDA5F48A...