*Payment will be made upon submission of a Per Diem Voucher following the trip with all receipts attached.
**Traveler’s signature indicates that he/she is aware of the travel policies of Valencia College and understands that authorization is granted subject to conformity with said policies.
Submit the form to Accounts Payable DTC-3
VALENCIA COLLEGE
PER DIEM FOR INTERNATIONAL TRAVEL
Enter the budget names, numbers, amounts due to the traveler (ONLY), and budget manager names.
CITIES/COUNTRIES VISITED:
REASON FOR TRAVEL/COURSE PREFIX AND TITLE:
____ I have included receipts for all expenses itemized below with this form (program provider invoice, airline invoice, hotel invoice, etc.).
____ I hereby certify that this travel claim is true and correct in every material matter; that the expenses were actually incurred by the undersigned as necessary travel
expenses in the performance of my official duties; that no other reimbursement has or is to be received from any other source and that same conforms with the
requirements of Section 112.061, Florida Statutes.
A. City 1: Room Rate: $________ # Nights: Misc. (Internet, etc.): $________ $________ $________
B. City 2: Room Rate: $________ # Nights: Misc. (Internet, etc.): $________ $________ $________
C. City 3: Room Rate: $________ # Nights: Misc. (Internet, etc.): $________ $________ $________
D. City 4: Room Rate: $________ # Nights: Misc. (Internet, etc.): $________ $________ $________
II. MEALS: OWED TO TRAVELER PAID BY P-CARD #_________ PAID BY CHECK IN PROGRAM FEE N/A
A. MEALS CITY 1: Breakfast $________ Lunch $________ Dinner $________ $________ $________
B. MEALS CITY 2: Breakfast $________ Lunch $________ Dinner $________ $________ $________
C. MEALS CITY 3: Breakfast $________ Lunch $________ Dinner $________ $________ $________
D. MEALS CITY 4: Breakfast $________ Lunch $________ Dinner $________ $________ $________
III. AIR/GROUND TRANSPORTATION: OWED TO TRAVELER PAID BY P-CARD #_________ PAID BY CHECK IN PROGRAM FEE N/A
TRAVEL BY:
Airplane
Bus/Van
Taxi
Ferry/Boat
Comments:
$________ $________
IV. PROGRAM REGISTRATION FEE: OWED TO TRAVELER PAID BY P-CARD #_________ PAID BY CHECK N/A
NUMBER OF PARTICIPANTS: PER PERSON PROGRAM FEE: $_________
Comments:
$________ $________
V. ADD’L PROGRAM FEES: OWED TO TRAVELER PAID BY P-CARD #_________ PAID BY CHECK N/A
Comments:
$________ $________
VI. MEDICAL/TRIP INSURANCE: OWED TO TRAVELER PAID BY P-CARD #_________ PAID BY CHECK
IN PROGRAM FEE N/A
$________ $________
VII. MISCELLANEOUS. (List all other expenses and amounts):
$________ $________
LESS ADVANCE PAYMENT TO TRAVELER: $________
BALANCE DUE / (OWED BY) TRAVELER: Business Office Receipt #:________________
$________
Print Name ___________________
Print Name ____________________
Rev. 04-2012
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