VALENCIA COLLEGE
PER DIEM AND OTHER LOCAL MILEAGE VOUCHER
NAME (print or type) ______________________________________ VID # V0___________________MC______________
PLACE VISITED ______________________________________________________________________________________
DATE AND TIME: Departure_________________________ Return___________________________________
REASON FOR TRIP ___________________________________________________________________________________
I. PER DIEM: _______Days @ $80.00 per day ……………………………………..…… $ ______________
II. A. SINGLE ROOM RATE _________Nights @ $______________ ______________
Paid by Check Request Amount ____________
Paid by P-Card Trans. ID#__________ Amount _____________
B. MEALS: ______Breakfast ($6) ________Lunch ($11) _______Dinner ($19)…… ______________
III. TRANSPORTATION:
A. Used college vehicle: YES NO
B. Used public transportation (ticket attached) -- cost of …………………………… ______________
C. Airline tickets charged to P-Card NOTE: Ticket and receipt MUST be attached
P-Card Trans. ID #_________________ Ticket amount $___________________
D. Used private vehicle __________ Miles @ $ .445 per mile ______________
E. Rental vehicle charged to: P-Card Trans. ID# ___________Amount __________
Other ____________________________________ _______________
IV. REGISTRATION FEE (Attach official receipt or registration form)
A. Paid by Check Request: Amount $________________
B. Paid by SPD Reimbursement: Amount $________________
C. Paid by P-Card: Trans. ID #_________________ Amount $_________________
D. Paid by Traveler ………………………………………………………………………. _______________
V. MISCELLANEOUS
A. Bridge, road and tunnel tolls …………………………………………………………. _______________
B. Taxi, airport limousine fare, attended parking, etc …………………………………. _______________
C. Other (Itemized): ____________________________________________ …………... _______________
(Example Car Rental, Internet Svcs, etc)
TOTAL TRAVEL EXPENSE $ _______________
VI. LESS: A. Advanced ………………………………………………………………………. (_______________)
B. Meals included in registration fee: _____B($6), _____L($11), _____D($19) (_______________)
BALANCE DUE TO (OWED BY) TRAVELER $_______________
Business Office Receipt #_____________________
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.
Traveler Signature _______________________________ Date ____________
Approved by Supervisor _________________________Print Name ________________________________ Date_____________
Charge to :
Index__________ Acct__________ Amount__________Bud. Mgr. Sign.________________Print Name_____________________
Index__________ Acct__________ Amount__________Bud. Mgr. Sign.________________Print Name_____________________
Index__________ Acct__________ Amount__________Bud. Mgr. Sign.________________Print Name_____________________
Submit this form to Accounts Payable DTC-3