6/14/19 RCF Form Bus Office
San Diego Miramar College
Revolving Cash Reimbursement Request
Department: : Date
Requested By: Room Number:
Issue Check To:
City/State/Zip Phone Number:
ployee ID # Supplier Fed ID #
Maximum reimbursement is $200. A single purchase cannot be split into several smaller payments.
Prior approval b
y department administrator/supervisor is required.
Original receipt(s)/invoice(s) must be attached.
Please list participants when making food purchases and/or attach event flyer. (May NOT use a GFU 1110 budget)
Equipment cannot be purchased through Revolving Cash.
Please refer to district procedure for complete guidelines. (AP 6300.10 Revolving Cash Funds)
Mail Check: H
old Check for Pickup
Vice President of Administrative Services
Check Date Am
ount: Received By:
Date of Event:
Description of Purchase/Service:
Charge Account Name: Charge Budget Number: