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Mayor/Councilmember: <br />Date of Report: <br />CITY COUNCIL <br />TRAVEL EXPENSE REPORT <br />1Ju111C1 GI IL u. <br />Location: <br />Date(s) of Travel: <br />* PLEASE SUBMIT WITH RECEIPTS (IF AVAILABLE) wI I HIN 5 UATO Hr I r-M I RHVCL <br />MEALS <br />not provided at Conference <br />Date Breakfast Lunch Dinner Amount <br />MISCELLANEOUS <br />(Includes Telephone, Internet, Taxi, Shuttle, Parkin <br />Date I Description of Expense Amount <br />TRAVEL EXPENSES <br /># Nights <br />Pd by City <br />Paid by <br />Requester <br />Lodging <br />Air Fare <br />Registration <br />TOTAL <br />$ <br />$ <br />TRANSPORTATION <br />Date Miles Driven x.445 per Amount <br />mile <br />Subtotal: Meals <br />Subtotal: Miscellaneous <br />TOTAL EXPENSES $ <br />Less: Travel Advance <br />(Due City or Carryover)/ <br />Due to Requester $ <br />Acct # <br />Subtotal: <br />Travel pd by Requester <br />Subtotal: Transportation <br />(Due City or) <br />TOTAL $ Due to Requester $ <br />Acct # <br />I hereby certify that the above is a true and correct statement of expenses incurred in the performance of <br />my duty as an official of the City of San Leandro. <br />(Signature) <br />(Approved) <br />(Date) <br />(Date) <br />Rev. 10/2/06 <br />