CITY OF PORT COQUITLAM
ACTUAL EXPENSE CLAIM

NAME:

REASON:

DATES COVERED:

ACTUAL EXPENSE CLAIM:

Not to exceed days at $95 per day for Council
$50 per day for Staff

TRAVEL, COSTS:

Return air fare from:

Air Limeusine Costs

Car allowance _ km at $.22 per km
($.354 per mile)

Parking
ACCOMODATION (Attach receipts):

Hotel (tax included)

OTHER EXPENSES (please itemize):

TOTAL ACTUAL EXPENSES CLAIMED:

CERTIFIED CORRECT:

DATE:

NOTES: -

(1) If travel originated after 12 noon, up to one-half the per diem rate
May be claimed. On return, if.travel compleced by i2 noon, up to
one~half the per diem rate may be claimed.

(2) Return economy air fare ie allowed plus air limousine costs.

(3) Car mileage rate May only be claimed when there is not air. service
or where car travel is obviously less expensive.

(4) Per diem costs are a maximum $95.00 per day for Council and $50.00
per day for Staff. The Treasury is assuming that you are certifing
that the expenses you haye incurred are at least che amount vou have
claimed if they are lesed ethe surplus muse be returned forthwith.

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