Get documents about "Any portion of car rental expense that is determined to be personal in nature
Document Sample
University of Central Arkansas
Request for Motor Pool Vehicle
PART 1
Requisitioning Acct. No./ Order
Department Object Code Date
Purpose of trip/
Destination
Type Vehicle
Required Automobile Van Bus
Number of
Travelers Individual Group No. Passengers
Departure Return
Time/Date Time/Date
Driver’s Ark. Driver’s
Name License No.
Exp. Date DOB
Approved By: Approved By:
Department Chairman Head Travel Administrator
PART 2 THIS SECTION TO BE COMPLETED BY MOTOR POOL SUPERVISOR
Description of Vehicle License
Vehicle Assigned Number Number
Date/Time
Returned Ending Odometer Reading
Date/Time
Departed Beginning Odometer Reading
Total Miles Traveled
Credit Card
Number Cost Rate per mile
Date Card
Returned Mileage Cost
Other Costs
VSP-1
on File Yes No Total Cost
FAX completed form to the Physical Plant 450-5399 or send to the Physical Plant via campus mail.
Note: Any portion of car rental expense that is determined to be personal in nature will be the responsibility of the
traveler, and the state will not reimburse the employee for such expenses. If the rental is paid for by direct billing, the
portion that is determined to be personal will be prorated and the traveler will be required to reimburse the university.
Rev. 1/29/2012
