Meal Per Diem Form by irt13940


									                   Meal Per Diem Form
Date                            _________________________

Name                            _________________________

Event Name & Date               _________________________

Location                        _________________________

Hotel Name                      _________________________

Day & Time Leaving              _________________________

Day & Time Returning              _________________________
to Liberal (entering city limits)

Days Out of Town                _________________________

# of breakfasts provided
by event or hotel               _________________________

# of lunches provided by event _________________________

# of dinners provided by event _________________________

Total meals requested                                        Per Diem Amount                  Total
                                                         In State       Out of State

Breakfast                       ___________              $9.00            $10.00          ________

Lunch                           ___________              $10.00           $10.00          ________

Dinner                          ___________              $19.00           $25.00          ________

Total Meal Per Diem                                                                       ________

If the conference, event or hotel provides a meal, no per diem shall be allowed for the meal provided.

No alcohol to be purchased with district per diem.

Due to location of the event, if the total meal expenditures for the entire trip exceed the per diem
provided, the employee can submit all receipts for proof of actual cost and request additional
reimbursement for costs exceeding the per diem allowance if approved by the Superintendent.

Per BOE Policy GAN-R

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