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HomeMy WebLinkAboutER000270553769Page 1 of 2 Expense Report Report Number ER000270553769 ConfirmationExpense report number ER000270553769 for 90.00 USD was submitted for approval. RECEIPT_LESS_AUDIT Submission Instructions1.To send required receipts to Accounts Payable, print this page and attach all required receipts.2.Make a photocopy of this page and the receipts for your records.3.Place this page and the receipts in an interoffice envelope, and send to Accounts Payable. •The expense report approver will be notified and requested to approve this expense report. Upon approval, a notification will be sent to you and Accounts Payable.•This expense report will be paid after it has been approved, and Accounts Payable has verified the receipts. Person Marx, Janet "Jan" (61530)Submission Date 11/07/2025 Expense Dates 10/08/2025 - 10/10/2025 Report Status Paid Reimbursable Total 90.00 USD Purpose J. Marx Travel Expense 2025 Cal Cities Annual Conf Expense Items Expense Type Expense Template Date Expense Class Source Description Receipt Missing Receipt Required Reimbursable Amount (USD) Per Diem SLO_Expenses 10/08/2025 Business Personal Funds 90.00 Amount Due to You 90.00 USD Page 2 of 2 10/8 10/9 10/10 **Conference Registration 675.00 x x 675.00 Meal Expenses (Breakfast)6.42 x *15.00 21.42 Meal Expenses (Lunch)*15.00 x 21.20 36.20 Meal Expenses (Dinner)*30.00 29.23 *30.00 89.23 **Marriott Long Beach Downtown 289.04 289.04 x 578.08 TOTAL $1,399.93 $0.545 per mile $1,399.93 1,309.93 90.00 $90.00 Employee Date with the City's travel guidelines and that no part is Cash Expenses Paid By Employee claimed for reimbursement of a personal nature.Cash Advances to Employee Amount Due Employee (City) Date Department Head TRAVEL EXPENSE SUMMARY By signing this expense report, the employee certifies Total Travel Expenses that the amounts listed were incurred in conformance Voucher/Credit Card Purchases Standard mileage tables provided in the City's travel Total Miles - Personal Vehicle guidelines may be used in lieu of odometer readings Reimbursement @ n/a MILEAGE DETAIL - PERSONAL VEHICLE Departure/Destination Odometer Readings Trip MilesStarting Mileage Ending Mileage Description Date TOTAL TRAVEL EXPENSE REPORT This form should be completed in legible handwriting or in Excel using the City's standard template TRAVEL EXPENSE DETAIL: Jan Marx's 2025 Cal Cities Conference Attendance GUEST FOLIO MARRIOTT LONG BEACH DOWNTOWN MARRIOTT LONG BEACH DOWNTOWN 111 EAST OCEAN BLVD LONG BEACH CA 90802 P:562-437-5900 F:562-499-2529 509 ROOM GD TYPE 56 ROOM CLERK MARX/JAN NAME CITY OF SAN LUIS OBI 990 PALM STREET SAN LUIS OBI CA 934013219 ADDRESS 249.00 RATE 10/10/25 DEPART 10/08/25 ARRIVE 10:31 TIME 12:59 TIME VSXXXXXXXXXXXX9178 PAYMENT 36587ACCT# MBV#: 46120GROUP Treat yourself to the comfort of Marriott Hotels in your home. Visit ShopMarriott.com. This statement is your only receipt. You have agreed to pay in cash or by approved personal check or to authorize us to charge your credit card for all amounts charged to you. The amounts shown in the credit column opposite any credit cardentry in the reference column above will be charged to the credit card number set forth above. (The credit card company will bill in the usual manner.) If for any reason the credit card company does not make payment on this account, you willowe us such amount. If you are direct billed, in the event payment is not made within 25 days after check-out, you will owe us interest from the check-out date on any unpaid amount at the rate of 1.5% per month (ANNUAL RATE 18%), or themaximum allowed by law, plus the reasonable cost of collection, including attorney fees. Signature X 10/08 GR ROOM 509, 1 249.0010/08 ROOM TAX 509, 1 32.3710/08 CITY FEE 509, 1 7.4710/08 TOURISM 509, 1 .2010/09 GR ROOM 509, 1 249.0010/09 ROOM TAX 509, 1 32.3710/09 CITY FEE 509, 1 7.4710/09 TOURISM 509, 1 .2010/10 CCARD-VS 578.08PAYMENT RECEIVED BY: VISA XXXXXXXXXXXX9178************ AUTHORIZATION *************APPROVEDTotal: $857.76 Card Type: VISA Card Entry: CHIP Acct #: ************ Approval Code: 072766********** EMV AUTHORIZATION ***********App Label: VISA CREDIT Mode: IssuerAID: A0000000031010 TVR: 8000008000 IAD: 06011203600000 TSI: 6800 ARC: 00 AC: 8C78E1DBCDC6C38F CVM: 5E0000.00======================================= EXP. REPORT SUMMARY ==============================================10/08 GR ROOM 249.00ROOM TAX 32.37CITY FEE 7.47TOURISM .2010/09 GR ROOM 249.00ROOM TAX 32.37CITY FEE 7.47TOURISM .20 See our "Privacy & Cookie Statement" on Marriott.com As a Marriott Bonvoy member, you could have earned points towards your free dream vacation today. Start earning points and elite status, plus enjoy exclusive member offers. Enroll today at the front desk. See https://members.marriott.com for more information Si �RSUC\<-S store #5106 1030 \,\ar\t-et�,,ac e or\ve Go'\eta, c�teo5) 9os�2.591 c\-\¥-o�n osi ,01os12.02.s ,0:2.6 �� '1,.'/..Y.A3?i1 ora�ier: 2. Re9: 2. c a f eorder \\ l e �ancrm Pro\0.45 1\ Latte I -15 �an\'\'\a SyrP o.SO SO'/ Gr Chai Latte 5,25 SO'/ ____________________.. ------• suotota'\ l)\scounts \ 1 . 2.So.ooo.oo i a)(. Gratu\tY i ota'\ 2..00\9.2.So.oo c n a 0 g e o u e -------------------______ .. ----------- �\sa '1,.'/..'f..'f..'l,.'1,.'/..'/..'f..'f..'l,.'/..9i 1S card £ntrv: co�i �Ci L£SS ,rans ,ype: S�Lt �PP Labe '\ : �l S� cR£01i �utn: 0,5005 �10: �000000003,o,o ,�R: 0000000000 i Sl : 0000 -----------cnec• c1osed --------------­ ,o,os/202.5 ,0•16 �� J o\n our 1oya'\tY program starbuc\t-s Re\•1ards� s\gn LIP tor promot\onal ema\1s �\s\t starbuc \t-s .c om/re\•1ards or do\•ln ,oat\ our aPP �t part\c \pat\n9 stores some restr\c�\ons app'\Y Breakfast split 3 ppl 19.25 / 3= $6.42 W. Mc Donald E. Jackson J. Marx Lunch 10-10-2025 split between 3 ppl 63.60 / 3 = $21.20 W. McDonald J. Marx M. Boswell --IH£- AESTAµAANT 201 Pine Avenue Long Beach, CA 90802 (562)317-5237 10/9/25, 9:07 PM Server: Loren K Ticket: Cl9-l Dining Room Table P2 Invoice: 251009-05-19 Credit Sale Status: Card Type: Card Number: Card Owner: Entry Method: 000000 -Approved VISA XXXXXXXXXXXX9178 CARDHOLDER/VISA Contactless Auth Code:034672 APPLAB: AID: VISA CREDIT A0000000031010 TC: 1 Crispy Fried Chicken 1 French Onion Soup 2 Fish n Chips 1 Carvery Veggie Bowl 1 Small Side French Fries (5oz) 1 Caprese Sandwich 1 Southwest Caesar Salad Chicken 1 Crispy Fried Chicken 1 Surf The Wedge 2 Chocolate Lava Cake 23.00 9.00 32.00 18.00 4.00 16.00 16.00 4.00 23.00 14.00 20.00 Subtotal 179.00 Sales Tax 18.80 Total 197.80 VISA -xxxx9178 80 AMOUNT 197.80 TIP 0&.00 TOTAL a1·2, W2 Sign x ______________ _ I agree to pay the total amount above according to the card issuer agreement. Suggested Tips 15%=26.85 18%=32.22 20%=35.80 Duplicate Copy Thank you for visiting us! © 2025 Heartland Payment Systems Total amount divided by 8 People233.82 / 8 = $29.23 eachW. McDonaldC. DietrickE. StewartM. ShoresmanJ. MarxE. FrancisM. BoswellE. Jackson