WSGC Travel Expense Form - Reimbursement Instructions Team budgets must be submitted to WSGC as outlined in the award agreement letter in order for reimbursements to be issued. All costs associated with this program must be necessary and reasonable for this award, following all applicable WSGC regulations.

1. Make purchases(s).1.1. Teams should select one team member to oversee the budget, ensuring collective purchases/expenses do not

exceed award amount.

2. Save all original digital and hard copy receipts.2.1. We recommend saving receipts in a folder until time of reimbursement submission.2.2. Circle date and total on receipt(s). 2.3. If food or lodging receipts cover more than one person, list participant’s name on receipt(s).2.4. Itemized restaurant receipts are required. If purchases are made on a credit card, a signature copy must be included. There is a $45 per diem per person for food.2.5. Alcohol and tips over 20% will not be reimbursed.2.6. All purchase receipts must be itemized, detailing each item purchased.

3. Complete a Travel Expense Form (see Tools and Tips on the WSGC website). Use a separate Travel Expense Form for eachevent. If your expenses exceed the allotted space on form(s), print off a second form to add the remaining expenses. Do not listboth supply and travel expenses on one form.

3.1. Carefully read and follow instructions before completing forms.3.2. Print out a Google map for verification of personal vehicle mileage ($.56 per mi). Circle the total miles. The mileage rate includes fuel costs. Gas receipts will only be reimbursed for rental vehicle travel.3.3. Organize your receipts to align with the Travel Expense Form (by receipt category and day of the week). Label each receipt with the coinciding row and column information (i.e. Receipt 1-Fri, 3-Mon, 11-Mon, etc).3.4. Provide the total expended amount from each receipt in the coinciding box on the expense form. 3.5. IMPORTANT: You must manually add all mileage together for your “Mileage Line Total”. If the decimal number is below .5, it should be rounded down. And if the decimal is above .5, it is rounded up (i.e. 52.1 miles would become 52 miles).3.6. For all other categories, the “Line Total" box will automatically sum receipts together – your total reimbursement being requested will automatically add up in the “Total” box.3.7. Initial and date each receipt with date of reimbursement submission. 3.8. Sign, date, and enter your phone number.3.9. Have your team lead and advisor complete their required signatures.

4. Submit the completed form(s) and receipts in one email by the due date(s) to:Connie Engberg cengberg@carthage.edu (262) 551-6548

Do Not:1. Submit partially completed forms.2. Submit forms without all required signatures.3. Submit forms past due date(s).4. Submit “flat” per diem rate requests.

**An example of a filled-out Project Expense form and accompanying receipts can be found on the following pages.

TRAVEL EXPENSE FORM

Email Form and Receipts To: Please Make Check Payable To:Connie Engberg Name:cengberg@carthage.edu Address line 1:(262) 551-6548 Address line 2:

City, State, Zip:Travel Start Date: Travel End Date: Team Institution:

Receipt Category Sun Mon Tue Wed Thu Fri Sat Line Total

1 Mileage Totalmiles x

23 Baggage Fee(s)45678

Meals ($45 per diem)9 -Breakfast

10 -Lunch11 -Dinner12 -Other13 Tips14 Miscellaneous 115 Miscellaneous 2

Team Member Signature Phone # Date

Team Leader Signature Phone # Date

Team Advisor Signature Phone # Date

Description

Air/Rail Fare

REQUISITIONER STATEMENT: I declare (under penalties of perjury) that this account of expenses is accurate and conforms to all applicable WSGC regulations. The expenses are actual, reasonable and were personally incurred in accordance to my award letter criteria.

Rental CarUber/Lyft/Taxi/MetroParking/TollsMisc. Ground TransportLodging

TOTAL ---------->

To receive reimbursement, this form must be submitted by each team member who made a purchase.

NOTE: The team leader cannot be reimbursed for purchases made by team members and then distribute the money.

Revised 04/2021

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Receipt 1-Mon and 1-Sat

Enterprise Rent a Car

Rental Location ORLJ\NDO INTL ARPT 1 JEFF FUQUA BOULEVARD ORLllNDO

Return Location ORLANDO INTL ARPT

Vehicle 11 FM1B2516 Model MAZDA3

Class Ori ven ICAR Class Charge ICAR License# 089HXP State/Province FLORIDA M/Kms Driven 457 M/Kms Out 28947 M/Kms In 29404

Rate Info

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Receipt 4-Mon

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(813) 752-2534SHl!LL 5108 GLfH HARWELL RO PLAHT CITY FL 33566 Merch U: 57542520200 Appr: 913628 lnuoice U: 086371 UNL-RfG

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Receipt 7-Sat

HAMPTON INN,3425 N. ATLANTIC AVE COCOA BEACH, FL 32931

TELEPHONE 321-799-4099 • FAX 321-799-4991

824 COLLEGE AVE

WINTHROP HARBOR IL 60096 UNITED STATES OF AMERICA

Confirmation Number: 80388488

8/19/2016

8/15/2016 2264568 GUEST ROOM 8/15/2016 2264568 STATE TAX 8/15/2016 2264568 CITY TAX 8/16/2016 2264818 GUEST ROOM 8/16/2016 2264818 STATE TAX 8/16/2016 2264818 CITY TAX 8/17/2016 2265114 GUEST ROOM 8/17/2016 2265114 STATE TAX 8/17/2016 2265114 CITY TAX 8/18/2016 2265312 BISTRO 8/18/2016 2265434 GUEST ROOM 8/18/2016 2265434 STATE TAX 6/18/2016 2265434 CITY TAX 8/19/2016 2265434 SERVICE RECOVERY: REVENUE 8/19/2016 2265434 STATE TAX 8/19/2016 2265434 CITY TAX 8/19/2016 2265571 vs *0752

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109.00

WSG 554505558 BLUE

$109.00 $7.09 $5.45

$109.00 $7.09 $5.45

$109.00 $7.09 $5.45

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$7.09 $5.45

($109.00) ($7.09)

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Hampton hotels are all over the world. Find us in Canada. Costa Rica, Ecuador, Germany, India. Mexico, Poland, Turkey, United

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Receipt 9-Mon

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2 DIET COK: 1 COKE 2 ICED TEA 1 COCONUT CREME, in<· ·c. · 3 COCONUT CREME, 1 re!d•, :- ,

1 regular, 1 regular 1 MANGO BERRY, regular 1 STRAWBERRY EXPLOSION, regular 4 CHIPS & SALSA,

1 add lg guacamole, 1 add lg guacamole, 1 add lg guacamole, 1 add lg guacamole

1 SHRIMP TACOS, with fruit 1 PATTY ME:..T

3 BLACK N BLUE BURGER 1 MANDARIN ORANGE SALAD,

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2 COCONUT MERINGUE PIE 1 MILK

2 COFFEE 1 DECAF COFFEE

Sub Tota 1:

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Suggested Gratuity GRAT-1s, 59.65 GRAT-20, 66.28

5.00 2.50 5.00

16.45

18.00 6.00 6.00

24.00 15.00 12.50 37.50

13.00 11.00 32.00 16.00 36.00 19.50 2.00 0.50

24.00 10.00

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