2013_01_24Costa Mesa Sanitary District
Expense Reimbursement Form for Directors
iName: Jim Fitzpatrick December 2012
I. Attach all receipts.
DATE OF EVENT PURPOSE OR OCCASION LOCATION TRAVEL* MEAL EXPENSE OTHER
12-14 WACO OCWD
IT-to Cesta Mesa Sanitary District Board.Meeting CMSD
4
12.11 Operations Committee CMSD
12.7 Tlerra Verde Inc(TV!) Twit. Irvine
Can be used for private auto as well es tad, limo and air fare.
II. Calculation
1. . miles at 55.5 cents per mile
Current Rale)
2. Total meals
4
3. • 1 days attendance at $ 221.00 per day
par Boa policy) sop 8914. Meeting
15. Other • i
Total = $
Conference/Event: Significant points, learned of benefit to the District and Its
ratepayers:
Location: ilSharedatBoardMeetingi
Per5Ordinance No. 55, "Board members shall provide brief reports
on meetings attended at public expense at the next regular Board
meeting." (Operations Code, Section 3.01.035)I
Ai
rector Signet 101.1 :rev 111/11)
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1