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i~ ' " : -. '.....~- ... .; . . . . ~. ,

CITY OF BULLHEAD CITYTRI 10S35PT TRAVELAUTHORlZATIONAND~~RE~~~W;'!!;:.',ISECnON] Plcaseprin tlcgibly ,.;' t z m j D J t . r ; i 2 ~ . ~ H : .~! G 4

[ ] T ra iD lD & C J SemiDlr 0 ConfbrenocTopio/Purpose I()'re. :'1 . . '.Mcctiq Dl*5 c : : 2 - 4 . 5 2. ' D e , 1 I r t 1 . I n : DIlCSITime:_ : = : - - J - t ~ l; 1 . ; _ ' / 1l....{~_-_.....c : . : :a . ~ . ! J . Q ' l . ! .. . :. . . _ Retunt Datdr'unc: 5{21 t I C '- 10fTmre I Modc : (llirdeone): . ... .._~~v~ir O!her ' _

i _ . . , ( : -fah..t.. - Personal Vehlde Roulld trip miks, II mlle- ------r SE CT IO N 2 - E XP EN SE S we EstImated Expeases CI~d Actual ExpmscsC om m on CInier (air, bus, train)

NOTES HotelName: U ' Od\i ..C ' i ,l ln 1 : H )WI\\ ' tLY\ V\)k\'~: \...\.:\,,1\; en V 00 t-e . ~ ,

Will p~ u:j P.H:=DfWI (Jed It (wcl

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TIU 10636CITY ' O F BULLHEAD CITY

TRAVEL AUTHORIZATION AND EXPENSE REPORT

1 SBCllON 2 - EXPENSES MIC Es t imamd e x e r e sCommon Curic: l (air, bus, IrIin)~1mtIon 4Lodgln& (Incl tax) II ni~_ L i st h o te l infon NOTESMeals (how man)'?): Brcllk:Cast2. Lwcll ~ D ln ne r ~MUcqe or G as ChqcsTaxilPartingc.~TelepIum~~ ~ ~ ) ~ ~ - - - - ~ ~ ~ - - - -AectNo, '01 ~. 5101'" 5.c;",J81.1f:/~{. SSE(UD eD CU lllber& l Bailnco _ [ $

. tisi~Adv-.cesussCUyCreditCardChcJCI _AMI' D UE C ITYAM TD UE EM PLO YEE Chk# _

$AmowIt St\~\.arco ' Q ( . c r l i : ( Q 'U r o o tL .~ M alIInJ A ddnIs I, _2 . ~ " _ _

~~g~RH, _3 . ~ _ _ _

Mailina Add re:u _

APPRO VALS B EFO RE TRA VElJNO A PPR OV AlS A FT ER T RA VE LIN G$0-$500 Dlvisign o r Department Dlrc:ctor approval J ~to NO ~/aflllfor,.~~8 bieurrwdw- an dOver $500 City MIUlaae&'1pPlO~~ ~~_~}lb9VC " I. ~~'".' _~J

thm ","lwd ItO or pa)'fMnf8for' i.mWl. u n I , " "oI1d.i~: _. oj . ; , -_ 0 ,

D'_~~ "'" 51lQIIOTraveler DateDlv lDp l ; DIG

F inance Dpt Date F1namc Dpt DlI teCltyMp: Date CityMgr DItC

.. , \ T,

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OS/24 /10 8:48 AM NiteVision 2009 SP1 H

.~~. ~ ~~iNr~~~Ar:FARMINGTONLAOlJ'INTK. FARMNGToN,NM87401 ~INN S & S U [T E St...:--:M3g;;;l~...,;a.2./-o_4A_IQ- ____-)_ -

Duke, JerryPo 10104BULLHEAD CITY, AZ 86427Company: GOVERNMENT RATE

Folio#: 04587413]Roo ... ..lll:l.Arri~O.SIi3!1 0

Depa~~~4/10Returns Club No :._-~VoucherlSbip/PO:

Trans # Date Description332410 5/2312010 Rrn : 103 GSA - GOVERNMENT332411 512312010 TAX - OCCUPANCY - CITY332412 512312010 TAX-OCCUPANCY-STATE332521 5124/2010 CC PMT - DISCOVER

Charges Payments Balance$69.00 $0.00 $69.0$3.45 $0.00 $72.45$4.83 $0.00 $77.2$0.00 $77.28 $0.0

Balance: $0.00

Method of Pay; Credit Card: DIS - ... 8783

Signature:

THANK YOUWE APPRECIATE YOUR BUSINESS

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Description

141 05~25-100 ............. 1. Iii -....Arr ival 05-: '24-10Depar ture 06-25-~

0 1 .. 5- -Rate Code : I UGOVP ag e N o. 1 of 1Chargee I Credits

81.005.374.861,27

Totel 92.50 0.0Balance 92.50

Jerry DukePo Box 10104Fort Mohave, AZ 86427US

F o lio N o.A IR N um b erG ro up C odeCompanyM e m be rs hip N o.Invoice No.I Date

052410 Accommoda t ion05241 0 State Tax05241 0 OcC\JpancYTax052410 Hotel Tax

Guest Signature: __ ~ _I have received th e goods a nd' o r s erv ice s in the a mo oo t s ho wn he ro n. I a g ree tha t m y Iia biity fo r this b il l I s no t waived and agree to be heldp ers on ally lia ble in th e e ve nt th at the in dic ate d p er so n, c om pa ny , o r a ss oc ia te f alls to pa y for a ny p art o r the full amount of th es e c ha rg es . Ifa c re dit c ard c ha rg e, I furth.er agree to perform the o bl ig a tio n s s et f or th in the c ar dh old er 's a g re em e nt w it h t he i ss u er .

H o lida y In n E xp re ss H o te l & SUites l5401 Alameda B l v d . NEIA lb U qu erq ue , N M 8 71 1 31Telephone: (505) 7972291 Fax: (505) 797~2292

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05/26110 ,9:33 AM NiteVision 2009 SP1 HF

~LAQ!jiNTAINNS a SUITES

LA QUINTA INN & SUfIES CLOVIS45 21 N . PR IN CE STC LO V IS , N M 881 01575-763-8777

Duke, Jerrypo box 1 01 04FO RT M O HAV E, AZ 86427Company: L

Folio#: 076746054

Trans # # Date Description249440 512512010 Rm: 2 11 U s er O v e rrid e249441 5125/2010 TAX - O CC U PA NC Y - C IT Y249442 5125/2010 TAX -OCCUPANCY -COUNTY249443 512512010 TAX - O CC UPA NC Y - STATE249569 5/26 /2010 CC PM T - D ISC OV ER

Departu :Returns Club No :Voucher lShip IPO:

Charges Payments Balance$70.00 $0 . 0 0 $70.00$1.71 $0.00 $71.71$3 .50 $0.00 $75.21$3.50 $0 . 0 0 $78.71$0 . 0 0 $78.71 $0 .0 0

Balance: S O . O O

Method of Pay: Credit Card; DIS - ... 8783

Signature:T HA NK Y O UW E A PPR EC IA lE Y O UR B U SIN ES S

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t. JERRY R.iox 1010~I tI lO Hi\V E. A Z 66427

Hampton Inn a. Suites-Las Cruces2350 East Griggs Avenue Las Cruces, NM 88001Phone (505) 527-8777 Fax (505) 527-8780n,me~ddre~

RATE PLANH H #AL :CAR:

room nU5:_e;-'arriv al d il :dep~rt\lre da .adult/child:room rate:

. ""1. , ,, , 1;. t.rd \' !IU,u"'int r .. c I 1ook -