8. Appendix F - OVR Driver Expense Log.pdf
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- Attached to
- 12-7811-Supplemental Driver
- Solicitation number
- 6100056346-B-2
- Issued by
- Adams County, Pennsylvania
About this file
The document is an expense log template, OVR-140 5/10, that is used by the Pennsylvania Department of Labor & Industry's Office of Vocational Rehabilitation (OVR) for invoicing non-emergency transportation services. The log requires the vendor name, OVR employee name, date, time, hours, purpose of travel, mileage, and various expense items such as tolls, parking, meals, and lodging. The total hours, miles, and expenses are calculated for reimbursement.
The related state and local contract opportunity is for supplemental non-emergency transportation drivers for OVR in the following Pennsylvania counties: Adams, Cumberland, Dauphin, Franklin, Lancaster, Lebanon, Perry, and York. The contract term is anticipated to begin upon approval through June 30, 2023. Bids must be submitted electronically by November 18, 2022 at 8:00 AM. This is a small business/small diverse business set-aside solicitation, and bidders must provide their certificate. Bidders will enter prices for ambulatory and non-ambulatory transportation services, with travel, food, and lodging capped at $1.00 each. The bid prices must not exceed the capped rates identified in the cost sheet.
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Text version
OVR-140
5/10
EXPENSE LOG for Invoice #________________
Vendor Name______________________________ OVR Employee Name______________________________
Date Time Begin
Time End
Hours Purpose of Travel Odometer Start
Odometer Finish
Mileage
Note: Time must be calculated in increments of 15 minutes, i.e. 1 hour 15 minutes would be 1.25 hours. Note: All trips are considered to be round trips unless otherwise noted. Total Hours________ Total Miles________
Pick Up County/Hourly Rate _________ Total Hourly Reimbursement_________ (Line item #1) Mileage Reimbursement Rate_________
Total Mileage Reimbursement_________ Tolls__________ Parking__________ Meals__________ Lodging__________ +
Total Misc. Expenses__________
Receipts Attached?______ Total (Line item #2) __________
MILEAGE LOG
pbrauchli
OVR-140
5/10 EXPENSE LOG for Invoice #________________ Vendor Name______________________________ OVR Employee Name______________________________ Date Time Begin Time End Hours Purpose of Travel Odometer Start Odometer Finish Mileage Note: Time must be calculated in increments of 15 minutes, i.e. 1 hour 15 minutes would be 1.25 hours.
Note: All trips are considered to be round trips unless otherwise noted.
Total Hours________ Total Miles________ Pick Up County/Hourly Rate _________ Total Hourly Reimbursement_________ (Line item #1) Mileage Reimbursement Rate_________ Total Mileage Reimbursement_________ Tolls__________ Parking__________ Meals__________ Lodging__________ Total Misc. Expenses__________ Receipts Attached?______ Total (Line item #2) __________ PrintButton1:
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