Contractor_Travel_Request_Form.xlsx
XLSX spreadsheet 42 KB Posted
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- HSCGG3-18-R-PWX700
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Contractor Travel Request Form
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Contractor Travel Request
| Instructions |
| This template is for Travel Planner or Traveler use ONLY. It is provided to assist in the communication of information and recommendations needed to complete official travel documents. After completing this form, please route for review and approval via the following workflow. When appropriate, please include quotes along with the travel request. Endorsement signatures required when for the appropriate positions depending upon the contract and circumstances. It is encouraged that the ALM and SLAM endorse for APLES travel requests. |
BPM / PCS --> CPM --> ALM / SLAM --> BC / SLD --> COR --> KO
| * NOTE: Provided for your convenience is the link to the GSA Rates Look-Up tool for Per Diem, M&IE, and Mileage |
| GSA Rates Look-Up Tool |
| ** NOTE: On the first and last travel day, employees are only eligible for 75 percent of the total M&IE rate for their temporary duty travel location. |
| Travel Background | |
| System Name / Business Area | Fleet Logistics System (FLS) |
| Project Name | MILSTRIP Modernization |
| Justification for Travel | Requirements gathering sessions with the SFLC |
| C4ITSC Spend Plan # | OSC-054-16.5 |
| Contractor ODC # | FLS-005 |
| Comments |
| Traveler Information | |||||||
| Traveler Name | |||||||
| (First and Last Name) | Contract Name | Labor Category | Comments | ||||
| 1. | Joe Smith | APLES | Business Project Manager | ||||
| 2. | Sally Jones | APLES | Applications Engineer | ||||
| 3. | |||||||
| 4. | |||||||
| 5. | |||||||
| 6. | |||||||
| 7. | |||||||
| 8. | |||||||
| 9. | |||||||
| 10. |
| Travel Information | ||||||||||
| Traveler Name | ||||||||||
| (First and Last Name) | Departure Location | |||||||||
| (City, State) | Destination Location | |||||||||
| (City, State) | Date | Transportation Mode | ||||||||
| (cost calculated for POV) | * Mileage | |||||||||
| Rate | Mileage | Cost Estimate | Comments | |||||||
| 1. | Joe Smith | Winchester, VA | Dulles, VA | 06/23/2016 | POV | $ 0.54 | 62 | $ 33.48 | ||
| 2. | Joe Smith | Dulles, VA | Atlanta, GA | 06/23/2016 | Air | $ 534.62 | See attached quote for round trip airfare | |||
| 3. | Sally Jones | Martinsburg, WV | Dulles, VA | 06/23/2016 | POV | $ 0.54 | 78 | $ 42.12 | ||
| 4. | Sally Jones | Dulles, VA | Atlanta, GA | 06/23/2016 | Air | $ 534.62 | See attached quote for round trip airfare | |||
| 5. | $ - 0 | |||||||||
| 6. | $ - 0 | |||||||||
| 7. | $ - 0 | |||||||||
| 8. | $ - 0 | |||||||||
| 9. | $ - 0 | |||||||||
| 10. | $ - 0 | |||||||||
| Total | $ 1,144.84 |
| Travel Expenses (Per Diem) | ||||||
| Traveler Name | ||||||
| (First and Last Name) | Location | |||||
| (City, State) | Start Date | End Date | Total Days | * Lodging Rate | Lodging Estimate | ** M&IE |
| Rate | M&IE | |||||
| Estimate | Tolls | |||||
| Estimate | Parking | |||||
| Estimate | Rental Car | |||||
| Estimate | Taxi | |||||
| Estimate | Daily |
Total
| 1. | Joe Smith | Atlanta, GA | 06/23/2016 | 07/01/2016 | 8 | $ 138.00 | $ 1,104.00 | $ 69.00 | $ 517.50 | $ 4.50 | $ 30.00 | $ 120.00 | $ - 0 | $ 1,845.00 |
| 2. | Sally Jones | Atlanta, GA | 06/23/2016 | 07/01/2016 | 8 | $ 138.00 | $ 1,104.00 | $ 69.00 | $ 517.50 | $ 4.50 | $ 30.00 | $ - 0 | $ - 0 | $ 1,725.00 |
| 3. | $ - 0 | |||||||||||||
| 4. | $ - 0 | |||||||||||||
| 5. | $ - 0 | |||||||||||||
| 6. | $ - 0 | |||||||||||||
| 7. | $ - 0 | |||||||||||||
| 8. | $ - 0 | |||||||||||||
| 9. | $ - 0 | |||||||||||||
| 10. | $ - 0 | |||||||||||||
| Total | $ 2,208.00 | $ 1,035.00 | $ 9.00 | $ 60.00 | $ 120.00 | $ - 0 | $ 3,570.00 |
Total Cost $ 4,714.84
Endorsements / Approvals
&"Arial,Bold"&10USCG Operations Systems Center (OSC) Contractor Travel Request Form &"Arial,Bold"&10&D Page &P of &N http://www.gsa.gov/portal/category/26429 image1.emf image2.emf image3.emf image4.emf image5.emf image6.emf image7.emf image8.emf image9.emf
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