132068CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FLORIDA 32233-4445
BRITTANY NORRIS
800 SEMINOLE ROAD
ATLANTIC BEACH FL 32233
INVOICE
NUMBER
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FLORIDA 32233-4445
INVOICE
DATE
MILEAGE ADJUSTM 01/30/2018
GROSS
5532 BRITTANY NORRIS
RETAINAGE
2.78
PURCHASE
ORDER NO.
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FLORIDA 32233-4445
TE..;::
Q Wcr
UMBER>
DISCOUNT
NO. 132068
....................
....................
....................
>CCOUNT
NUM BER
001-1001-511-55-00
Bank of America
Jacksonville, Florida
Member FDIC
NET
AM
OUNT
2.78
$**********2.78
63-4 NO. 132068
630
VOID AFTER SIX MONTHS
NET.: AMOUNT :::::
........................:...........................
.....................................................
5532 02/22/2018
$**********2.78
TWO AND 78/100 DOLLARS*****************-**-**-****-*--*******************************
PAY
TO THE
ORDER OF
BRITTANY NORRIS
800 SEMINOLE ROAD
ATLANTIC BEACH FL 32233
**NON-NEGOTIABLE**
AUTHORIZED SIGNATURE
**NON-NEGOTIABLE*
AUTHORIZED SIGNATURE
_Revised 11/06/17
Date
Traveler
Department
Account Number
Destination, Dates, Times
City of Atlantic Beach, Florida
STATEMENT OF ACTUAL EXPENSES - 2018
1/30 /I
Brittany Norris I/154"3 Z
City Commission
001-1001-511.55-00
Destination
Reason for Travel
Departure: date - day - time
Return: date - day - time
Transportation
Private vehicle
Gas for City vehicle
Airline
Car rental agency
Parking / Shuttle
Total Transportation Expenses
Registration Agency
Florida League of Cities, Inc.
Lodging
Reviewed by
//3af/6
225 Shorecrest Drive, Altamonte Springs, Florida (Embassy Suites by Hilto:
FLC 2018 Institute for Elected Municipal Officials (IEMO)
Thursday - 4:00 PM
Sunday - 5:00 PM
278.00 miles X $
Confirmation #
Embassy Suites by Hilton Orlando North
3 night(s)
Meal Allowance
Breakfast
Lunch
Dinner
54394234
X
3 X $
3 PIA ID
Other Expenses
Telephone charges related to City business
Taxi, Tolls
Miscellaneous
Total Travel Expenses
Summary of Travel Expenses
Total actual expenses
Less advanced amount
Amount due to traveler
Refund due City (Attach receipt from City)
Trav`eler's Signatu
CK
FEB 2 2 2018
$
$
Signature & Approvals
aivie Date 30
_ f�
Date
Department d Approval
ACTUAL,, ADVANCE
/57..1/
$ 1418?3 $ 148.73
$ $ -
$ $
5 $ -
$ $ -
ti J-( $ 148.73
$ 300.00 $ 300.00
112.00 $ 336.00 $ 336.00
7.00
8.00
15.00
858.73
$ 21.00 $ 21.00
$ 8.00 $ 8.00
$ 45.00 $ 45.00
$ ?.� $ 858.73
SG/. 6-i
1 j?r 1 I r
Finance Director' Approval
1 hereby certify that the above expenses were incurred by me as necessary traveling expense in the performance
of my official duties.
O:\City Clerk\INTERNAL USE\Travel\(Draft 2018 Travel Form for Norris - FLC ISMO s.xlsjActual Expenses
Date
Name & Address
NORRIS, BRITTANY
1183 VIOLET STREET
ATLANTIC BEACH FL 32233
UNITED STATES OF AMERICA
Confirmation Number 94047394
1/21/2018
DATE
Embassy Suites Orlando - North
225 Shorecrest Drive
Altamonte Springs, FL 32701
407-834-2400 Fax 407-834-2117
Mit 80110 BASE) ON MINA,
ANO :EMU Or STAY SHOU;.O 1G.,
CNOOBE TO WART EARLS M'i
=NCI TO CHANGE MT
Room:
Arrival Date:
Departure Date:
Adult / Chad
Roorrl Rate:
520/KNGN
1/18/2018 6:42:00 PM
1/21/2018
1/0
112.00
Rate Plan: IEM
HH # 968848109 BLUE
AL:
Car:
EMBASSY SUITES
11 0 T F 1. S •
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REFERENCE DESCRIPTION
1/19/2018 3780027 CHECK -131225
1/19/2018 3780028 GUEST ROOM
1/19/2018 3780414 GUEST ROOM EXEMPT
1/20/2018 3780852 GUEST ROOM EXEMPT
"BALANCE"
AMOUNT
($336.00)
$112.00
5112.00
$112.00
SO 00
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