Capital Consulting Corporation REIMBURSEMENT VOUCHER

11821 Parklawn Drive, Suite 100

Rockville, MD 20852

ATTN: REIMBURSEMENTS: Susan Kerin See Reverse Side for Guidelines and Procedures.

All submissions must include departure hour, return hour, and appropriate receipts.

This form must be signed by the individual submitting the claim for payment.

Complete A through E in this section (please type or print clearly):

A. / Name: / F. / Project #: / 4161 / Task #: / 003
B. / Address: / G. / Program: / Multinational DSMB
H. / Location (city/state): /

Rockville, MD

City/State / Honorarium /

$200

C. / Social Security #: / I. / Dates of Service: /

April 26, 2017

D. / Date and Time of Departure / Date and Time of Return:
E. / Telephone # - Home: / Work: / ( ) / ext.

I. Transportation

A. / Air/Train Transportation / $ Prepaid
B. / Other Surface Travel (taxi, limo, subway; submit receipts) / $
C. / Private Auto: / Total Miles / @ $.53.5/mile = / + tolls / $ / $
D. / Parking (submit receipts) / $
**Total Reimbursable Transportation** / $

II. Per Diem

Maximum meal allowance is $69 for a full day. You get 75% or $51.75 for any travel day (including if it is on a meeting day) Meal expenses will not be reimbursed without inclusion of departure and return times. Receipts for hotels are required; meal expenses are not. Meal per diem is a set amount, regardless of the expense incurred. Provided meals will be deducted from the per diem.

Hotel: Number of Nights: / Amount to Be Reimbursed: / $ Prepaid
Meals: / Day 1 / Day 2 / Day 3 / Day 4 / Day 5 / Day 6
**Total Reimbursable Per Diem** / $

III. Other (Specify)

e.g., baggage / **Total Reimbursable Other** / $
**GRAND TOTAL PAYMENT DUE** / $

I hereby certify that this is a true statement of reasonable and necessary travel expenses incurred in the performance of consultation for Capital Consulting Corporation (CCC).

Make checks payable to (print):
Consultant ’s Signature : / Date :
CCC’s Project Manager’s Signature: / Date:


CAPITAL CONSULTING CORPORATION REIMBURSEMENT GUIDELINES AND PROCEDURES

Capital Consulting Corporation (CCC) will reimburse travelers for necessary and reasonable expenses incurred while acting as a consultant to CCC. Reimbursement for travel under Government contracts is limited by the Federal Travel Regulations (FTR). Upon submission of proof of out-of-town travel costs, travelers will be given a per diem allowance for meals and incidental expenses at the rate specified in the current FTR for the destination city, and will be reimbursed for actual lodging to a specified maximum.

EXPENSES

Reimbursement expenses for authorized work performed for a Government contract may include lodging and subsistence, transportation, and miscellaneous expenses. Receipts are required for:

(1) Lodging, if not paid by CCC. Claimed expenses without required

(2) Air, train, bus fare, even if prepaid by CCC. receipts will be disallowed.

(3) Ground transportation.

(4) Registration fees.

The traveler should not pay for the expenses, including meals, of another traveler. If this does occur, it is the responsibility of the travelers to reimburse each other.

LODGING AND SUBSISTENCE

Lodging and subsistence-related expenses will be reimbursed up to the amounts listed under section II on the reverse side.

The method of computation for a partial day of travel is a flat three-quarters (¾) of the applicable M&IE rate. A partial day of travel is considered the first or last day of travel. Therefore, regardless of the time of departure or arrival at his/her residence or duty station, a traveler will receive only ¾ of the M&IE allowance for the applicable dates. Full days in travel status will continue to be counted as a whole day.

No per diem allowance is payable for 12 hours or less of travel. (Usually this is applicable for 1-day trips). If a traveler is in travel status for over 12 hours, where no lodging is required, the traveler receives ¾ of the applicable M&IE rate.

Federal travel regulations prohibit reimbursement for meals inside a 50-mile radius of the traveler's home/workplace. If a traveler receives a catered meal, the Federal per meal allowance for the destination city will be deducted from the per diem.

TRANSPORTATION

Air and rail transportation will be reimbursed at full or less than full coach-class rates. First-class fares are not reimbursable unless authorized in advance by the Contracting Officer. The use of a rental car also must be authorized in advance by the Contracting Officer. Please attach transportation receipts to this voucher.

Tips for taxi service are reimbursable for up to 15% of the fare. Any other tip amounts are not reimbursable.

Mileage is reimbursed at a rate of $0.53.5 per mile.

MISCELLANEOUS EXPENSES

Excess baggage is reimbursable only if it is Government-related material.

Long-distance telephone calls are reimbursable for up to $5 per day.

MAIL REIMBURSEMENT VOUCHER WITH RECEIPTS TO: Capital Consulting Corporation

11821 Parklawn Drive, Suite 100

Rockville, MD 20852

ATTN: Susan Kerin

(301) 468-6004 x459