Certification of Employee Routine Field Travel
Name of Employee Date
Job Title Fiscal Year (annual certification required)
Division/Department Work Domicile (regular campus/site)
In accordance with Louisiana Office of State Travel Regulations , I understand that field travel under a 30 mile radius of an employee’s regular work domicile is not reimbursable unless the employee is certified for regular, routine field travel.
I hereby certify that routine field travel is a regular and necessary part of the performance of the above employee’s duties, for the noted fiscal year, as described below:
Check one:
Practicum/ Clinical Instruction/ Cooperative Education – Employee has regular duties as part of a practicum, clinical instruction, or cooperative education course.
Technical Service Duties – Employee has regular duties to provide technical services to various college campuses/sites.
Other Duties (Describe below):
This employee is approved for reimbursement of routine field travel mileage and parking expenses, for the noted fiscal year, submitted in accordance with the College’s policies and procedures for reimbursement.
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Signature of Immediate Supervisor
Title Division/Dept
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Authorized for Routine Field Travel Reimbursement:
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Assistant Vice Chancellor/Controller Date
Form 1380/003 (7/10)