Completed only by thel rk 0 the Board's Office Agenda Date: I z" CBS Sign Off

COUNTY OF ALAMEDA OUT-OF-STATE TRAVEL AUTHORIZATION REQUEST

~ TO:

FROM: SUBJECT: DATE:

AUTHORIZATION NUMBER

Su.san S. Muranishi,. County Administrator Agency / Department Head - Print Nancy E. O'Malley OUT-OF-STATE TRAVEL (OOST) AUTHORIZATION REQUEST

I am requesting your approval ofthe following OOST request prior to the event taking place.

PLEASE TYPE I PRINT LEGIBLY District Attorney Victim Assistaace OiviSQS

AGENCY / DEPARTMENT DIVISION / UNIT TRAVElER'S NAME· JOB TITLE / CLASSIFICATION or VENDOR #PLEASE TYPE I PRINT LEGIBLY

1. Sr. Victim-Witness Consultant_. - ­2.

3,

*NOTE: The only eligIble personal servIces contractors are those who are reImbursed traveVevents as stated 10

hislher contractual agreement with the County, Must specify Vendor # above. "

DETAILS OF TRAVEL

. DATES (DURATION): From: 4/161W2 / To: 4/20/20lL

POINT OF ORlGIN (City/State): Oakland, CA I DESTINATION (City/State): New Orleans, LA

PURPOSE OF TRIP: _X_CONFERENCE - ­ MEETING - ­ SEMINAR - ­ TRAINING _OTHER

NAME OR TITLE OF EVENT (no acronyms please): 12th AJinuar Family Justice Center Conference

1. AUDITOR'S MAXlMUM REIMBURSEMENT (per person): $ COST PER TRANS TICKET: $: to(O~V

ITEMS COVERED: x: Transportation _It Food & Lodging .. ,Event Fees -------------------- ­TOTAL COST (Max Reimb/person )( no. of travelers): $ \btD~O 0 COUNTY TIME-OFF ONLY

ACCOUNTING INFORMATION / FUNDING SOURCE

BUSINESS ACCOUNT FUND . ORGANIZATION PROGRAM PROJECT/GRANT No. UNIT No. No. .No. No.

))A,..~r (" /"'4/.. J 106M :::l,7;/; ~ ~/l Aft\.A~cJ

2. NAME OF FUNDING SOURCE (please Specify):

3. AMOUNT OF FlJNDING 4. COUNTY COST AMOUNT (Noted on the Board Agenda) Ito toO. Lf.D

(PRINT NA.'A.E) PHONE NUMBER: 5101267·8872

REQUESTED BY: Kelti Sage

CAO:

3~-/L . (DATE)

'fJ ~ I(V (PRINTNAM ..._ -.. IGNATURE I ATE

Note: Travel agency should FAX the completed form to Au ontroller Agency to the attention of Travel Approver. FAX # (510) 272-6502. The Auditor-Controller's Office will notify the travel agency of the Authorization Number by phone or FAX

RETURN TO: Towanda Lee'"'" QIC 20702I..

110-25 (0411 0) Completed only by the <t k of ~he Board's Office Agenda Date: n n CBS Sign Off \ rAJ

V'

COUNTY OF ALAMEDA OUT-OF-STATE TRAVEL AUTHORIZATION REQUEST

Ihl=A=U=TH=O=RI=Z=A=T=I=O=N=NUM==BE=R==================================lJ11

TO: Susan S. Muranishi, County Administrator FROM: Agency / Department Head - Print Nancy E. O'Malley Si&natu,elbtfU1­SUBJECT: OUT-OF-STATE TRAVEL (OOST) AUTHORlZATION REQUEST DATE:

I am requesting your approval of the following OOST request prior to the event taking place.

* NOTE: The only ehglble personal services contractors are those who are reIIDbursed travel/events as stated m

PLEASE TYPE I PRINT LEGIBLY

District Attorney AGENCY/DEPARTMENT OIVlSION / UNIT

TRAVELER'S NAME • JOB TITLE / CLASSIFICATION or VENDOR #PLEASE TYPE I PRINT LEGIBLY

~ . FUM Oev elWYY'i'd aw;\.JpecA&1\ 0-9 C2~ Ur'1.

2. ~

3. ..

hislher contractual agreement with the County. Must specify Vendor # above. '.

DETAILS OF TRAVEL

DATES (DURAnON): From: ~ /l(p /20\1.­ To: C8 /20.L..2ol 1­

POINT OF ORlGIN (City/State): Oa.k..lC\vtd I (~ I DESTINATION (City/State): NM or .Q.Qa.V1S L-A­

PURPOSE OF TRlP: / CONFERENCE - ­ MEETING - SEMINAR - ­ TRAINING OTHER

NAME OR TITLE OF EVENT (no acronyms please):~Clm~l1 ju..5~(J2... 0evrkr CAJ'A.fe 1'e Y'\.(L

1. AUDITOR'S MAXIMUM REIMBURSEMENT (per person): $ COST PER TRANS TICKET: $: (DO~D

/ F

ITEMS COVERED: I Transportation .:L. Food & Lodging __ Event Fees ------- ­ --­TOTAL COST (Max Reimb/person x no. of travelers): $lObD~ D COUNTY TIME-OFF ONLY

ACCOUNTING INFORMATION / FUNDING SOURCE BUSINESS ACCOUNT FUND ORGANIZATION PROGRAM PROJECT/GRANT No.

UNIT No. No. No. No. /''J A." r'c (", //'1 j..}/.. / It)/)~/') ;;) :2\/1 ':} A l'\ /"I AAAr~

2, NAME OF FUNDING SOURCE (please Specify):.. \ 0(00. 4-D3. AMOUNT OF FUNDING 4. COUNTY COST AMOUNT (Noted on the Board Agenda) _

~ 2l\S-j~IL (pRi1\iT NAME) (QIC) (SNritfRE) (DATE)

PHONE NUMBER:trll) Z1t1-~~ TIE LINE: _ FAX NUMBER($10J 'UJ71-81'0't

SIGNATURE)

0,2,1 -/2....~~~~vErl2\&w 0'MAu.£Uf- _ (DATE)I (pRINT NAME)!

CAO: It\~ rWt---­ >l2." I \'2/ ~

Note: Travel agency should FAX the completed fonn to itor-Controller Agency to the attention of Travel Approver. FAX # (510) 272-6502. The Auditor-Controller's Office will notify the travel agency of the Authorization Number by phone,or FAX

I, RETURN TO: Towanda Lee - QIC 20702

- - - -

-------------------------

Completed only by the. Agenda Date: CBS Sign Off

II

110-25 (04/10)

COUNTY OF ALAMEDA OUT-OF-STATE TRAVEL AUTHORIZATION REQUEST

II AUTHORIZATION NUMBER

TO: Susan S. Muranishi, County Administrator FROM: Agency / Department Head - Print Nancy E. O'Malley SUBJECT: OUT-OF-STATE TRAVEL (OOST) AUTHORIZATION REQUEST DATE:

I am requesting your approval of the following OOST request prior to the event taking place.

PLEASE TYPE 1PRINT LEGIBLY ra.yY'\; \'1 0\\50 -\-\ ce. Ce.llkrz.District Attorney

AGENCY 1DEPARTMENT DIVISION 1UNIT TRAVELER'S NAME' JOB TITLE 1CLASSIFICATION or VENDOR #

PLEASE TYPE I PRINT LEGIBLY

l. NtA1I1 Ci (N\[712.. U'~-(vd"~1 ~((t{fh 5p?{I·~isrI I-- ...... V

2.

3. ..* NOTE: The only ehglble personal services contractors are those who are relIDbursed travel/events as stated ill

I . h h C M 'fy # bhis/her contractua agreement Wit t e ourtty. ust speci Vendor a ove. "

DETAll.S OF TRAVEL

DATES (DURATION): From: .1- @ / '2.012 To: .~_i..f).D/ '201

POINT OF ORIGIN (City/State): OCL\c:\i\t\d I CA I DESTINATION (City/StateYNesv OpJe.ans I LA

PURPOSE OF TRIP: VCONFERENCE MEETING SEMINAR TRAINING OTHER

NA!v1E OR TITLE OF EVENT (no acronyms please): \l:'M ~o. \ \'(\\\':~C'o.\\ O'"u.\ ~CI~.\,/ j\l>..~lr' lJI C.-e y\,~)}-

1. AUDITOR'S MAXIMUM REIMBURSEMENT (per person): $ foOD~1)/ COST PER TRANS TICKET: $:

ITEMS COVERED: \/Transportation \/Food & Lodging' Event Fees

0 COUNTY TIME-OFF ONLYTOTAL COST (Max Reimb/person xno. of travelers): $ \Cbb;)'D

ACCOUNTING INFORMATION I FUNDING SOURCE

BUSINESS ACCOUNT FUND ORGANIZATION PROGRAM PROJECT/GRANT No. UNIT No. No. No. - No.

l7\..d A ;:-r­ 1("",/1') 41:-. / 1/ a I') III /) IQ~..... Q .....,/\, /'IA /'C\~rJ

2. NAME OF FUNDING SOURCE (Please Specify):

3. AMOUNT OF FUNDING 4. COUNTY COST AMOUNT (Noted on the Board Agenda) \b~O.40

(QIC) '1-.S0D \

TIE LINE: RINTNAME)

PHONE NUMBER: ZIP"1- -'Ol(l1-~

RINTNAME) CAO:

APPRO DEPT.

(GNA) 2\ / $" \ 20\ "2.­

.-y 0 (;,.,-VA (DATE) _ FAX NUMBER: Z- &7 ·t - U VV-'

Note: Travel agency shoUTd FAX the completed form to A tor-Controller Agency to the attention of Travel Approver. FAX # (510) 272-6502. The Auditor-Controller's Office will notify the travel agency of the Authorization Number by phone or FAX

RETURN TO: Towanda Lee - QIC 20702