Expense Per Diem Tracker

EXPENSE PER DIEM TRACKER

Company Name:    Department:

Employee Name:    Employee ID:

Project/Cost Code:    Business Purpose:

WHEREAS

WHEREAS, the Company requires an employee to undertake travel or field services for bona fide business purposes and provides a per diem allowance to cover meals and incidental expenses; and

WHEREAS, the Employee agrees to document all per diem days and reimbursable expenses in accordance with the Company policy and to certify the accuracy of the information herein for purposes of reimbursement;

WHEREAS, the parties desire to record the travel dates, per diem entitlement, expenses advanced, and the agreed method and schedule for reimbursement and reconciliation.

SCOPE OF WORK

PER DIEM & ITEMIZED EXPENSES

Standard Per Diem Rate (if not individually listed below): $    Currency:

Total Per Diem: $    Total Lodging: $    Total Other: $

Gross Total Reimbursement Due: $    Advance Received: $    Balance Due: $

PAYMENT TERMS

The Company will reimburse eligible expenses following verification and approval. Reimbursement will be processed according to the selected schedule below. Employee certifies that all expenses claimed were incurred for legitimate business purposes and are accurate to the best of Employee's knowledge.

Reimbursement Schedule: Next payroll cycle Within 30 days of approval Other:

Late Payment: In the event of Company delay in reimbursement beyond the agreed schedule, a late fee of may be applied to amounts due, subject to Company policy and applicable law.

TERM AND TERMINATION

This tracker, and any advance or reimbursement obligation referenced herein, applies to travel commencing on and ending on unless otherwise reconciled.

Either party may require reconciliation or termination of any advance arrangement with written notice to the other party not less than days prior to the requested change. Termination does not relieve Employee of obligations to return any unspent advance or to substantiate expenses already claimed.

CONFIDENTIALITY

Employee acknowledges that certain travel assignments may involve confidential business information. Employee agrees to protect and not disclose any confidential information observed or received in the course of performing duties, in accordance with any existing confidentiality obligations between Employee and Company.

GOVERNING LAW

This Expense Per Diem Tracker and any reimbursement obligations shall be governed by and construed in accordance with the laws of the state of without regard to its conflict of laws principles.

ENTIRE AGREEMENT

This document, together with any referenced Company travel policy and supporting receipts submitted herewith, constitutes the entire agreement between the parties with respect to per diem and expense reimbursement for the travel described herein, and supersedes all prior oral or written arrangements on the same subject.

EMPLOYEE CERTIFICATION

By signing below, Employee certifies that all amounts claimed are true, accurate, and were incurred in connection with Company business. Employee acknowledges responsibility to return any unspent advances and to comply with Company receipt and documentation requirements.

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