Okaloosa County BOCC — August 2, 2016 — Public Relations Entertainment Expense Reimbursement Form

OKALOOSA COUNTY BOARD OF COUNTY COMMISSIONERS PUBLIC RELATIONS AND ENTERTAINMENT-RELATED EXPENSE REIMBURSEMENT REQUEST Okaloosa County, while recognizing that expenditures of this nature are customary within the tourism and airline industries, is cognizant of the public perception of county funds being used to purchase such items. Because of this, separate accountability and justification for expenditures are provided herein. Specific Authority: Florida Statutes 125.0104(9) and 331.20 Employee Name: _________________________________________________ Department: ______________________________________________________ Date: ______________________________________________________________ Nature of Expenditures, ie: meals, entertainment, transportation, lodgings, etc. ____________________________________________________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________________________________________________ Persons on whose behalf funds have been expended Name Title Company or Agency Relationship Attach additional list if needed Itemized list of expenditures being requested for reimbursement Date Item Description Purpose Amount P-card Total Attach additional list if needed Return on Investment The return on investment or expectation of gains from the expenditures noted herein is: ____________________________________________________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________________________________________________ I hereby affirm that the above information is true and I hereby affirm that to the best of my knowledge that the expenses correct and that expenditures noted herein serves a reported herein were for official business of Okaloosa County and such legitimate public purpose. business was performed for the purpose(s) stated above. Department Head Approval: __________________________________________________ Employee’s Signature: _________________________________________ Title/Department: _____________________________________________________________ Title: _____________________________________________________________ Department: ____________________________________________________ Date: ____________________________________________________________________________ Date: _____________________________________________________________