ࡱ> \^[ Abjbjss \$A``$ ,.GIIIIIIt`II^ GGmf)3t0pP|II.` i:   The American Society of Colon and Rectal Surgeons 85 West Algonquin Rd., Suite 550, Arlington Heights, IL 60005 (847) 290-9184 Fax: (847) 290-9203 Website: http://www.fascrs.org/ E-Mail: ascrs@fascrs.org  TRAVEL EXPENSE REIMBURSEMENT FORM (Attach All Original Receipts) NAME:_________________________________ DATE SUBMITTED:_____________ ADDRESS:_____________________________________________________________________ ______________________________________________________________ PHONE: AREA CODE:_____________ NUMBER:____________________________ PURPOSE OF TRIP:______________________________________________________ ________________________________________________________________________ DATE OF TRIP:__________________________________________________________ Any person incurring expenses for which reimbursement from the ASCRS is required, is requested to pay those expenses and complete this reimbursement form. This form with all supporting original receipts, should be forwarded to the ASCRS Bookkeeper no later than 7-10 days after travel. (Please see ASCRS Travel Policy Guidelines and Bookkeeper address on reverse side.) If other reimbursement agencies are involved in your travel, please indicate the prorated share chargeable to ASCRS on your receipts. On this form, enter only the amount due you from ASCRS. TRANSPORTATION Air Travel (attach ticket stubs)..$____________ Ground Travel (personal auto use @ $.50/mile).$____________ Taxi, parking, tolls, etc$____________ HOTEL ACCOMMODATIONS: (attach receipts per guidelines)..$____________ MEALS..$____________ MISCELLANEOUS..$____________ TOTAL REIMBURSEMENT REQUESTED $____________ THE AMERICAN SOCIETY OF COLON AND RECTAL SURGEONS TRAVEL EXPENSE REIMBURSEMENT GUIDELINES It is the policy of the American Society of Colon and Rectal Surgeons to reimburse members and employees for reasonable expenses incurred while traveling on Society related business. Original receipts for all reimbursable expenses greater than $25 must be attached. Transportation: Regarding air travel, domestic travel will be reimbursed at coach class fare. It is expected that all ASCRS members and staff will do advance-purchase ticketing to obtain the lowest airfare for that trip (usually 3-4 weeks ahead), including Saturday stay-over if applicable. Trip cancellation insurance is advised for non-refundable airline tickets. Overseas travel will be reimbursed at business class airfare. Privately-owned or rented vehicle transportation used instead of air travel will not exceed cost of airfare to the same destination, and is reimbursable at $ .50/mile. Compact or intermediate class (whichever is the lower rate) rental vehicles are reimbursable. Collision Damage Waiver insurance should be obtained and is reimbursable for that class vehicle. Living Expenses: Standard first class, but no luxury, hotel or motel should be used. Unauthorized accompanying individual expenses (e.g., spouse) are at members expense. Reasonable meal charges are reimbursed. Excess amounts should be substantiated by explanatory note. It is expected that members will exercise discretion in selection of hotel accommodations, meals and transportation. Individuals are free to upgrade any category at their own expense. All personal expenses, including entertainment, are at members expense. A $300,000/person travel and accident insurance policy is carried by ASCRS for those traveling on ASCRS-related business. For unanswered special questions, contact ASCRS Executive Officer. 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