ࡱ> SUR >9bjbj΀ kD '''''$KKKP\LK&6CDd6&8&8&8&8&8&8&(+>8&E'PPP8&''}&P^''6&P6&:$,X%{KX % "&&0&*%.+z+X%f%0+'%<L6,f<<<8&8&^<<<&PPPP+<<<<<<<<< : Pre-Approval for Reimbursement of 3rd Party Lodging Reimbursement for lodging in an establishment that is being rented out by a third party is not allowed unless approved by OSBM in advance. Requests for third party lodging must provide evidence of savings to the State. An exception may be granted for requests that do not show a savings with sufficient justification to support the necessity for third party lodging. Applicants must provide their budget officer and OSBM all details regarding the arrangement, including (1) the amount to be charged, (2) the length of stay, and (3) contact information. A signed rental agreement must be presented to receive reimbursement (Section 5.1.8 Third Party Lodging, State Budget Manual). PLEASE FILL OUT A SEPARATE FORM FOR EACH LEASE AGREEMENT Campus:  FORMTEXT       Dates (# nights):  FORMTEXT       Funding: General Fund Budget Code OR Name of Grant/Other Source  FORMTEXT       Will the campus be billed directly?  FORMTEXT       Purpose of Visit:  FORMTEXT       Name(s) of Individual(s) Covered on Lease Agreement, attach additional pages if neededAmount to be Reimbursed1,2Estimated Daily Rate FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      TOTAL REIMBURSEMENT REQUEST3 FORMTEXT       1If the unit is shared by several individuals, split cost evenly (or pro-rate if lengths of stay vary). 2If the lease agreement calls for payment in a foreign currency, do not convert into USD. List the cost as stated on the lease (e.g., CZK 8,800). Approval will be determined based on exchange rate at the time of approval. 3Total must match lease agreement. If it does not, please provide an explanation:  FORMTEXT  #%34u ( , D H ]      ! " ʿʿʿʿʿʳʧʏyncR jh'h'>*CJUaJh~hCJaJh~hIUCJaJhTh7SCJaJhThCJaJh~h5CJaJh~hTCJ\aJh~h CJ\aJh~h 5CJaJh~h4QCJaJh~h CJaJh~h 5>*CJH*aJh~h 5>*CJaJh~h5>*CJaJ 4    \ b   $Ifgd)al $$d&dNPa$gdgd gd gd" , -   , 4 6 J L N X Z \ ^ ` b θέlYM?h~hT5>*CJaJh~h4Q>*CJaJ%jh'>*CJUaJmHnHu&jth'h*>*CJUaJh'>*CJaJjh'>*CJUaJh~hTCJaJh~h4QCJaJh~hCJaJ+jh'h'>*CJUaJmHnHu jh'h'>*CJUaJ&jh'h*>*CJUaJh'h'>*CJaJ    X Z \ ^ r t v ԶujbVbDV#jh'h*CJUaJjh'CJUaJh'CJaJh~h~CJaJh~h4Q>*CJaJ&j\h'h*>*CJUaJh~hIUCJaJh~h)aCJaJh~h4QCJaJh~hTCJaJ%jh'>*CJUaJmHnHujh'>*CJUaJ&jh'h*>*CJUaJh'>*CJaJ @(*,68:<Pr]K]#jah~BGhbCJUaJ(jh~BGhCJUaJmHnHu#jh~BGhbCJUaJjh~BGhCJUaJh~BGh~CJH*aJh~BGhZgCJH*aJh~BGhCJaJh~BGhZgCJaJh~h)aCJaJh~h~CJaJh~h4QCJaJjh'CJUaJ"jh'CJUaJmHnHu:bq^^^$Ifgd)al kdD$$IflF,!i T t0U"6    44 layt~BGPRT^`dfz|~޾޳޾޳޾޳}޾޳k޾޳#jh~BGhbCJUaJ#jh~BGhbCJUaJ#jhh~BGhbCJUaJ#jh~BGhbCJUaJh~BGhCJaJh~BGhZgCJaJ(jh~BGhCJUaJmHnHujh~BGhCJUaJ#jh~BGhbCJUaJ#bdq^^^$Ifgd)al kdK$$IflF,!i T t0U"6    44 layt~BG.Vq^^^$Ifgd)al kdR$$IflF,!i T t0U"6    44 layt~BG *,.0DFHRTXZnpr|~޾޳޾޳޾޳}޾޳k޾_h~BGhZg5CJaJ#j h~BGhbCJUaJ#j| h~BGhbCJUaJ#j h~BGhbCJUaJ#jh~BGhbCJUaJh~BGhCJaJh~BGhZgCJaJ(jh~BGhCJUaJmHnHujh~BGhCJUaJ#jqh~BGhbCJUaJ"VXq^^^$Ifgd)al kd]$$IflF,!i T t0U"6    44 layt~BG 46q[HH$Ifgd)al $$Ifa$gd~BGl kdh $$IflF,!i T t0U"6    44 layt~BG  "$&028:<J 0@KN 8̺ץך{s{hhh\hQhhshh~hTCJaJh~hT 5CJaJh~hT CJaJh~CJaJh~h~CJaJh~CJH*aJh~hIUCJaJh~BGhZgCJaJ(jh~BGhCJUaJmHnHu#j h~BGhbCJUaJh~BGhCJaJjh~BGhCJUaJh~BGhZg5CJaJh~BGh~5CJH*aJ68:2KFAAFFFgd~gdIUkd $$IflF,!i T A t0U"6    44 lapyt~BG89:DE2 2 2222222222\3^3`33344444 4컰yldYMjh'CJUaJh~hT CJaJh~CJaJh~hZg0JCJaJ#j h~hZgCJUaJjh~hZgCJUaJh~hZgCJaJh~hTCJaJh~h4QCJaJh~hIUCJaJ"jhCJUaJmHnHuU#j hhbCJUaJjhCJUaJhCJaJ      Does the daily rate exceed the State approved daily rate? (Consult State Budget Manual @  HYPERLINK "http://www.osbm.state.nc.us/files/pdf_files/BudgetManual.pdf" http://www.osbm.state.nc.us/files/pdf_files/BudgetManual.pdf for current rates.)  FORMCHECKBOX No a Please submit this form along with a copy of the lease agreement.  FORMCHECKBOX Yes a Go to question #2. Does the daily rate exceed standard mid-range hotel rates in the area?  FORMCHECKBOX No a Submit this form, a copy of the lease agreement and three hotels for comparison.  FORMCHECKBOX Yes a Go to question #3. What extenuating circumstances support this request? Please provide sufficient documentation and an explanation to justify an exception to State Budget policy.  FORMTEXT           Office of State Budget & Management 116 West Jones Street Raleigh, NC 27603, (919) 807-4700, www.osbm.state.nc.us/ 22224445555t66668:8<8@8B8F8H8L8N8 hh^h`gdO hh^h`gdT & F hh^hgdTgd  4&4(4*4,4.4044464444444444555555555ϵĪujjbWE#jhh'h*CJUaJh~hZgCJaJh~CJaJh~h;)CJaJh~hOCJOJQJaJ#jhhbCJUaJhCJaJjhCJUaJh~hOCJaJh~hTCJOJQJaJh~h7SCJaJh~hTCJaJjh'CJUaJ#jhhbCJUaJh'CJaJ5555t6v6666666 888$8&8(828486888<8>88888888ѿ贬|˸𾱱𾱱𾱱ϲղ'ղ6@䴳(ϴʵʵ~Z䴳"䴳Ա#b䴳䴳䴳~;)䴳#'*䴳'䴳~䴳ϴ~䴳'䴳888889:9<9>9 & F hh^hgdTgdh$hdh^ha$gdh$a$gd89 989:9<9>9h~hZgCJaJh~BGhTghTgCJaJhhhTgCJaJ21h:p7S/ =!"#$% 5 01h:p7S/ =!"#$% tDText1tDText2tDText3tDText4tDText5$$If!vh55i 5T#v#vi #vT:V l t0U"655i 5Tyt~BGtDText6tDText7vDText17$$If!vh55i 5T#v#vi #vT:V l t0U"655i 5Tyt~BGtDText8tDText9vDText10$$If!vh55i 5T#v#vi #vT:V l t0U"655i 5Tyt~BGvDText11vDText12vDText13$$If!vh55i 5T#v#vi #vT:V l t0U"655i 5Tyt~BGvDText14vDText15vDText16$$If!vh55i 5T#v#vi #vT:V l t0U"655i 5T/ yt~BGvDText20$$If!vh55i 5T#v#vi #vT:V l A t0U"655i 5Tpyt~BGvDText18DyK =http://www.osbm.state.nc.us/files/pdf_files/BudgetManual.pdfyK http://www.osbm.state.nc.us/files/pdf_files/BudgetManual.pdfyX;H,]ą'ctDCheck1tDeCheck2tDeCheck3tDeCheck4vDText19^ 2 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~_HmH nH sH tH @`@ NormalCJ_HaJmH sH tH DA`D Default Paragraph FontRi@R  Table Normal4 l4a (k (No List VoV Default 7$8$H$!B*CJ_HaJmH phsH tH j@j 4Q Table Grid7:V06U@6 Zg Hyperlink >*B*ph4@"4 Header  !4 @24 Footer  !PK![Content_Types].xmlj0Eжr(΢Iw},-j4 wP-t#bΙ{UTU^hd}㨫)*1P' ^W0)T9<l#$yi};~@(Hu* Dנz/0ǰ $ X3aZ,D0j~3߶b~i>3\`?/[G\!-Rk.sԻ..a濭?PK!֧6 _rels/.relsj0 }Q%v/C/}(h"O = C?hv=Ʌ%[xp{۵_Pѣ<1H0ORBdJE4b$q_6LR7`0̞O,En7Lib/SeеPK!kytheme/theme/themeManager.xml M @}w7c(EbˮCAǠҟ7՛K Y, e.|,H,lxɴIsQ}#Ր ֵ+!,^$j=GW)E+& 8PK!Ptheme/theme/theme1.xmlYOo6w toc'vuر-MniP@I}úama[إ4:lЯGRX^6؊>$ !)O^rC$y@/yH*񄴽)޵߻UDb`}"qۋJחX^)I`nEp)liV[]1M<OP6r=zgbIguSebORD۫qu gZo~ٺlAplxpT0+[}`jzAV2Fi@qv֬5\|ʜ̭NleXdsjcs7f W+Ն7`g ȘJj|h(KD- dXiJ؇(x$( :;˹! I_TS 1?E??ZBΪmU/?~xY'y5g&΋/ɋ>GMGeD3Vq%'#q$8K)fw9:ĵ x}rxwr:\TZaG*y8IjbRc|XŻǿI u3KGnD1NIBs RuK>V.EL+M2#'fi ~V vl{u8zH *:(W☕ ~JTe\O*tHGHY}KNP*ݾ˦TѼ9/#A7qZ$*c?qUnwN%Oi4 =3ڗP 1Pm \\9Mؓ2aD];Yt\[x]}Wr|]g- eW )6-rCSj id DЇAΜIqbJ#x꺃 6k#ASh&ʌt(Q%p%m&]caSl=X\P1Mh9MVdDAaVB[݈fJíP|8 քAV^f Hn- "d>znNJ ة>b&2vKyϼD:,AGm\nziÙ.uχYC6OMf3or$5NHT[XF64T,ќM0E)`#5XY`פ;%1U٥m;R>QD DcpU'&LE/pm%]8firS4d 7y\`JnίI R3U~7+׸#m qBiDi*L69mY&iHE=(K&N!V.KeLDĕ{D vEꦚdeNƟe(MN9ߜR6&3(a/DUz<{ˊYȳV)9Z[4^n5!J?Q3eBoCM m<.vpIYfZY_p[=al-Y}Nc͙ŋ4vfavl'SA8|*u{-ߟ0%M07%<ҍPK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 +_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!Ptheme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK]  D4D 22" P8 458>9 !bV62N8>9  !-3HTZ)/1=CEQWZflnzgsy#`xG W {  FFFFFFFFFFFFFFFFFFFXG G G G F8@0(  B S  ? Text1Text2Text3Text4Text5Text6Text7Text17Text8Text9Text10Text11Text12Text13Text14Text15Text16Text20Text18Check1Check2Check3Check4Text19"H 2F[ohyH |   4[0DXmzX   4   ² ò    9*urn:schemas-microsoft-com:office:smarttagsState;*urn:schemas-microsoft-com:office:smarttagsaddress:*urn:schemas-microsoft-com:office:smarttagsStreet8*urn:schemas-microsoft-com:office:smarttagsCity>*urn:schemas-microsoft-com:office:smarttags PostalCode        !4::H[Nq01DEXZmn6FGeefz||}}~~uvxC E F z      oS2Z~Q8r&Ƌ^`o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.^`CJOJQJo(^`CJOJQJo(opp^p`CJOJQJo(@ @ ^@ `CJOJQJo(^`CJOJQJo(^`CJOJQJo(^`CJOJQJo(^`CJOJQJo(PP^P`CJOJQJo(oSQ8r          @N $O$O0}N OTgT ^';)~BG7SIUZg/cb,4Q~S,T%)a *hV&.xQ   @@...t @ $@2Unknown G*Ax Times New Roman5Symbol3. *Cx Arial?Wingdings 3MCentury Schoolbook3@Tunga?= *Cx Courier New;WingdingsA BCambria Math"1hJJ!4d 2QHX ? !xx JWallace   Oh+'0 px    JWallace Normal.dotm 2Microsoft Office Word@@Dd@Dd՜.+,D՜.+,< hp  nc state government   Title 8@ _PID_HLINKSAW,9=http://www.osbm.state.nc.us/files/pdf_files/BudgetManual.pdf$  !"$%&'()*+-./0123456789:;<=>?@ACDEFGHIKLMNOPQTRoot Entry F0T{VData #1Table,+WordDocumentkDSummaryInformation(BDocumentSummaryInformation8JCompObjy  F'Microsoft Office Word 97-2003 Document MSWordDocWord.Document.89q