Requester Leila Tome- Assistant Admnistrative 4/11/2020

SER 61.92 Amount of Travel Advance 96,000.00 MZN

Section 1 - Lodging (if applicable)

Location Outside Maputo

Hotel #1 Day Month Year Under USAID Max?

Check in date
Check out date
Total paid for lodging #1 MZN Yes

Hotel #2 (only if applicable) Day Month Year

Check in date
Check out date
Total paid for lodging #2 MZN Yes

Hotel #3 (only if applicable) Day Month Year

Check in date
Check out date
Total paid for lodging #3 MZN Yes

Total Lodging from Section 1 0.00 MZN

Section 2 - Other Reimbursable Costs

Receipt # Vendor & Description Amount (MZN)
1 Perdiem Ali Alfredo Malando DPS- Nampula- 5 dias 1050 diario 5,250.00
2 Perdiem Osvaldo Jantar DPS- Nampula- 5 dias 1050 diario 5,250.00
3 Perdiem Jordao Pedro-TMG-SDSMAS-Malema 1 dia a 1500 diario 1,500.00
4 Perdiem Salomao Cunchia-Enfermeiro Geral-SDSMAS-Malema 1 dia a 1500 diario 1,500.00
5 Perdiem Regina Passe DPS-Nampula 5 dias a 1050 diario 5,250.00
6 Perdiem Marcelino Figueira Tec Superior N1-SDSMAS-Ribaue 2 dias a 1700 diario 3,400.00
7 Perdiem Lemos Muhambi -TMG-SDSMAS-Ribaue 1 dia a 1500 diario 1,500.00
8 Perdiem Januario Sitora- Tec Superior N1-SDSMAS- Ribaue 1 dia 1,700.00
9 Perdiem Azarias Gimo- DPS- Nampula 5 dias 1050 diario 5,250.00
10 Perdiem Elmane Sergio Joao-DPS- Nampula 5 dias 1190 diario 5,950.00
11 Perdiem Manuel Pedro Cocorico DPS-Nampula 5 dias a 1190 diario 5,950.00
12 Perdiem Regina Passe DPS-Nampula 5 dias a 1190 diario 5,950.00
13 Perdiem Abilio Cristovao Alfredo DPS- Nampula 5 dias a 1190 diario 5,950.00
14 Perdiem Leonardo Felix Matinada DPS- Nampula 5 dias a 1190 diario 5,950.00
15 Perdiem Nere Luis TMG-SDSMAS-Erati 3 dias a 1500 diario 4,500.00
16 Perdiem Rodwell Rodgers Melo TMG-SDSMAS-Mossuril 2 dias a 1500 diario 3,000.00
17 Perdiem Edgar Luis Jose Pereira- TMG-SDSMAS-Mossuril 1 dia a 1500 diario 1,500.00
18 Perdiem Rahamane Carlos -Tecnico de Estatistica- Mossuril 1 dia a 1500 diario 1,500.00
19 Perdiem Regina Passe - DPS-Nampula 5 dias a 1050 diario 5,250.00
20 Perdiem Gito Marcelino- DPS Nampula 5 dias a 1050 diario 5,250.00
21 Perdiem Azarias Gimo- DPS- Nampula 5 dias 1050 diario 5,250.00
22 Perdiem Osvaldo Jantar DPS- Nampula- 5 dias 1050 diario 5,250.00
23 Perdiem Gino Gonsalves- DPS- Nampula 5 dias a 1050 diario 5,250.00
24
25
26
27
Additional reimbursable expenses listed on other page -

Total Other Reimbursable Costs from Section 2 97,100.00 MZN

Total M&IE from Section 3 - MZN

Other adjustments (attach memo with detailed explanation) MZN

Total to Pay to Employee (Refund to Project) 1,100.00 MZN

Certification:
I certify that all of the information that I have provided on this expense report and related backup
documentation is truthful, complete and accurate.

Leila Tome- Assistant Admnistrative

Approval:
I confirm that I reviewed this expense report and related backup documentation and
I approve for payment.

Antonio Mussa - Chief of Party

Printed on 04/11/2020 at 10:14:23

Requester Leila Tome- Assistant Admnistrative 5/24/2019

Amount of Travel Advance

Section 2 Continued - Other Reimbursable Expenses
Receipt # Vendor & Description
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
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31
32

Total Additional Reimbursable Costs listed on this page - MZN

 Location Outside Maputo M&IE Breakdown (USD):

Day Month Year Breakfast 17.00

First day claiming M&IE Lunch 29.00
Last day claiming M&IE Dinner 45.00
Incidentals 23.00
Total Days of M&IE 1 Total 114.00
Applicable Travel Day M&IE Due
Date Meals Provided? M&IE Rate Adjustment in USD Applicable M&IE Rates (USD):
1 Tuesday, November 30, 1999 No Meals Provided 114.00 75% 85.50 Select One -->
2 No Meals Provided No Meals Provided 114.00
3 No Meals Provided Breakfast Provided 97.00
4 No Meals Provided Lunch Provided 85.00
5 No Meals Provided Dinner Provided 69.00
6 No Meals Provided Breakfast and Lunch 68.00
7 No Meals Provided Lunch and Dinner 40.00
8 No Meals Provided Breakfast and Dinner 52.00
9 No Meals Provided Breakfast, Lunch, and Dinner 23.00
10 No Meals Provided Not Claiming M&IE -
11 No Meals Provided
12 No Meals Provided
13 No Meals Provided
14 No Meals Provided
15 Select One -->
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29 Select One -->
30 Select One -->
31 Select One -->

Other adjustments (attach memo with detailed explanation):

Total M&IE (USD) -

Total M&IE (MZN) -

Policy on Reductions in M&IE Reimbursement
The following circumstances will cause a reduction in the M&IE reimbursement:
Meals furnished by the the project, USAID, USAID implementer, or any U.S. Government agency
Meals provided by a conference/workshop/seminar/training/etc.
Meals in which the traveler pays for a meal for one or more persons and submits the bill in the expense report
The M&IE reimbursement will NOT be reduced in the following circumstances:
If a meal is provided by a common carrier (i.e., airline)
If a meal is provided by the hotel (i.e., complimentary breakfast)
If a meal is provided by a private party who would not otherwise bill it to a US federal contract

Requester's Initials ________ Printed on 04/11/2020 at 10:14:23

 Location Outside Maputo M&IE Breakdown (USD):

Day Month Year Breakfast 17.00

First day claiming M&IE Select Day Select Month Year Lunch 29.00
Last day claiming M&IE Select Day Select Month Year Dinner 45.00
Incidentals 23.00
Total Days of M&IE Total 114.00
Applicable Travel Day M&IE Due
Date Meals Provided? M&IE Rate Adjustment in USD Applicable M&IE Rates (USD):
1 No Meals Provided 75% Select One -->
2 Lunch Provided No Meals Provided 114.00
3 Lunch Provided Breakfast Provided 97.00
4 Lunch Provided Lunch Provided 85.00
5 Lunch Provided Dinner Provided 69.00
6 Lunch Provided Breakfast and Lunch 68.00
7 Lunch Provided Lunch and Dinner 40.00
8 Lunch Provided Breakfast and Dinner 52.00
9 Lunch Provided Breakfast, Lunch, and Dinner 23.00
10 Lunch Provided Not Claiming M&IE -
11 Lunch Provided
12 Lunch Provided
13 No Meals Provided
14 Select One -->
15 Select One -->
16 Select One -->
17 Select One -->
18 Select One -->
19 Select One -->
20 Select One -->
21 Select One -->
22 Select One -->
23 Select One -->
24 Select One -->
25 Select One -->
26 Select One -->
27 Select One -->
28 Select One -->
29 Select One -->
30 Select One -->
31 Select One -->

Other adjustments (attach memo with detailed explanation):

Total M&IE (USD) -

Total M&IE (MZN) -

Policy on Reductions in M&IE Reimbursement
The following circumstances will cause a reduction in the M&IE reimbursement:
Meals furnished by the the project, USAID, USAID implementer, or any U.S. Government agency
Meals provided by a conference/workshop/seminar/training/etc.
Meals in which the traveler pays for a meal for one or more persons and submits the bill in the expense report
The M&IE reimbursement will NOT be reduced in the following circumstances:
If a meal is provided by a common carrier (i.e., airline)
If a meal is provided by the hotel (i.e., complimentary breakfast)
If a meal is provided by a private party who would not otherwise bill it to a US federal contract

Requester's Initials ________ Printed on 04/11/2020 at 10:14:23

Select DaySelect Month Year Select One -->

1 1 2016 In Maputo
2 2 2017 Outside Maputo
3 3 2018
4 4 2019
5 5 2020
6 6
7 7
8 8
9 9
10 10
11 11
12 12
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Current M&IE Rates Current Maximum Loding Rates

In Maputo Outside Maputo In Maputo 220.00

Breakfast 17.00 17.00 Outside Maputo 189.00
Lunch 27.00 29.00
Dinner 44.00 45.00
Incidentals 22.00 23.00
Total 110.00 114.00

Select One --> In Maputo Outside Maputo

No Meals Provided 110.00 114.00
Breakfast Provided 93.00 97.00
Lunch Provided 83.00 85.00
Dinner Provided 66.00 69.00
Breakfast and Lunch 66.00 68.00
Lunch and Dinner 39.00 40.00
Breakfast and Dinner 49.00 52.00
Breakfast, Lunch, and Dinner 22.00 23.00
Not Claiming M&IE 0.00 0.00
Please select from drop down -->

Jafete Guedes - Director of Finance/Operations

Antonio Mussa - Chief of Party
Guilhermina Fernandes - SME Technical Advisor
Sarmento Armando - Technical Director
Salimone Nhancume - HMIS Specialist
Nelia Ombe - Grants and Subk Manager
Ana Xerinda - Project Accountant
Teofilo Luis - Nampula Provincial Manager
Elias Cossa - SBCC Advisor
Abdul Ismael - Nampula SME Specialist
Leila Tome- Assistant Admnistrative
Please select from drop down -->

Antonio Mussa - Chief of Party

Debora Freitas Lopez - Home Office Director
Home Office Representative