Requester Valleri Mbofana - Office & Transport Assistant (Beira)

8-Sep-23
Location &
Purpose of the Supervisao e Apoio tecnico Distrito de Chibabava
Trip

SER 64.51 Amount of Travel Advance 43,730.00 MZN

Training Code

Section 1 - Lodging (if applicable)

Location Outside Maputo
Hotel #1 Day Month Year Activity Under USAID Max?
Check in date 27 3 2023
Check out date 31 3 2023
Total paid for lodging #1 22,000.00 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 22,000.00 MZN

Section 2 - Other Reimbursable Costs

Receipt # Vendor & Description Amount (MZN) Activity
1 Pagamento combustivel 5,644.32
2 Pagamento combustivel 3,288.96
3 Portagem 80.00
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
Additional reimbursable expenses listed on other page -

Total Other Reimbursable Costs from Section 2 9,013.28 MZN

Total M&IE from Section 3 16,546.82 MZN

Other adjustments (attach memo with detailed explanation) MZN

Total to Pay to Employee (Refund to Project) 3,830.10 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.
Requester´s Signature Reviewer´s Signature Approver´s Signature

Valleri Mbofana - Office & Transport Luis Muchate - Finance and Markos Layton - Finance/Operations Director
Assistant (Beira) Administration Manager

Printed on 09/08/2023 at 12:55:04

Requester Valleri Mbofana - Office & Transport Assistant (Beira) 8-Sep-23

Section 2 Continued - Other Reimbursable Expenses

Receipt # Vendor & Description Amount (MZN)
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60

Total Additional Reimbursable Costs listed on this page - MZN

Requester´s Initials ________ Reviewer´s Initials ________ Approver´s Initials ________

Printed on 09/08/2023 at 12:55:04
 Location Outside Maputo

Day Month Year

First day claiming M&IE 27 3 2023
Last day claiming M&IE 31 3 2023

Total Days of M&IE 5

Applicable Travel Day M&IE Due
Date Location Meals Provided? M&IE Rate Adjustment in USD
1 Monday, March 27, 2023 No Meals Provided 57.00 75% 42.75
2 Tuesday, March 28, 2023 No Meals Provided 57.00 100% 57.00
3 Wednesday, March 29, 2023 No Meals Provided 57.00 100% 57.00
4 Thursday, March 30, 2023 No Meals Provided 57.00 100% 57.00
5 Friday, March 31, 2023 No Meals Provided 57.00 75% 42.75
6 No Meals Provided
7 Mid-trip Return Date
8 Mid-trip Departure Date
9 Breakfast and Lunch
10 Breakfast and Lunch
11 Breakfast and Lunch
12 Breakfast and Lunch
13 Breakfast and Lunch
14 No Meals Provided
15 No Meals Provided
16 No Meals Provided
17 No Meals Provided
18 No Meals Provided
19 No Meals Provided
20 No Meals Provided
21 No Meals Provided
22 No Meals Provided
23 No Meals Provided
24 No Meals Provided
25 No Meals Provided
26 No Meals Provided
27 No Meals Provided
28 No Meals Provided
29 No Meals Provided
30 No Meals Provided
31 No Meals Provided

Other adjustments (attach memo with detailed explanation):

Total M&IE (USD) 256.50

Total M&IE (MZN) 16,546.82

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 ________ Reviewer's Initials ________ Approver's Initials ________

Printed on 09/08/2023 at 12:55:04
 PSM Mozambique
Trip Report Form

Traveler: Valleri Mbofana - Office & Transport Assistant (Beira)

Trip Dates: Day Month Year

Start Date: 27 3 2023
End Date: 31 3 2023

Destination(s):

Purpose of trip:

Trip Results/
Summary

Next Steps/
Follow-Up: