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Jerry F. Kenny, Ph. 0. 3710 Central Avenue, Suite E Phone (308) 237 -5728; Fax (308) 237 -4651 <br />Executive director for the Governance Committee Kearney, Nebraska 68847 Email: kennyj @headvvaaterscorp.com <br />Purpose of trip., Attendance at ISAC meeting <br />Individual ft60Uestih9 th6 trip: DAVID MAItMOREIK <br />pP p nmCart: U1 per aiem. inis <br />approval form and all recei ts,shouid be sent to the Executive Director, Jerry F. Kenny, at 3710 Central Avenue, Suite E, Kearney, NE 68847. <br />Signature of Claimaht Date <br />Apprc+val <br />.xecutive Director <br />Date <br />I <br />travel Prom <br />Travel To <br />PBrk m Rate (enter under Brkfast) or Actual Expenses <br />Mileage <br />Miles Rate Amount <br />Air Fare <br />TOt� <br />Date <br />Location <br />Location <br />Lodging <br />Lunch <br />Dinner <br />Other <br />Expenses <br />IMPORTANT: <br />One form is raduired <br />for each <br />trip. Travel <br />must be itemized <br />for each day <br />Raroinfc <br />miicf do s4 i,­4 <br />pP p nmCart: U1 per aiem. inis <br />approval form and all recei ts,shouid be sent to the Executive Director, Jerry F. Kenny, at 3710 Central Avenue, Suite E, Kearney, NE 68847. <br />Signature of Claimaht Date <br />Apprc+val <br />.xecutive Director <br />Date <br />I <br />