Spreadsheet: 28b4eb62-4e29-48a3-9a60-21a783f32f19
Sheet: 02 04 2013

UNC-General Administration
Conference / Meeting Approval Form (Rev 02/04/2013)
 |  |  |  |  |  | Conference Type (select one)
1 | General Information: |  |  |  |  | Internal |  |  | External
a. | Conference Title: |  |  |  |  | Fund Type (select one)
 |  |  |  |  |  | State* |  |  | Discretionary Trust*
b. | Department FRS Account: |  |  |  |  | Contract and Grant* |  |  | Restricted Trust
 | Note:
 | *If state, contract and grant, or restricted trust funds are used, a letter of invitation to participants, agenda, and list of participants must be attached for audit purposes to qualify as a "LUMP SUM TRAVEL SETTLEMENT".  Also, the meals and breaks must comply with the OSBM daily subsistence allowances entitlement guidelines for conferences and meetings: Lunch: $10.45, Dinner: $17.90.  Additionally, overnight stay criteria must be met by participants included in the lump sum payment.
c. | Meeting Sponsor / Coordinator: |  |  |  |  |  |  | Telephone No.:
d. | Meeting Date(s): |  |  |  |  |  |  | No. of Participants:
e. | Meeting Location: |  |  |  |  |  |  | Facility Type (select one)
 | ** Appropriate state facilities were not available or their cost was greater than a non-state facility |  |  |  |  |  |  | State** |  | Non-State
f. | Meeting Purpose / Justification:
 | List Participants or Attach Listing:
2.        Conference / Meeting Expenses Requesting Approval for:
a. | Meeting room rental: |  |  | per day for |  | for day(s)
b. | Hotel room rental: |  |  | per participant per day for |  | for day(s)
c. | Coffee breaks: |  |  | per attendee per day for |  | day(s)
d. | Meals:
 |  | per attendee for breakfast for |  |  |  | days(s)
 |  | per attendee for lunch for |  |  |  | days(s)
 |  | per attendee for dinner for |  |  |  | days(s)
e. | Other costs: (describe):
3 | Required Payment Information:
a. | Primary vendor payment information:
 | Vendor Name:
 | Point of Contact: |  |  |  |  |  |  | P.O.C. Phone No.
 | Address:
 | City, State, Zip Code
b. | If necessary, additional vendor to be paid:
 | Vendor Name:
 | Point of Contact: |  |  |  |  |  |  | P.O.C. Phone No.
 | Address:
 | City, State, Zip Code
4.           Designated Individual Lobbying Expense Reporting Certification: (e.g. Legislators, Legislative Staff, and GS 138A3(3) Public Servants.)
 |  | Does the meeting costs include reportable lobbying expenditures for UNC on behalf of legislators, legislative staff, appointed or elected state officials, heads of state departments, Community College officials, employees of the Governor’s Office, etc. with the intention of influencing current or future legislative or executive action, or both.  (Yes or No)  If yes, departments must note attendees classified as designated individuals (e.g., legislators, legislative staff, or public servant, as defined in G.S. 138A-3(30)) on the final participant list submitted with the payment request.
5.        Required departmental approvals:
a. | Individual Requesting: |  |  |  |  |  |  | Date Approved:
b. | Division Vice President: |  |  |  |  |  |  | Date Approved:
c. | Sr. VP for AA or COS or COO: |  |  |  |  |  |  | Date Approved:
d. | Accounting Certification: |  |  |  |  |  |  | Date Approved: