Milage Reimbursement Signed — File 24-1725

CITY OF SOMERVILLE MILEAGE REIMBURSEMENT INSTRUCTIONS GENERAL INFORMATION Orlglnal receipts must be submlttea tor all clalmed expenses (t0lls/parl<lng). Tape receipts lo 8 X. 111/Z paper and attach to this form. Attach a copy of Mapqµest directions showing· approximate mileage, Obtain require.ct signatures and submit this cQmpleted report with original receipts to the Auditor's office on a baton. NAME: LEON KROLIKOWSKI DEPT OF INTERVIEW: POLICE Total Amount of Expenses Submitted: j $ 2as.Mo I ADDRESS: 32 Wascussue Court New Canaan, CT06840 PRIVATE AUTOMOBILE MILEiAGEi Travel na.fe 1-rom 10 32 Wascussue Court 93 Highland Avenue 5/8/2024 New Canaan, CT 06840 Somervme, MA 02143 93 Highland Avenue 32 Wasoussue Court 5/9/2024 Somervllle, MA 02143 New Canaan, CT 06840 Totals CERTIFICATION I certify that this acooUntlng Is correct and that I have not rece1veQ previous re1mourseroents ror mese expenses. ==J.,=1;:',;,:.., o ,;;:J<I eVfffY!!,Jngl<lo/<,yood 12/12/2024 Candidate Date 11111eane 176.0 176.0 352.0 APPROVAL HR Director ' current Rate 10,a 011s1r-ar nu us1ness 1-1uroose Travel from home to 0,67 $ 117,920 Interview location Travel from Interview 0.67 $ 117.920 location from h\'.)me 0.67 $ . 0.67 $ . 0.67 $ 0.67 $ . 0.67 $ . 0.67 $ . 0.67 $ . 0.67 $ . $ 236.840 $