Littleton Public Schools Exhibit

Policy Code    BIBA-E-1 Policy Name     Board Member Conferences,                                  Conventions, and Workshops Adoption             October 9, 2008 Revised

CERTIFICATION OF EXPENSE AUTHENTICITY

I certify that the following expenses were incurred by me for the following trip:

____________________________ from ________ to ________ on behalf of District 6. I was unable to obtain receipts, however, payment is due as follows:

____________________           ________________________________             _______________

____________________           ________________________________             _______________

____________________           ________________________________             _______________

____________________           ________________________________             _______________

                                                                                                TOTAL            _______________

_______________________________________________                                  _______________

Signature                                                                                                          Date

_______________________________________________                                  _______________

Approval Signature                                                                                           Date

Account Number(s) ____________________________________________________________________