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Michele Lahey Expense Summary
2007-2008
Functional Centre: 201.9000.71110101090171125200002
CATEGORY
Travel- Travel-Out of
Accounting Local/Parking Province Taxi Miscellaneous Meals
Period InvQice Number 624IQOOO 62414000 6 ~ 4 1 0 0 0 1 69500000 69o0000Q GST Total Comments
APR-08 TRA YEL-25JAN07 7,223.94 !.36 7,225.30 MAYO CLINIC JAN 23-25/07
APR-08 REIMBURSE-28FE807 102.57 6.15 108.72 CAR EXPENSES FEB01-28/07
APR-08 REIMBURSE-21 MAR07 96.74 502.42 231.36 42.45 872.97 V. TRON DINNERJMILE/EXTRA (QUEBEC) FEB16-MAR21/07
APR-08 REIMBURSE-3 1 MAR07 33.07 1.98 35.05 CAR EXPENSES MAR01-31/07
MAY-08 TRA VEL-20APR07 300.87 16.48 317.35 CAPHC BOARD RETREAT, TORONTO, APR19-i0/07
MAY-08 TRA VEL-26APR07 537.76 30.79 568.55 CHILD SUMMIT -OTT A W A-APR25-26/07
MAY-08 REIMBURSE-JOAPR07 137.28 1,778.21 114.93 2,030.42 CAR EXPENSES APR01-J0/07
MAY-08 REIMBURSE-JOAPR07-2 38.64 74.52 872.30 51.18 1,036.64 MEALS/GIFTS/PARK APR07-J0/07
JUN-08 REIMBURSE-29MAY07 37.74 51.89 333.85 775.18 46.51 1,245.17 MEALS/GIFTS/PARK/CAB APR07&30; MA Y03-24/07
JUN-08 REIMBURSE-3lrv1A Y07 1,220.58 73.23 1,293.81 CAR ALLOWANCE MAY 2007
JUN-08 REIMBURSE-29JUN07 53.77 28.30 239.04 8.03 18.25 347.39 G1FTS/PARKINGfTAXVFUEL MAYJO-JUN29/07
I st Quarter Total 1,720.39 8,564.99 80.19 2,425.62 l ,886.87 403.31 $ 15,081.37
Total to Date 1,720.39 8,564.99 80.19 2,425.62 1,886.87 403.31 $ 15,081.37
M. Lahey
APPLICANT COPY
288
Capital Health
EDF!ONTON AREA
DATE:
To:
FROM:
Copv:
Re:
April10, 2007
Sheila Weatherill
Michele T.
Allaudin Merali
Expenses - Mayo Visit
Executive Vice President &
Chief Operating Officer- Health Services
Gp.PITAL HEAI.if.!
RECEIVED
APR 1 3 2007
Attached please find a summary of expenses for my visit to the Mayo Clinic on
January 23-25, 2007. You had previously indicated that Capital Health will reimburse
me for these expenses.
Thank you.
Capital Health Corporate Office
1J2.07 Walter CE!!ntre, 8440-112 Street, Edmonton, Alberta T6G 287
(780) 4071671 (Fax) 407-1675
email : m/ahey@cha.ab.ca
www.capitalhearth.ca
APPLICANT COPY
289

-=-
Name: Michele Lahey
Travel & Employee Expense Claim Form
(In Canadian Dollars)
1 Employee Number: !
'
I Union Name:
Position: Executive Vice President & COO- Health Services I Department: SPCORP
Business Phone: 407-1671 I Period From: January 23 to January 25, 2007
Expenses Paid (please attach receipts). Do not include amounts paid by .Capital Health or reimbursed I reimbursable by
h . . C I h h
anot er orgamzatlon. ete details on t e ot er side of the form
Bal Unit Location Functional Centre Account Non-Canadian
Canadian$
"ifGST
Rate (including
e.g. 201 e.g. 9000 e.g. 71135050044 e.g. 69500001 Currency
GST)
included
201 9000 71110101090 sg5eggog... $7,225.30
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Total $7,225.30
The information on this form is collected under section 4 of the Regional Health Authorities (Ministerial) Regulation and
will be used to process your claim . .
I hereby certify that the expenses listed above were incurred on Health business and have not been previously
claimed by me or on my behalf from Capital Health or other organization.
Employee Signature:
(Signature)
Approved By:
(Prlrrt name)
(Signature)
NOTE:
Date:
President & CEO - Capital Health
/
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Phone# 407-8008
Date 13
Phone#
Date
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Expense claim must be properly authorized and must be supported by original receipts or a copy as certified by the
approver. The approver must initial individual items that are not supported by original invoices or do not have all the
required supporting documents to indicate approval without support. Unsupported claims over $1,000 require level'4
approval.
GST amounts included in the expense claims will be calculated by Accounts Payable.
For all employees on the payroll system, expense reimbursements will be deposited to employee bank account.
For physicians, contracted employees and those not paid through the payroll system, expense reimbursements will be mailed
through th internal mail system.
See the other side of this form for expense claim limits.
Approved claim form with receipts should be sent to Accounts Payable (Capital Health Centre, North Tower - 10th Fl. , 10030 -
107 Street, Edmonton, AB T5J 3E4)
Out of proVince expenses also require approval of Chief Operaffng Officer or Vice President.
i -0313 March, 2006
Section 17(1)

APPLICANT COPY
290
EXPENSE CLAIM DETAILS
Date Particulars Accomm.$ Meal$ Registration $ Transportation $ Other$
Mileage
km
Expenses re Mayo Clinic Visit
as attacheded
.
.
Total km
*(or alternate rate as outlined in Section 2- Travel below)@ $0.43*
Totals
I I
I
EXPENSE LIMITS
1 . Meal Allowances
When traveling on C a p i t ~ l Health business, the employee may be reimbursed at the Per Diem meal allowance of:
Breakfast $8.00 (if the departure time is earlier or the return time is later than 7:00 a.m.)
Lunch $10.00 (if the departure time is earlier or the return time is later than 1:00 p.m.)
Dinner $17.00 (if the departure time is earlier or the return time is later than 7:00 p.m.)
For meal expenses that exceed the above amounts, the supervisor may approve higher amounts, with receipts, provided these are
reasonable.
Meal expenses must be supported by restaurant receipt (not just credit card receipt) and information on either the names of the individuals or
organizations whose representatives attended the lunch/dinner meeting. '
2. Travel
Use of personal automobile- From March 1, 2006, reimbursement at the rate of $0.43 per km for the first 15,000 kilometers of approved
travel in a fiscal year (April1 to March 31)and $0.40 for each kilometer there after (except where collective agreement specifies
otherwise).
Business car insurance is reimbursable up to $260 per year with receipts in accordance with Capital Health Policy.
Effective March 1, 2006, out of scope employees required to provide a vehicle as a condition of employment and meeting the following
requirements on a regular and continuing basis as approved by an authorized manager.
1. Monthly travel in excess of 340 kilometers; or
2. Monthly expense equivalent to four (4) return cab fares at $20 one way; or
3. Daily requirements to utilize personal vehicle in the course of duties -reimbursed at $0.50 per kilometer.
If union contract rate differs from $0.43 then contract rate must be used.
Includes all forms of transportation costs, including taxis and buses for local travel.
Driving to and from work is not considered business travel and cannot be claimed.
3. Advance
Travel advance may be requested provided travel expenses are likely to exceed $500.
APPLICANT COPY
291
Summary of Expenses
Michele Lahey
Rochester, MN
January 23-25, 2007
Travel:
Airport Transfer
Airport Transfer
Accommodation:
/ A23 US Funds
$23 US Funds
/
Marriott Rochester "' $538.28 US Funds
Marriott Rochester ./$5.00 US Funds
Meals:
Lunch
Dinner
Lunch
Snack
Coffee
Dinner
Coffee
./$31.70 US Funds
./$31.29 US Funds
/$9.42 US Funds
/$2.99 US Funds
/$124.82 US Funds
/$8.19 US Funds
Paid to Mayo Clinic:
January 23
January 25
(@ 1.211041 = $27.85 Cdn) ,/
(@ 1.210062 = $27.83 Cdn) /
January 23-25(@ 1.210745 = $651.72 Cdn) v'
January 26 (@ 1.212000 = $6.06 Cdn) /
January 23
January 24
January 24
January 24
January 24
January 24
January 25
$28.89 Cdn ;;14. o ')
(@ 1.211041 = $38.39 Cdn) ../
(@ 1.211041 = $37.89 Cdn) ,
(@ 1.211041 = $11.41 Cdn)
1
(@1.211041=$3.62Cdn) /
(@ 1.210062 = $151.04 Cdn) v
(@ 1.210062 = $9.91 Cdn) /
us Funds(@ 1.210984 = $6,054.92 Cdn) (Jan 24/07)
..$555 US Funds(@ 1.153 = $639.91 Cdn) (March 30/07)
/Reverse Charge- $404 US Funds(@ 1.148861 = $464.14 Cdn) 1
Total Amount Paid: $5,151 US Funds ($6,054.92 + $639.91 - $464.14 = Cdn)
TOTAL TO BE REIMBURSED: $7 225.30 CON
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TURK CLUB 9.99
SAND SALMON CLUB
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NO BACON
WATR PRRIER 17oz 3.99
SUBTOT.AL
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HMSHo:o : 11222
STARBUCKS llr: CONCDUflSE
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CHK 6594 JAN25'07 9:35AM
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CARAMEL MACHIATO
Grnd LATTE
Subtotal
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Amt Paid
Cash
Change Due
t.l.S. s
Thank You!
4.19
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APPLICANT COPY
294
APPLICANT COPY
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APPLICANT COPY
296

ROCHESTER
MAYO CLIMIC AREA
307 'LAHEY/MICHELE/MS
ROOM NAME
NSQN
TYPE
01/23 STATETAX
01/24 OAKROOM
01/24 AQUAF'INA
01/24 MOVIES
01/24 ROOM
01/24 STATETAX
01/25 AQUAFINA
01/25 CCARD-BK
5ETTLED TO:
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307' 1
1577 307
1
MOVIE
307' 1
307' 1
1 BTL
VISA
101 S. W. First Avenue
Rochester, MN 55902
(507) 280-6000
{507) 280-853f Fax
Marriott com
GUEST FOLIO
219.00 01/25/07 06:45 10114
RATE OEPAAT TIME ACCT#
. 01/23/07 14:39
. ARRIVE
PASSPORT:
PAYMENT .
.
24.09
31.29
2.50
15.81
219.00
24.09
2.50
TIME
538. 28
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MR#:
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WANT YOUR FINAL HOTEL BILL BY EMAIL? JUST ASK THE FRONT DESK!
.,\\arrtott.
ROCHESTER
MAYO CLINIC AREA
101 SW. First Avenue
Rochester, MN 55902
{507) 280-6000
(507} 280-8531 Fax
Marriott.com
This statement is your only receipt. You. have agreed to pay in cash or by approved c:heck.or to authorize us to credit card forafl llmounts tharg!CI to
you. The amount shown in the credits column oppos;te any credit card e.ntry In the reference column above Wfll bot! charged to t he credit card number set forth above. (The
credi t card company will bill in the usual manner.) If ior any reason the cred1t company does not make payment on this account. you will owe: 1.15 s uch amount. Jfyou are
direct billed, in everrt pa'Y"'ent is not n"'ade within 25days after check-out, you will us interest from the check-out date O:'l. any un!)aid amou!'lt at the rate. of l.So/c per
month (ANNUAL RATE 18%), or the maximum allowed by law, plus the reasonabl e cost of collection, Including attomey fees.
Signature X
FOR RESERVATIONS AT ANY MARRIOTT HOTEL, CALL (800) 228 9290
. .r..-
Section 17(1),(4)(e.i)

APPLICANT COPY
297
.\\arrloff.
ROOf ESTEll
MAYO CUNlC AREA
307 LAHEY/MICHELE/MS
ROOM NAME
NSQN
L
ADDRESS
01 23 ROOM
01/23 STATETAX
01/24 OAKROOM
01/24 AQUAFINA
3 '
307' 1
1577 307
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MOVIE
219.QO 01/25/07
RA.TE; DEPART
01/23/07
ARRIVE
PASSPORT:
PAYMENT
2 .
24.09
31.29
2.50
15.81
219.00
24.09
101 S.W. First Avenue
Rochester, MN 55902
(507) 280-6000
(507) 280-8531 Fax
Marriott com
GUEST FOLIO
12:00 10114
TIME ACCf#
14:39
TllfE
MR#:
' 01/24 MOVIES
01/24 ROOM
01/24 STATETAX
01/25 BK CARD
3.07' 1
307' 1
$535.78
TO BE SETTLED TO: VISA CURRENT BALANCE .00
THANK YOU FOR CHOOSING MARRIOTT! TO EXPEDITE YOUR CHECK-OUT,
PLEASE CALL THE FRONT DESK, OR PRESS M.ENU ON YOUR
TV REMOTE CONTROL TO ACCESS VIDEO CHECK-OUT.
- - -- ---- ------- ---- EXP. REPORT SUMMARY ------ - --- - - ----- --
01/23 ROOM 219.00
STATETAX 24.09
01124 OAKROOM
' AQUAFINA
MOVIES
ROOM
STATETAX
31.29
2.50
15.81
219.00
24.09
WANT YOUR FINAL HOTEL BILL BY EMAIL? JUST ASK THE FRONT DESK!
.,\\arrtott
ROCHESTER
MAYO CLINIC AREA
101 S.W. First Avenue
Rochester, MN 55902
(507) 280-6000
(507) 280-8531 Fax
Marriott. com
This ts your only rec.eipt. You have agreed to pay fn QSh ot by apProved personal chec.k or to authorize us to charge your credit c11rd for all amounts ch.erged. to
yo1.1. The amount s hown in the credits column opposite any credit card entry ir. the reference column a bove wlll be c:harged to t he ue.dit card number set forth above. (The
credit card company w1ll bill in t he. us ual manner.) lffor a ny rea5on credit catd company does not make payment on this you will owe us such amount. "you are
billed, ln the event payment Is not made wrthin 25 days after check-out, ycu will owe u.s interest from t he check-out date on any unpaid amount zt the. rate of per
mont h (ANNUAL RATE 18%), or t he maximum allowed by Jaw. plus the reasonable cost of colledion, including attorney fees.
Signature X -------------------------------
FOR RESERVATIONS AT ANY MARRIOTT HOTEL, CALL (800) 228 9290
Section 17(1),(4)(e.i)

APPLICANT COPY
298
Section 17(1)

Section 17(1)

APPLICANT COPY
299
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MICHELE T LA
J.Ai\f23 ........... 'lrliscli.G'Rit[:Msfi:lio6Eriiliuf'MN . ................................... l3aj9
Foreign Currency-USD 31.70 Exchange rate-1.211041
J'A'N.23 ............ iii.sPER-Mi'NEATERY'&.B"REw6iib.MoN.f6N-Iiif ....................... .. 89.
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IMPORTANT INFORMATION
Add a Co-APplicant to your RBC
Ro al Bank Visa Card
Adding a co-applicant to your RBC Visa card has many
benefits. They will share all the exclusive benefits,
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s.17(1)
APPLICANT COPY
300
Section 17(1)

Section 17(1)

Non Responsive