Credit Card
Kilometers
Hours
Site Report
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Form - KM
Name
This field is for validation purposes and should be left unchanged.
Mileage repayment
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Request Number
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Total
Direct Supervisor
*
Andreev Morin
Catherine Dagenais
Charles D'Amours-Lavoie
Alexandr Spasov
Florin Naiche
Gabriel St-Jean
Geneviève Gariépy
Hooman Mazin
Jess Beaudoin-Wallace
Kimberly Soucy-Ratajczak
Marie-Annick Fiset
Mylène Bérard
Pay
Human Resources
Tanya De Spirt-Fast
Paul Boilard
Employee First Name
*
Employee Last Name
*
Employee Email
*
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ForwardEmail
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ForwardEmail_CC
Trip #1
Starting Point
*
Home
Planiform
CIP
Other
Address
*
City
*
Point of Arrival
*
Home
Planiform
CIP
Other
Address
*
City
*
Client's Name
*
Project Number
*
Task Number
*
Date of trip
*
MM slash DD slash YYYY
km trip 1
*
Did you use the A25 bridge?
Yes
No
Comments
Add a 2nd trip
*
Yes
No
Trip #2
Starting Point
*
Home
Planiform
CIP
Other
Address
*
City
*
Point of Arrival
*
Home
Planiform
CIP
Other
Address
*
City
*
Client's Name
*
Project Number
*
Task Number
*
Date of trip
*
MM slash DD slash YYYY
km trip 2
*
Did you use the A25 bridge?
Yes
No
Comments
Add a 3rd trip
*
Yes
No
Trip #3
Starting Point
*
Home
Planiform
CIP
Other
Address
*
City
*
Point of Arrival
*
Home
Planiform
CIP
Other
Address
*
City
*
Client's Name
*
Project Number
*
Task Number
*
Date of trip
*
MM slash DD slash YYYY
km trip 3
*
Did you use the A25 bridge?
Yes
No
Comments
Add a 4th trip
*
Yes
No
Trip #4
Starting Point
*
Home
Planiform
CIP
Other
Address
*
City
*
Point of Arrival
*
Home
Planiform
CIP
Other
Address
*
City
*
Client's Name
*
Project Number
*
Task Number
*
Date of trip
*
MM slash DD slash YYYY
km trip 4
*
Did you use the A25 bridge?
Yes
No
Comments
Add a 5th trip
*
Yes
No
Trip #5
Starting Point
*
Home
Planiform
CIP
Other
Address
*
City
*
Point of Arrival
*
Home
Planiform
CIP
Other
Address
*
City
*
Client's Name
*
Project Number
*
Task Number
*
Date of trip
*
MM slash DD slash YYYY
km trip 5
Did you use the A25 bridge?
Yes
No
Comments
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