Contract worker authorization for official travel


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BPA F 2250.01e

(09-2017)

(Page of )

U.S. DEPARTMENT OF ENERGY

BONNEVILLE POWER ADMINISTRATION

CONTRACT WORKER - AUTHORIZATION FOR OFFICIAL TRAVEL







Electronic Form Approved

by Forms Mgmt. 09/27/2017




Privacy Act Statement:

Authority: 42 U.S.C. 7101, et seq.; Federal Travel Regulation; DOE M 552.1-1A DOE Travel Manual.

Purpose: BPA will use this information to document and authorize official business travel of contract workers.

Routine Uses: A record from this system may be disclosed to the Internal Revenue Service for notification regarding taxable reimbursements. A record in this system may be disclosed to BPA/DOE employees and contractors in performance of their jobs who have a need for the records in the performance of their duties. A record in this system may be disclosed to the appropriate local, state, or federal agency when the records alone, or in conjunction with other information, indicate a violation or potential violation of law, whether civil, criminal, or regulatory in nature. Other routine uses of this information may be found in Privacy Act System of Records DOE-26 Official Travel Records.

Disclosure: Compliance is voluntary; however, failure to furnish this information may delay or preclude authorization for travel or reimbursement for travel expenses.

Directions for Completion of Form:

Note: This is a two-part form and is to be used for either Part A (yearlong limited open) or Part B (trip-by-trip or training) authorizations (not both).

Part A is to be used for day-to-day travel (mission operational purpose) and may be used for the full fiscal year.

Part B is for a single trip and is only to be completed as would be needed for a specific trip or for travel associated with training.
Contract Workers should always carry an approved copy of this authorization when traveling for BPA. Listed below are the Purpose Categories

PURPOSE CATEGORIES


Mission (Operational): Travel to a particular site in order to perform operational activities. Travel to attend a meeting to discuss general agency operations, review status reports, or discuss topics of general interest. Examples: Contract worker’s day-to-day operational activities, as defined by the worker’s assignment, to include, but not be limited to: hearings, site visit, information meeting, inspections, audits, investigations, and examinations.
Training: Travel in conjunction with educational activities to become proficient or qualified in one or more areas of responsibility. 5 USC 4101(4) states that ‘training’ means the process of providing for and making available to a worker, and placing or enrolling the worker in an planned, prepared, and coordinated program, course, curriculum, subject, system, or routine of instruction or education, in specific, professional, technical, mechanical, trade, clerical, fiscal, administrative, or other fields which will improve individual and organizational performance and assist in achieving the agency’s mission and performance goals.

1. Traveler’s Name (Last, First, Middle Initial) (Must be Legal Name)

a. HRMIS No.

b. Dept. ID

     

     

     

c. Official Duty Station (City, County, State)

d. Residence (City, County, State)

e. Employer (Supplier Name)

     

     

     
PART A – TRAVEL AUTHORIZATION FOR MISSION OPERATIONAL PURPOSES (Up to full Fiscal Year)

1. AREA:

check all that apply:

 BPA Service Area

 CONUS

2. TRANSPORTATION:

check all that apply:

 Commercial Carrier

 Privately Owned Vehicle  BPA Vehicle

3. Authorized Dates of Travel (NTE Current Fiscal Year)

     

4. Explain BPA’s Work Product that Supports this Travel:

     

Prior to Travel please email (as an attachment)/send completed form to: SupplementalLabor@bpa.gov

5. BPA Manager’s Signature (I certify that this Authorization for Official Travel is justified and in BPA’s best interest.)

a. Date







6. Contract Worker’s Employer Signature (Authorization from Supplier)

a. Date






PART B – AUTHORIZATION FOR OFFICIAL TRAVEL (Single Trip or Travel Associated with Training)


1. PURPOSE

Check one:

 Training

NOTE: Training attendance approval is based on a case by case basis and is also required

 Other (Specify)

     

2. TRANSPORTATION:

Check all that apply:

 Commercial Carrier  Rental Car  Privately Owned Vehicle  BPA Vehicle

3. Authorized Dates of Travel

4. Estimated Number of Travel Days

5. Temporary Duty Location

     

     

     

6. Estimated Costs

Lodging

M & IE

Transportation

Registration Fee

Other

Total

$

     

$

     

$

     

$

     

$

     

$

     

7. Explain BPA’s Work Product that Supports this Travel:

     

8. BPA Manager’s Signature (I certify that this Authorization for Official Travel is justified and in BPA’s best interest.)

8a. Date







Prior to Travel please e-mail (as an attachment)/send completed form to: SupplementalLabor@bpa.gov

9. Contract Worker’s Employer Signature (Authorization from Supplier)

9a. Date







FILE CODE:TT-11 RETENTION: See Agency File Plan.

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