DATE:* MM slash DD slash YYYY EMPLOYEE NAME:* PROJECT:* GENERAL CONTRACTOR:* List*DESCRIPTION OF ITEMTOTAL AMOUNTAUTHORIZED BYCOMMENTS The items listed above will be reimbursed to the employee who purchased items only. All reimbursements "must" be accompanied by the original receipt, so make a copy for your records. This form is only for items purchased out-of-pocket by the employee and authorized prior to purchase for Curtis Drilling Co. projects. Once the form has been filled out correctly then it is to be handed in to dispatch office for proper distribution. Thank you - ManagementEmailThis field is for validation purposes and should be left unchanged.