Employee Name: ______________________________________________________ Expense Date Ranges: _______________ through _______________
| Date | Amount | Category | Mileage | Explanation |
| 1/1/0000 | 45 x IRS Standard Reimbursement | Mileage | 45 | Drove to airport |
| 1/2/0000 | $400 | Air travel | n/a | Flew to LA |
| 1/3/0000 | $55.00 | Meals | n/a | Dinner |
| 1/5/0000 | $750.00 | Hotel | n/a | 3 nights stay |
This content is for CoAction Insurance policy holders.
To request portal access, send an email to losscontrol@coactionspecialty.com with “Coaction LC Portal” in the subject line and include your policy number in the email body.
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