PUBLIC PURPOSE VERIFICATION FORM
To be completed and submitted with request for reimbursement/payment of meals/refreshments with District Funds.

The Vendor to be paid is 	. The amount to be paid is 	.
Centerville Community School Board of Education adopted procedure:
In-District meals will be reimbursed or provided during the course of meetings/programs, when a specific district purpose can be documented, or when the normal lunch period is compressed to accommodate the schedule. Food may be served before or after contract hours in lieu of extended contract payments. Documentation (list of participants/minutes/notes/summary of meeting) is to accompany the claim for reimbursement.

Requesting Administrator: 	Building	 Date of food/refreshment service: 		
Time of food/refreshment served: 	a.m. 	p.m. Type of meeting: 		
List of participants: identify by name and category (employee/parent/etc.) when participants exceed 10 in number state the number and category.

The specific District Purpose served by providing refreshments/food (complete those that apply)
 	courtesy refreshments for parents/volunteers/citizenry
 	refreshment/food provided employees in lieu of salary as the meeting took place outside of normal working hours
 	other  	

Attach minutes/notes/summary of the meeting.