<p> FORT LEWIS COLLEGE Citibank Travel VISA Card Application and Agreement</p><p>First Name: </p><p>Last Name: </p><p>MI:</p><p>Home Address: Street: City:</p><p>State: Zip:</p><p>Work Phone:</p><p>Fort Lewis ID #:</p><p>Required Signatures:</p><p>Cardholder: Signature: ______Date: ______</p><p>Print Name: ______E-mail: ______</p><p>Department: ______</p><p>Approving Authority: Signature: ______Date: ______</p><p>Print Name: ______Phone: ______</p><p>Department: ______E-mail: ______FORT LEWIS COLLEGE Travel Card Agreement</p><p>Fort Lewis College is pleased to provide you with a state authorized travel card. This card represents Fort Lewis College’s trust in you as a responsible employee to safeguard College funds and to make travel-related decisions and arrangements consistent with all applicable rules and policies.</p><p>I, ______, acknowledge receipt of the Fort Lewis College Travel Card. As a cardholder, I agree to comply with the terms and conditions of Fort Lewis College Fiscal Rules, State Travel Rules, and this Agreement. Additionally, I acknowledge receipt of information in regards to access to Fort Lewis College Fiscal Rules and the State Travel Management Program.</p><p>As the cardholder, I agree: (To indicate that you agree, please read each line and initial) _____ To accept responsibility for the protection and proper use of the card as outlined in this Agreement and all relevant rules. _____ The card will be used only by me to pay vendors for allowable purchases of goods and services for official state government travel. _____ I will not use the card for personal purchases or personal travel. _____ I understand that Fort Lewis College will monitor the use of the card. _____ If my card is lost, stolen, or compromised in any manner, I shall immediately advise my travel compliance designee (Director of Purchasing/Travel) and the bank issuing the card. _____ If my card is lost, stolen, or compromised in any manner, I will promptly provide written notice to the issuing bank as provided for by the contract. _____ I will submit travel expense reports for reimbursement of travel charges within 30 days of completion of travel. _____ I understand that I am personally responsible for all charges made by me on this travel card and for making payment to the issuing bank within the bank’s prescribed timelines, but in no instance, later than 61 days past the first billing. _____ I understand that 1% (1 percent) interest per month will be charged on the entire unpaid balance if not paid within 60 days. _____ I understand that in the event of willful or negligent default of these obligations, Fort Lewis College shall take any recovery and/or disciplinary action deemed appropriate that is permitted by law. _____ Upon notification of my transfer from Fort Lewis College, termination of employment, suspension or cancellation of my card privileges, I agree to notify my Fort Lewis travel compliance designee (Director of Purchasing/Travel) and to promptly return my card to my agency.</p><p>FLC Fiscal Rules: http://www2.fortlewis.edu/fiscalrules/home.aspx</p><p>State Travel Management Program (STMP): http://www.colorado.gov/dpa/dcs/travel By contract, cardholders are required to report lost, stolen or compromised Citibank cards immediately by contacting Citibank Customer Service (available 24/7) at 1-800-248-4553 For questions about Citibank individual card set up, transfers or terminations please call the Office of Purchasing/Travel at 970-247-7430. Use of Citibank VISA cards is restricted to official state business only.</p>