I certify that the expenses reported on this form are accurate and legitimate business expenses incurred on behalf of PDC PEACE PLAN.

I understand that falsification of expense reports may result in disciplinary action, up to and including termination.

I agree to comply with PDC PEACE PLAN policies and procedures regarding expense reporting and reimbursement.

Signature:

I, hereby submit this expense report for reimbursement and certify that the information provided is accurate and true.