Expense Disclosure Reporting Form

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1 Expense Disclosure Reporting Form Name: Pieter Lambooy, VP Operations For the Period: May 16 Travel, Seminars/Conference and Associated Expenditures Date of expense Destination Purpose Airfare Other Transportation Accommodation Meals (includes per diem allowances) Seminar / Conference / Registration fees Total 1 April 28 30, 2016 Calgary & Banff Attended Alberta Health Services Mental Health Advisory Committee meeting and Alberta Motor Transport Association (AMTA) meeting $ $ $93.00 $ May 4, 2016 Calgary Partnerships in Injury Reduction (PIR) meeting $ $43.82 $ May 19 20, 2016 Toronto Attended Association of Workers Compensation Board of Canada (AWCBC) All Committee meeting $ $24.00 $ $97.00 $1, $ $ $ $ $ $ $0.00 Travel Related $2, Notes Non travel related Expenditures (Business meals, etc ) Dates Purpose Total 1 $ $ $ $ $ $ $ $ $ $0.00 Non Travel Related $0.00 Notes Total claimed for reporting period: $2, Page 1 of 1

2 Mileage & Per Diem Allowances Employee Name Expense Type Submitted Date Trip Info Trip Start Date Trip End Date Expense Trans Date Detail Description Total Amount (Includes GST/HST) Summary Item Reference AHS Mental Health Advisory Cmte in Calgary and AMTA in Travel Meal Allowance Pieter Lambooy Travel Meal allowance 5/1/2016 Banff 4/28/2016 4/30/2016 4/28/2016 $ Drive Edm to Calgary April Pieter Lambooy Mileage AHS Mental Health Advisory Cmte in Calgary and AMTA in 5/1/2016 Banff 4/28/2016 4/30/ : Drive Calgary to Banff April 29: Drive Calgary to 4/30/2016 Edm April 30/16 $ /17/2016 at 07:00 AM to 05/19/2016 at 09:30 PM - Toronto - AWCBC All Committees Meeting [OoP] Ontario [C/S] ~ AWCBC -NWISP Breakfast and lunch provided on Weds May 18 and Thurs May 19 Pieter Lambooy Travel Meal Allowance committee meeting which I 5/27/2016 chair 5/17/2016 5/19/2016 5/17/2016 $

3 TJ<.1P #I.:Jh,.RIMROCK ~ r:~ollt ICOT E I. Mr. Pieter Lambooy Edmonton, Ae. _ Canada Room No. Arrival Departure Conf. No. Ref. No /29/16 04/30/16 Group Name Company Name AB Motor Transport Assn - 2C Alberta Motor Transport Assoc Cashier No. : 20 Date Description Charges Credits CAD CAD 04/29/16 Package /29/16 04/29/16 04/29/16 04/30/16 Self Parking GST Room Tourism Levy Balance 0.00 CAD Enjoyed Your Stay? Please take time to share your experience on Trip Advisor. Thank you for choosing The Rimrock Resort Hotel. We look forward to your next visit! The Rlmrock Resort Hotel 300 Mountain Ave. Banff, AB, CA T1L 1J2 Telephone GST: R

4 TR.1P-tt 2 Dollar Thrifty Autc1otive Group Canada In 2006 AirPQrt RD NE GST R Calgary~ AB T2E6MS Phone: 403) Fox : 403) RA#: Renter: PIETER LAMSOOY Rented: 05/04/ YYC Returned: 05104/ YYC Uriit#: Closs : MVAR Odom Out: 4,218 In: 4,285 Kilometers Driven 67 - C H A R G E S - Hourly Dally Net T&f.I Energy RecoverY. Fee Veh l\c Fee ana Air Tax Rec Premh111 Location Charge - Y Customer Faci.l it:y Charge Fuel Charge For Un\t:# Goods and Services Tax YYC Subtotal of Other Charges Total Charges Payment: tg~'f ~i)osits/paymeots Net Due ?l Piew l..;im wolt fof<i ff'f (.,.l\fj.. (?ental MA'-{ L! 2clb. 1 t C/8 OVU.~A ll.qe. a.eo IT )6 N\Ai l~r 2CI h. TOTAL CH~' P\eose shore your feedback. Visit: survey.co Enter Access Code: YYC CPftl)let:e a brief survey about your rental experience.

5 ' eticket Receipt Prepared For LAMBOOY/PIETER MR RESERVATION CODE ISSUE DATE TICKET NUMBER ISSU JN GAIR LINE ISSUING AGENT 27Apr16 WestJet/SDX FREQUENT FLYER NUMBER Itinerary Details TRAVEL DATE AIRLINE DEPARTURE ARRIVAL OTHER NOTES 04May WS104 EDMONTON INTL AB, CAN.ADA 805am CALGARY INTL AB CAN.ADA 8.55am Seat Number 07C (CONFIRMED) Baggage Allowance NIL Booking Status OK TO FLY Fare Basis MA05TL Not 'lahd Before 04MAY Not 'lahd Mer 04MAY 04May WS145 _J CALGARY INTL AB CAN.ADA 4:50pm EDMONTON INTL AB. CAN.ADA nme 5:39pm Seat Number 070 (CONFIRMED) Baggage Allowance NIL Book ng Status OK TO FLY Fare Basis MAOSTL Not valid Before 04MAY Not valid Alter 04MAY Allowances Baggage Allowance YEG (0 YYC - 0 Pieces WESTJET Prices of adduional baggage pieces: CAD up to 50 pounds/23 kilograms and up to 62 linear inches/158 linear centimeters CAO up to 50 pounds/23 kilograms and up to 62 linear inches/158 linear centimeters YYC to YEG. 0 Preces Prices of additional baggage pieces: CAO up to 50 pounds/23 kilograms and up to 62 linear inches/158 linear centimeters CAD up pounds/23 kilograms and up to 62 hnear inches/158 hnear centimeters ADDITIONAL ALLOWANCES AND/OR DISCOUNTS MAY APPLY DEPENDING ON FLYER SPECIFIC FACTORS /E.G. FREQUENT FLYER STATUS/MILITARY/ CREDIT CARDFORM OF PAYMENT/EARLY PURCHASE OVER INTERNET.ETC Carry On Allowances YEG to YYC. YYC to YEG - 1 Piece 0JVS - ) Carry On Charges YEG to YYC YYC to YEG - (WS WESTJET) Carry-on fees unknown - contact carrier

6 Payment/Fare Details Form or Payment CREDIT CARD Fate Calculatton Line Fare Taxes/Fees/carrier Im posed Charges YEA WS YYC122.00W S YEA122.00CAD244.00END CAD CAO CAl (AIR TRAVELLERS SECURITY CHARGE) CAD 17.ll XG (GOODS AND SERVICES TAX (GST}) CAD SQ (AIRPORT IMPROVEMENT FEE (AIF)) CAD YQI {OTHER AIR TRANSPORTATION CHARGES) Total Fare CAD Other Charges SEAT ASSIGNMENT# (YE~ YVC I QTY 1, CAO YYC YEG/ QTY 1) Taxes Form of Payment Total Total Fare and Other Charges CA00.50 CREDIT CARD CAD CAO Positive identification required for airport check in Notice: Travel info QST # TQ0001 GST # For details about flying with ~stj:et. print the j m~o r tant flight information pa &!ssa~ or browse our travel info: Bagaage fees ($25 $118 per bag; additional $75 $88.50 per bag for overweight or oversize) Baggage allowances (Carry.on, checked. sporting goods, restricted items) Children. infants and expectant mothers Fares. ta xe s~ n d tges (Changes and cancellations, baggage. service fees) Gu es ts with special needs IQ reoyirem!?nts lnfhght services (lnfhght entertainment and buy on board menu) Seat selection (Seat maps, seats 1n Plus) At 11\estJet. getting you to your destination safely and on time are top pr iorities for us. To help ensure an on-time departure, we adhere to our chec!c-111 rnq. baqgage _cut-off times. Please make sure you 're familiar with these rules. and give yourself enough time to get through security and arrive at your departure gate on t ime or we will

7 T~1f -I 3. Room ctr~ Folio# ROYAL YORK Cashier# /0wc~C' Page# 1 of 1 c~ 100 Front Street W Toronto, ON, Canada M5J 1E3 Group Name AWCBC ~J T (416) F (416) H.S.T. Registration# Association of Workers' Compensation Boa Mr Pieter Lambooy Invoice No. Arrival Departure Date Description Additional Information Charges Credits Room Charge HST- Rooms DMP Fee* HST-DMP Fee* Room Charge HST- Rooms DMP Fee* HST-OMP Fee* Total Balance Due GSTSumma!1 Room: 0.00 F&B: 0.00 Other: 0.00 Total: 0.00 HSTSumma!1 Room: F&B: Other: Total: Thank you for choosing Fairmont Hotels & Resorts. To provide feedback about your stay please contact Edwin Frizzell General Manager, at Edwin.FrizzellGM@Fairmont.com. We also invite you to share memories of your experience on our community forum - visit For information or reservations, visit us at or call Fairmont Hotels & Resorts from : United States or Canada I ~ tt\lt my " blbty tar lh t b-u is not waived and I agroe to be holct potmtn;ly labia ri U'la evont that Cho t'ioc:.1ed ~C3". ~m~ny or uaooa\.ion '"''to pa~ POI rtr pan ot or 1"9 tu1r 1mount of tl'llltle chllrges. Owrcu Nlarce 1ubfed ta surcharge at 11'1f1rateof1.5% per lnor1lh aftorone monttl % Ott annum I I hi_.. c:ceptad dekvery of The GloM nd Mad. t&ad I rtf'uhd. I would M"9 bnf'i ligitmo far $1 00 rman-fnj nd S2 00 ts.t.i aad.t 10 my cc:ount {Al pertigp11t:11v hglelt J DetMaton Ma"'eting PtOQ'9rTI fo Thank you for choosing to stay with Fairmont Hotels & Resorts

8 ~s.e. cl' AiJ ~ z,: TR1P.t;3. e Ticket Receipt Prepared For LAMBOOY/PJETER MR RESERVATION CODE ISSUE DATE TICKET NUMBER ISSUING AIRLINE ISSUING AGENT FREQUENT FLYER NUMBER 20Feb16 W estjetjsdx Itinerary Details TRAVEL DATE AIRLINE DEPARTURE ARRIVAL OTHER NOTES 14May 19May WS428 WS441 EDMONTON INTL AB, CANADA 7 :00am TORONTO ON. CANADA 12 4lpm Terminal TERMINAL 3 TORONTO ON, CANADA EDMONTON INTL AB, CANADA 7:15pm Term inal ' TERMINAL pm Seat Number (CONFIRMED) Baggage Allowance NIL Booking Status OK TO FLY Fare Basis XClSU Not valid Before 14MAY Not valid Mer 14MAY -I Seat Number 06C - (CONFIRMED) Baggage Allowance NIL Booking Status OK TO FL y J Fare Basis XClBU Not \t.lhd Before 19MAY Not valid Mer 19MAY I Allowances Baggage Allowance YEG to yyz - 0 Pieces Pnces of additional baggage pieces: CAD up to 50 pounds/23 kilograms and up to 62 linear inches/158 linear centimeters CAD up to 50 pounds/23 kilograms and up to 62 hnear inches/158 hnear centimeters yyz to YEG - 0 Pieces WESTJET Pnces of additional baggage pieces: CAD up to 50 pounds/23 kilograms and up to 62 hnear inches/158 hnear centimeters CAD up to 50 pounds/23 kilograms and up to 62 linear mches/158 linear centimeters ADDITIONAL ALLOWANCES AND/OR DISCOUNTS MAY APPLY DEPENDING ON FLYER-SPECIFIC FACTORS /E.G. FREQUENT FLYER STAnJS/MILITARY/ CREDIT CARDFORM OF PAYMENT/EARLY PURCHASE OVER INTERNET.ETC Carry On Allowances YEG to yyz. yyz to YEG -1 Piece ryvs - WESTJET}

9 Carry On Charges YEG to YYZ, YYZ to VEG - 0JVS - WESTJET) - Carry-on fees unknown - contact carrier Payment/Fare Details -. Form of Payment CREDIT CARO. Fare Calculat on Line YEA WS YT WS YEA198.00CAD396.00END Fare CAD TaxesfFeesfcarrier-lmposed Charges CAD CAl (AIR TRAVELLERS SECURITY ~-1 I '. I -- CAD XG (GOODS AND SERVICES TAX (GST)) l CAD 3.25 RCl (HARMONIZED SALES TAX (HST)) CAD SQ (AIRPORT IMPROVEMENT FEE (AIF)) CAD YQI (OTHER AIR TRANSPORTATION CHARGES) Total Fare CAD Other Charges SEAT ASSIGM.1ENT # (YEG-VYZ f QTY 1, yyz. VEG f QTY 1) Form of Payment CAD40.00 CREDIT CARD Total CAD Total Fare and Other Charges CAD Positive identification required for airport check in Notice: Travel info QST # TQ0001 GST # For details about flying with W!stjet, pn nt the important flight information package or browse our travel info: Baggage fees ($25-$118 per bag; addltional $75-$88.50 per bag for overweight or oversize) Baggage a!19wances (Carry-on. checked, sporting goods, restricted items ) Children. il'tfants and expectant mothers Fares. taxes and fees (Changes and cancellations, baggage. service fees) Guests with special needs ID requirements tn01ght services (lnflight entertainment and buy-on-board menu) Seat selection (Seat maps, seats in Plus) At ~s tjet. getting you to your destination safely and on time are top priorities for us. To help ensure an on-time

10 rr.1 P.JJ-3 P1e./e.r W.mbco~ Tri. Location De :1ce ID Device TStl Sales Pe11ocl Ill Ti x Date Trx Tune CUSTOMER RECEIPT RECU DU CLIENT ~ Ticket Sale I Vente de billet UP ADL:LT J 1200 UP ADULTE Total Amount Montant Total Payment B r Ca!>h Pa1em ent comptant Currency ID ~, I CANS ID de devise rt \,le- '\JO ll~~ sf&~ /;P- $MRTAou a.v~t - ~t- -

11 , CREDIT CARD RECEIPT UP Express Union TVM TORONTO, ON TYPE: ACCT: AMOUNT: CARDI! : PURCHASE MASTERCARD S12.00CAD DATE/TIME: 2016/05/ i 91.3:21:47 REF#: AUTHOR. ~ VERIFIED BY P IN INVOICE#: /027 APPROVED - THANK YOU IMPORTANT - Retain This Copy For You~ Reco ds ("IJSTOMER COPY U.P UnJon Pv ~ E>cpress ADULT ONE-WAY ADULTE P~o? ~ lrt.im.~f ~U,,; ~~~ /(:},~, TO I A AERO PORT PEARSON AIRPORT 19 MAY/MAI : Mint takq lrip witr.n 1 hour ol lu i;;arca Coit la re ht trajet ~u plus 1 heure apr~s ~c~ t Not rdund;ible. not tr;in sf~ble Non remboursabl 11, non lr.l'\sferable Reta n I orinspection Conserver pour 1nspecllon U0101 CCARO TN C~ ~ ~~

CHERYL JOHNER BOARD OF TRUSTEES - WARD A FOR THE PERIOD: SEPTEMBER 2017 to NOVEMBER 2017

CHERYL JOHNER BOARD OF TRUSTEES - WARD A FOR THE PERIOD: SEPTEMBER 2017 to NOVEMBER 2017 DATE (1) DESCRIPTION OF EVENT EXPENSE TYPE NET AMOUNT (2)(3)(4) ATTACHMENTS 1) BUSINESS TRAVEL meetings outside