Hotel, Motel, and Bed & Breakfast rates for State of Iowa employee business travelers.
Rates effective July 1, 2019 - June 20, 2020. Please complete and submit by Friday, June 28, 2019.

*Form must be submitted in Google Chrome or Safari.*
Please provide all information requested. If not applicable or not available, please indicate N/A. Properties with incomplete information will not be included in the State of Iowa's In-State Lodging Directory for state employee business travelers.
Please submit all information for inclusion in the State of Iowa's In-State Lodging Directory.
Property Name *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Toll Free Reservation Phone Number *
Your answer
Reservation Email Address *
Your answer
Website *
Your answer
TDD for the Deaf *
Your answer
Does your facility meet or exceed the Americans with Disabilities Act (ADA) accessibility guidelines? *
State of Iowa employees traveling on official state business are limited to a reimbursement rate of $65 per day for a single occupancy room, plus applicable taxes. As validation of entitlement to State of Iowa rates, participating facilities must accept one of the following forms of identification: 1) State of Iowa employee identification card issued by the department or agency; 2) State of Iowa payroll ID (state warrant stub); 3) Written documentation on official state department letterhead signed by an agency officer identifying the bearer as traveling on official state business.
Will this property honor a $65 single room rate, plus applicable taxes, for State of Iowa business travelers? *
If NO, what single room rate will this property offer for State of Iowa business travelers? *
Your answer
What double occupancy room rate will this property offer State of Iowa business travelers? *
Your answer
When will the single and double room rates listed above be honored for State of Iowa employee business travelers? *
Will the state rates and provisions of this agreement be extended to Political Subdivisions? (Political Subdivisions include city and county governments, school districts, community colleges, or combination thereof. Note: Employees of the State's Regent Universities are State employees). *
Will state rates and the provisions of this agreement be extended for State employee personal travel? *
As the General Manager/Owner of this Property,
* I agree to honor agreement rates as herein described.
* I certify the information listed in this Rate Agreement is accurate.
* I certify the rates quoted will be valid 7/1/19-6/30/20, subject to availability.
* I understand any of the following could result in this agreement's cancellation:
- Failure to honor the quoted rates and policies
- The submission of inaccurate information
- Deficiencies in service levels
* I understand submission of this form does not guarantee acceptance by the State.
I hereby certify I have been informed of the above requirements. *
As the General Manager/Owner, please enter your Name to confirm your acceptance of this agreement: *
Your answer
Please provide your Contact Information (Phone Number, Email Address) *
Your answer
Date *
BEFORE YOU SUBMIT: Please print a copy of this completed Rate Agreement form for your records; then submit the form. Thank you!
If you have questions or need assistance, contact or 515-281-5922.
Never submit passwords through Google Forms.
This form was created inside of State of Iowa. Report Abuse - Terms of Service