The Gordon R. Irlam Charitable Foundation
1723 Karameos Dr
Sunnyvale, CA 94087

Expense report / Reinbursement request

Submitted by: Gordon Irlam
Date: 2006-12-28
Purpose: Quarterly expense report
Reference: 2006-GRICF-04

Date Category* Description Amount
2006-10-02    Health    Dentist   $115.00
2006-10-05    Health    Insurance - October   $217.00
2006-10-06    Travel    Global Problems, Global Solutions conference - 258 miles
  2836 Mayfield Rd - 3942 Forbes Ave, Pittsburgh, PA - return  
$114.81
2006-10-06    Travel    Meals/incidentals per diem (1 x $54.00/day)
  General Services Administration Pittsburgh PA rate  
$54.00
2006-10-06    Travel    Hotel - 1 night   $135.66
2006-10-12    Health    Psychiatrist   $84.14
2006-10-20    Health    Prescription   $974.00
2006-10-31    Health    Dentist   $85.00
2006-11-06    Health    Insurance - November   $217.00
2006-11-13    Pubs    GIMP and CSS books   $62.68
2006-11-23    Pubs    CSS Cookbook book   $29.69
2006-11-30    Health    Psychiatrist   $120.00
2006-12-01    Health    Doctor copay   $15.00
2006-12-08    Health    Lab work   $336.00
2006-12-08    Health    Insurance - December   $217.00
2006-12-11    Health    Dentist   $80.00
2006-12-22    Health    Summacare: January - March   $2131.89
Total expenses   $4988.87
Less advances   $0.00
Reinbursement due   $4988.87

* - Valid categories: Grants, Travel, Pubs, Office, Health, Programs, Other
Travel includes conf./meetings, transport, car-$0.445/mile, lodging, M&IE

Comments:

Signature:

Approved by: Tracy Deskin

Signature:

Date: 2006-12-28