| Submitted by: | Gordon Irlam |
| Date: | 2010-12-30 |
| Purpose: | Quarterly expense report |
| Reference: | 2010-GRICF-04 |
| Date | Category* | Description | Amount |
|---|---|---|---|
| 2010-10-01 | Health | Professional society membership | $250.00 |
| 2010-10-05 | Health | Insurance | $376.00 |
| 2010-10-29 | Health | Prescription | $70.00 |
| 2010-11-05 | Health | Insurance | $376.00 |
| 2010-11-12 | Health | Doctor | $25.00 |
| 2010-11-17 | Health | Flu shot | $24.00 |
| 2010-11-29 | Health | Prescription | $81.00 |
| 2010-12-05 | Health | Insurance | $376.00 |
| 2010-12-13 | Health | Dentist | $154.00 |
| 2010-12-29 | Health | Therapy (13 x $150.00) | $1950.00 |
| Total expenses | $3682.00 | ||
| Less advances | $0.00 | ||
| Reinbursement due | $3682.00 | ||
| * - Valid categories: | Grants, Travel, Pubs, Office, Health, Programs, Other |
| Travel includes conf./meetings, transport, car-$0.55/mile, lodging, M&IE |
Comments:
Signature:
| Approved by: | Purobi Phillips |
| Signature: | |
| Date: |